Bowen therapy and fascia

The Bowen Technique has a very specific effect on fascia, which is the tissue that surrounds organs, muscles, and muscle fibres etc. and creates a network in the body.  Primarily, Bowen moves are made directly on muscles (although some moves are also performed on tendons, ligaments, joints and nerves), but because all these structures are surrounded by a network of fascia, it is inevitable that whatever structure is activated, the fascia that surrounds it (and is integral to it), is affected at the same time, albeit with slightly different physiological effects.

Fascia and connective tissue have varied roles in the body.  For example, one of fascia’s crucial functions in efficient movement is its property of recoil, which is dependent on good hydration (an important effect of Bowen work).  This can be seen clearly in the denser sheet-like areas of fascia such as the thoraco-lumbar aponeurosis, which is the starting point for a lot of Bowen work.  One reason that Bowen insisted on beginning a treatment at this point in the body was partly as an assessment tool for the therapist to ascertain any asymmetrical tightness in the erector spinae muscles (in other words if the body was compensating for some postural imbalance resulting in either tightness or increased muscle bulk on one side).  He talked about these two moves (one on the left and one on the right over the erector spinae musles and thoracolumbar aponeurosis level with L4) as ‘putting the stoppers in’, something that apparently Ernie Saunders taught him and similarly insisted on.  Anatomically it also makes sense to start a treatment here as it is directly over one of the attachment sites of the dural membranes at L3 & L4.  The dura form a very strong relationship in the body (W G Sutherland described it as a reciprocal tension in the dural membranes) between the key attachment sites which are:

• Coccyx
• Sacrum (at S2)
• Lumbars (at L3 & L4)
• Top of the neck (at C2 & C3)
• The base of the skull at the foramen magnum of the occiput
• Within the skull at the temporal bones, the sphenoid and the ethmoid (sometimes called the third eye)

Interestingly, the areas of the body Tom Bowen was keen on working directly correlate to these dural attachment sites, perhaps because he realized that they have a strong reciprocal effect on posture.  Whether he picked this information up intuitively, talking to colleagues or by reading textbooks we shall never know, but what is clear is that there is a lot of parallels in understanding with osteopathic, chiropractic and craniosacral principles.  In chiropractic the relationships between the lumbar and cervical regions are termed Lovett Brothers, something that is a key principle of Sacro Occipital Technique (SOT) first proposed by Major Bertrand DeJarnette, a chiropractor, osteopath and engineer in 1924.

One of the most helpful papers to come out of the Fascia Research Group, which is part of the Division of Neurophysiology at the University of Ulm in Germany, was the paper by Robert Schleip entitled Fascial Mechanoreceptors and their potential role in deep tissue manipulation (Schleip 2003). Although this paper was largely looking at the effect of therapies such as Rolfing, it has huge importance for the understanding of Bowen work in terms of why we might vary pressure, location and speed of touch depending on what the therapist is trying to achieve.

Our understanding of fascia has improved vastly over the last 20 years, mostly as a result of the impressive work done in Germany at Ulm, but the general public’s understanding of connective tissue in general and fascia specifically is rudimentary to say the least. If you mention at a party that you work with fascia, most people will assume you work with guttering, soffits and all things related to just beneath the roof.  Actually the use of the word fascia in this context shares the same Latin origin of its use in reference to the body – in other words a ‘band, bandage, ribbon or swathe’, which is basically what it does in the body. Fascia wraps organs, blood vessels, nerves, muscles and muscle fibres.  It forms ‘ribbons’ in the body, some of which are very tough, that help support the frame.  However it is also the most richly innervated tissue in the body with a very high density of sensory nerves, in particular nerves called proprioceptors, which help our nervous systems orient to our surroundings.  You could say that our fascia is like our antennae, constantly responding to what is going on in our environment and where we are in space.

Dr A. T. Still, the founder of osteopathy, had additional views on the functions of fascia:

Thomas Myers in his book ‘Anatomy Trains’ has done a great job at identifying some of the key structural bands of fascia in the body, which have such an important and inter-related effect on posture.  His identification of what he calls the ‘superficial back line’ which extends from the plantar fascia of the feet all the way through to the attachment of the paraspinal muscles to the back of the head (and extending to the forehead close to where the dural attachments are at the Crista Galli of the ethmoid) is a fascial relationship that is addressed a lot in Bowen work.  What is interesting is that because there is a clear functional, and therefore anatomical, difference between the superficial back line and the front line, Bowen therapists work these areas separately, starting with the client lying on their front so the therapist can access the back fascia before turning them over at some point in the treatment and working the front fascia.   Actually much of the front fascia in the human has a very similar construction to that of our four-legged friends.  Its function is primarily to support all the organs like the heart, stomach, liver and other organs of digestion that hang off the spine.  In us bipeds, these organs still hang off the spine, supported by the front fascia which has its origins in the attachment sites at the base of the cranium.  It’s just that because we now stand upright, some of those organs tend to hang down a little more (and unfortunately, more in some of us than others!).

Fascia also creates the ability of the various structures in the body like muscles and blood vessels, to move freely one against another.  In the neck for example, the sheets of fascia that envelop these structures appear like tubes, whereas in the back they form great sheets which come together to tether at the sacrum and iliac crests.  These sheets form what are called ‘aponeuroses’, so called because early anatomists thought they were nerves (and they were not far off the mark).  Because these sheets contain and enfold many large muscles, damage such as can be caused by accidents or operations, which involve cutting through several layers of fascia, can cause tethering which can have effects far beyond the site of the original injury through the reciprocal relationships of what is termed biotensegrity.  Serge Gracovetsky in his wonderful but slightly impenetrable book ‘The Spinal Engine’ points out the potentially damaging consequences of operations that affect the lumbar fascia, particularly when the ilium is used as a ‘bone bank’, thereby affecting the attachment sites of the lumbo-dorsal fascia (Gracovetsky, 2008 p 222).  A more accessible explanation of Serge Gracovetsky’s concept of the evolution of the spine as an ‘engine’ vital to movement is found in Eric Dalton’s invaluable book ‘Dynamic Body’ (Dalton, 2012 p308).

Excerpted with permission from Using the Bowen Technique to Address Complex and Common Conditions by John Wilks and Isobel Knight