To a patient, fascia-focused therapies can seem almost magically simple in their ability to gently relieve pain. But fascia is structurally and neurologically complex. We practitioners need tools that help us to navigate this complexity, to determine how and where fascial restriction is causing problems. The most well-known methods in this field use direct palpation and/or functional assessments (motion, gait, motor weakness, etc.) to find primary restrictions in the body, and these are important tools. At Fascia Sense, we are introducing an indirect palpation method based on proprioceptive feedback, which can find primary restrictions quickly and accurately. Called Barrier Depth Assessment, this skill is powerful in its own right, and can greatly enhance the speed and thoroughness of other assessment methods.

The Barrier Depth is a particular, measurable quality of tissue found with careful, smoothly increased compression. As illustrated here, it represents an inflection point in a curve where depth of tissue compliance is plotted against manual pressure. As manual pressure is increased, resistance to compression increases until a point where a sudden "jump" in pressure is required to continue movement of the tissue. After this point, the acceleration of pressure required to press deeper slows down again. The point on the curve right where the additional "jump" of pressure would be required is the Barrier Depth (BD). BD is not obvious with normal palpation techniques, but becomes quite easy to detect with the proper training and practice.

​When used in specific ways, BD reveals problem areas at specific anatomic locations. In short, when engaging with restricted fascia, BD becomes shallower, and during appropriate treatment BD becomes deeper. When treatment is complete, BD becomes "normal", and comparable to the BD of adjacent tissue. To understand this method better, lets take a look at the specifics of how it works:

• Pressure is applied from the surface of the body from two points, with vectors aiming at a third point, somewhere in the fascial system that the practitioner wants to evaluate. The vectors of pressure give the best result at an angle close to 90 degrees. As an example, let's say the practitioner's hands are positioned at the posterior and lateral thigh, aiming pressure at approximately 90 degrees, toward deep hamstring musculature. 
• When the vectors are carefully aimed to intersect at a third point, the normal reaction is a slight deepening of the BD. In other words, the BD of either single hand is less than the BD at both hands when applied simultaneously. This seems to be some sort of whole-body proprioceptive reflex, as the reaction on aiming at a specific site in the body will be the same from any two points of contact (with vectors close to 90 degrees in relationship to each other).

• When the target anatomy has fascial restriction, the opposite happens. The BD with two vectors of compression becomes shallower, at both sites of contact. This is true whether the restriction is intrinsic (densification or stiffening of fascia) or extrinsic (tight clothing, swelling from injury, interface with implanted hardware, etc.). Again, this seems to be based on proprioceptive feedback.

• The degree of decrease in BD seems to correlate with the intensity of "proprioceptive confusion" created by the restriction. This shows up clinically as local or distant effects on muscle tone, motor strength, range of motion, coordination, functional activities or other measures. In other words, the shallower the BD, the more severe and significant the fascial restriction.
• When treatment is successfully applied, there is typically a shift from shallow BD to deeper than normal BD. In the case of the treatment methods we teach at Fascia Sense Therapeutics, this change in BD is used to guide and monitor the release, making for gentler, faster treatment. 
• Finally, completion of treatment is signaled by normalization of BD, with again only slight deepening of BD with two vectors of hand pressure, versus just one. 

BD palpation is effective at revealing different types of fascial restrictions, including single points of densification, densified scar tissue, pathways of interconnected points on dysfunctional "chains", and seemingly neurologically-driven stiffening we call "residual strain". At Fascia Sense we use instruction methods and physical tools that make learning BD palpation extremely effective and reliable. This means our students can use BD palpation  with confidence to assess and guide treatment, in a way that helps them deliver powerful results to their patients.