Bone: The Forgotten Fascial Element

Researchers at the University of California have recently discovered a mechanism within bone that causes it to enlarge and change its structure with injury. This breakthrough discovery puts an entirely new light on musculoskeletal disorders and many other conditions, such as concussion, motor vehicle collisions and sports injuries.


THE IMPLICATIONS of this powerful new discovery, which completely changes our understanding of the effects of injury, could hold the key to your success in relieving a multitude of painful and limiting conditions that you never thought you could affect. Since this discovery can have a significant influence on myofascial tension (by imposing tension on soft tissues from the inside-out), an understanding of the role of these bone changes and how to address them, could provide a powerful additional tool to helping you improve therapeutic outcomes.

As a young chiropractic intern, something strange got my attention as I was reviewing some x-ray images. At first, I wondered if it was just an anomaly, but it kept showing up again and again. When I compared the images of hips, knees and shoulders from one side to the other, it appeared that one side was noticeably larger than the other. I mentioned it to the head of the radiology department, but he did not have an explanation. In addition, it seemed that the larger side often displayed more arthritic changes, such as articular degeneration, sclerosis and osteophyte formation. At the time, I was also an instructor in the dissection lab, so I began to verify this phenomenon, and noticed that these differences were a fairly common finding. It made me question a number of my assumptions about what might be causing many of the musculoskeletal disorders we were
treating.

Put it To the Test

Figure 1: Checking the size of the patella using calipers

I invite you to verify this for yourself. Measure the size of the patella, the distal head of the femur, the greater trochanter, the proximal head of the tibia or the proximal head of the humerus on one side versus the other. Do this on yourself or some of your clients. You can use your fingers or an inexpensive set of calipers (See Figure 1). If you then squeeze each side, you might notice that the larger side is often more tender. You might also notice that the quadriceps or the iliotibial band on the side of the larger femoral head or trochanter is more hypertonic. That is because the larger bone creates more tension on the surrounding soft tissues, which can lead to joint dysfunction, strain and pain. After you do this, you might get a sense of why I got excited so many years ago.

Microscopic Evidence

For many years, I was like a voice in the wilderness, as I explored ways to address what I began to see as a major contributor to structural imbalance. So, I was overjoyed when research under the direction of physicist, Dr. Paul Hansma at the University of California, confirmed my observations.[1] Using the powerful Atomic Force Microscope (AFM), his team verified the structural effects of injury within bone at the cellular and molecular level. It revealed that bone changes shape and actually gets bigger with injury (See Figure 2).

Figure 2: Microscopic evidence of bone expansion with injury

It became clear to me that bone was, in fact, a fascial element that had been ignored, based on the assumption that it was simply a rigid, unresponsive element, and therefore unaffected by injury (except when it was fractured). The evidence instead, clearly pointed out that it was not only responsive to all of the mechanical effects of injury, but that was likely a key factor in contributing to biomechanical imbalance in many of the conditions we encounter in practice. In a sense, it appeared that bone, which is essentially ‘mineralized collagen’, might be considered to be the forgotten fascial element. Due to its density, it absorbs much of the energy of impact trauma, as well as significant strain. Its subsequent enlargement results in myofascial tension, articular dysfunction and many other painful conditions. In the case of the cranium and spinal column, these changes may lead to neurological consequences, while injury to the thoracic and pelvic areas appear to influence certain types of visceral dysfunction.

A New Approach to Treatment is Born

Since those early discoveries, over 40 years ago, I have been on a quest to determine the universal principles that might explain the underlying structure of the body and its response to injury. I knew that if we had a better understanding of these fundamental concepts, it would pave the way for more consistent, objective and measurable results for our clients. Inspired by pioneers like Dr. Stephen Levin, an orthopedic surgeon who introduced me to the concept of tensegrity*, my search led me to explore developments in cellular and molecular biology. Dr. Donald Ingber, a cell biologist at Harvard, published his findings on the mechanical properties of the cytoskeleton (internal structure of the cell) in the January 1998 issue of Scientific American, in which he stated that cells respond to mechanical stress by becoming enlarged and rigid[2] (See Figure 3). Science was catching up with my clinical observations.

Figure 3: High power microscopy reveals the geodesic cellular structure (cytoskeleton).

Research regarding the cytoskeleton and the extracellular matrix (the fibrous network linking cells to one another as a continuous fabric)[3], as well as the developing field of electrobiology[4],[5], inspired me to develop a form of therapy, consistent with these scientific principles. The result is the current treatment system, called Matrix Repatterning, which I have been teaching to practitioners from around the world for over 25 years. In addition to normalizing joint function, myofascial tone, neurological and visceral function, Matrix Repatterning appears to answer the mystery of the changes in bone structure I had noticed so many years earlier. By precisely determining the location of these changes and then applying a gentle form of manual therapy along with a bio-compatible magnetic field, it has been possible to consistently restore bone to a more normal size and shape, often within just a few minutes! It has been remarkable to witness the profound influence this form of treatment has had on such a wide range of conditions. Even more gratifying, has been the fact that other practitioners, trained in this breakthrough system, have been able to
achieve the same level of results.

