Spinal defacilitation

Spinal defacilitation is a technique included in a book on myofascial release by Sharon Weiselfish-Giammatteo and J. Kain. The term “defacilitation” refers to reversing a facilitated segment. A state in which the spinal cord is more sensitively activated than usual is called “facilitation,” and reducing that excitation is called defacilitation.

The book introduces it as a foundational technique for people with high muscle tone throughout the body. In the low back pain protocol addressing the lower back, pelvis, and spine, it is used midway through, after the joints have been treated, and is immediately followed by Lumbosacral decompression in Integrative Manual Therapy and Craniocervical decompression. The book also says it can be added to any protocol after several hours of treatment to help balance the body.

In IMT, sensory signals coming from the muscles, joints, and fascia are understood to pass through the spinal cord and spread throughout the central nervous system. The idea is that when these signals are excessive and persist for too long, the spinal cord itself becomes overactive, making even the muscles and organs served by that segment more prone to tightening.

For this reason, before directly releasing a painful muscle, this approach first considers reducing excitation in the spinal cord, the pathway through which these signals travel. The extremely light force is also intended to gently signal the nervous system rather than push on muscles to release them.

• Position — The recipient lies on their back, facing the ceiling. The practitioner stands beside them facing toward their head, slides one hand between their straightened legs, and supports the sacrum with the palm. The fingers remain flat rather than curling toward the lower lumbar spine. The body should feel comfortably supported on the palm.
• Pressure — The practitioner places their body weight through the elbow to keep the sacrum from twisting, while gently applying upward pressure along the spine, one segment at a time. The force is less than 5 grams. It is described as the weight of one US five-cent coin. The intention to direct the force upward is considered more important than how firmly the practitioner presses.
• Fulcrum — When the practitioner encounters a point where the tissue no longer follows easily and meets resistance, they slow down just before it. If needed, they may place two fingers of the other hand on the restricted segment to help it release. They then maintain the same force until changes reach the craniocervical junction beneath the skull.
• Release — The practitioner keeps the hand in place until neither the practitioner nor the recipient feels any further changes in movement or sensation. They wait without following the sacrum's movement or trying to lengthen the spine. In this approach, the body's own traction is then understood to arise naturally and lengthen the spine.

The first session takes the longest. It may take 30 to 45 minutes, and is said to shorten to under 5 minutes once the body becomes accustomed to it. Since the recipient only needs to lie still, some people breathe deeply and drift off to sleep.

• People whose neck, shoulders, and lower back are all stiff at once, and who do not know where to start releasing the tension
• People who feel that the areas around an injury keep becoming stiffer
• People whose whole body tightens when they are very tense
• People who find strong pressure uncomfortable and want manual treatment with very light stimulation

• Wear comfortable clothing. Since the practitioner's hand will contact the lower back and buttock area, loose-fitting trousers are a good choice.
• It is okay not to feel anything. Many people feel as though nothing is happening. If you notice warmth, a sense of your body settling, or deeper breathing, feel free to tell the practitioner.
• Tell the practitioner beforehand if you have a history of surgery or injury involving your lower back or sacrum. The hand placement can be adjusted to suit your circumstances.
• Do not rush afterward. Get up slowly, drink some water, and notice how your body feels.

IMT includes an approach in which the body is positioned according to a tender point, and the practitioner waits until tissue changes stop. It is called DeFacilitated Fascial Release, and resembles the positioning used in Strain-counterstrain. Rather than focusing on a tender point in a specific muscle, spinal defacilitation works upward along the entire spine with the aim of reducing spinal cord excitation. It shares with Myofascial release the use of gentle force and waiting for tissues to release.