By Travis Krick FSN,CMT
Understanding the movement of fluid inside and outside of the tissues is vital when it comes to massage and bodywork. Fluid flows inside the cells as intracellular fluid or outside the cells as extracellular fluid. This balance of the two is what creates homeostasis within the body. When it comes to massage and bodywork, many therapists are well versed in blood flow and lymph, and how all the various tissues such as fascia, muscle, or bone change due to fluid balance. Lymphatic drainage has long been the standard manual therapy for massage therapists to activate fluid movement, but there is far more to the story than purely lymph.
The discovery of lymph dates to Hippocrates in about 400BC. Since that time, it has been a slow understanding through better technology and imagery that the lymph vessels are a complete system and correlate to many other systems, such as the vascular system and the nervous system. The lymph acts as garbage collectors for the body, all the waste products from cells and the blood end up in the lymph glands then filter the waste products and eventually is returned into the bloodstream via the thoracic duct. This means that the lymph is tightly regulated with the veins and blood of the body. the other fluid such as the cerebral spinal fluid or the brain doesn’t have lymph vessels and therefore rely on another detoxification system known as glymph.
Just as the lymph vessels follows veins the glymph vessels follow the arteries. The spine and brain makeup the central nervous system and are insulated from the rest of the fluid in the body. The fluid of the spine (CSF) doesn’t only remove waste products is also transports neurochemical products such as dopamine, serotonin, acetylcholine, histamine, and noradrenaline to the brain. Which balance the brains chemistry and the overall hormonal profile of the body. The neurons of the brain are often considered the most important because that is what causes the brain to work and preform function, but there is another cell called the Glial cell that is just as abundant as neurons and arguably just as important.
Glial cells are like the lymph vessels of the body they help protect and insulate the neurons from waste products. This is a primary component of the glymphatic system. The glymphatic system utilizes pressure from the arteries for movement thus if any arterial degradation is in the body because of disease such as cardiovascular disease, diabetes, or oxidative stress, it can hinder the brain and spinal cord to eliminate waste products. This can result in mental fog or central nervous system dysregulation. In rodent studies it was found that the single biggest factor in activation of the glymphatic system is sleep.
As a bodyworker anytime the words cardiovascular disease, type 2 diabetes, or neurological disease are mentioned the spine and neck should be an area of focus. Releasing the erectors along the spine is a great way to encourage fluid movement of both the lymph and glymph. There is a connective tissue membrane called the dura that covers the CNS and links the lymphatic system with the glymphatic system.
Treatment surrounding the dura can help an extreme amount to activate the parasympathetic nervous system and increase glymphatic movement. Two of the best techniques for this is gua sha with jade tools directly over spine and cupping the around spinae erectors. Once the thoracic and lumbar muscles and fascia are addressed then work to the cervical spine and surrounding neck can be achieved. With a pressure gradient of glymph moving up the spinal cord into the brain and excess dilation of the underlying vasculature, this helps create natural fluid movement through the neck.
The myodural bridge of the neck connects to the posterior rectus capitis in between the atlas and axis (C1, C2) and can become inflamed if glymphatic flow in hindered. By opening the dura along the mid and lower spine it will help create space in the upper cervical and act as a pump to move fluid. Understanding the underlying mechanisms of fluid physiology and how it relates to the surrounding tissue is important when addressing any system of the body but especially when working with the CNS. There can tend to be a lot of fear when it comes to doing bodywork around the spine and neck, while it is true, they are sensitive areas they are also areas that must be worked on with commitment. Nearly 50% of adults in the US struggle with neck pain each year, its time as bodyworkers that we understand how to approach it from a deeper technical understanding, so that we can be sure to provide the best results possible.
Work Cited
https://www.medicalnewstoday.com/articles/325493
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