*Tensegrity: the term, coined by Buckminster Fuller, is derived from a combination of the words ‘tensional’ and ‘integrity’, referring to the stable and flexible arrangement of proteins and other filaments that provide structural support, flexibility and mechanical integrity inside the cell and between cells.

Case Study 1:
A Young Hockey Player Gets Back in the Game

Steve* was a teenage hockey player, who experienced significant pain in his left knee for over 2 years. Six Matrix Repatterning treatments were provided over a two month period. There was an almost immediate reduction in the size of his knee, and a marked reduction in pain. He was subsequently able to return to hockey and resume all his normal activities. His parents remarked how delighted they were as they could once again “hear the sound of Steve running up the stairs”, instead of hobbling slowly and painfully, as he had for the previous 2 years.

Upon comparing the two sets of X-rays of Steve’s knees, actual measurements by orthopedic specialists monitoring the condition, confirmed a reduction in the diameter of the femoral distal head and the tibial proximal head, by approximately 5 mm. The medial aspect of the joint space has been restored and the varus angle reduced.

*Steve’s name has been changed.

Figure 4: Pre-treatment

Figure 5: Post-treatment. Left femoral and tibial epiphyses: size reduced approximately 5mm, knee joint space restored and varus angle reduced.

Summary

As clinicians, I believe it is crucial that we recognize the verified scientific fact that bone and other deep fascial structures are structurally and physiologically altered by injury, literally at the cellular and the molecular level[6]. These changes appear to be associated with the mechanical strain and decompensation seen in many of the painful, limiting and degenerative conditions we encounter in our practices. In developing Matrix Repatterning, I attempted to take these discoveries into account. I recognized that common injuries often resulted in enlargement and deformity within the densest structures of the body (the skeletal frame and the deep fascia associated with the fluid-filled organs) and that the associated dysfunction in the soft tissues and joint structures, were often secondary to the mechanical stresses imposed on them by these changes.

Matrix Repatterning has demonstrated measurable results, unprecedented in the field of manual therapy, include radiographic, laboratory, orthopedic and neurological improvement[7] verified by independent radiologists, researchers and clinicians. To date, practitioners trained in this gentle and safe procedure, report that they are getting results they were unable to achieve using conventional methods, while enjoying a much higher level of practice satisfaction and success. It is my hope that we will continue to explore improved methods to alleviate the suffering for the countless people around the world, who are looking for real solutions, rather than just providing temporary symptom relief.

REFERENCES:

1 Fantner GE, Hassenkam T, Kindt JH, Weaver JC, Birkedal H, Pechenik L, Cutroni JA, Cidade GA, Stucky GD, Morse DE, Hansma PK , Sacrificial bonds and hidden length dissipate energy as mineralized fibrils separate during bone fracture, Nat Mater. 2005 Aug;4(8):612- 6. Epub 2005 Jul 17. [Return to article.]

2 Ingber DE, The Architecture of Life, Scientific American, Vol. 1, 1998. [Return to article.]

3 Pischinger A, The Extracellular Matrix and Ground Regulation, Basis for a Holistic Biological Medicine, North Atlantic Books, Berkley, 2007. [Return to article.]

4 Chakkalakal DA, Mechanoelectric transduction in bone. J Mater Res]. 1989;4: 1034-1046. [Return to article.]

5 MacGuintie LA, Streaming and piezoelectric potentials in connective tissues, In: Blank
M (ed) Electromagnetic fields: biological interactions and mechanisms. Advances in Chemistry Series 250. American Chemical Society, Washington DC, ch. 8, pp 125-142, 1995. [Return to article.]

6 Roth GB, The Matrix Repatterning Program for Pain Relief, New Harbinger Publications, Oakland, CA, 2005. [Return to article.]

7 Doidge, N., The Brain’s Way of Healing, Penguin Books, New York, 2015. [Return to article.]

George Roth, DC, ND, CMRP
 

Dr. Roth is a graduate of the University of Toronto, Canadian Memorial Chiropractic College and the Ontario College of Naturopathic Medicine and has studied osteopathic medicine at Doctors' Hospital North, Columbus, Ohio. He is the developer of Matrix Repatterning and is the Director of Education at the Matrix Institute in Toronto. Dr. Roth has presented seminars at numerous hospital and university‐based symposia throughout North America. He is the co‐author, with Kerry D’Ambrogio PT, of Positional Release Therapy (Elsevier, 1997), and the author of The Matrix Repatterning Program for Pain Relief (New Harbinger, 2005). His work is also featured in the Brain’s Way of Healing, by Dr. Norman Doidge (Penguin, 2015).