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Muscle-Tendon Change, Marrow Washing & Fascial Training: Part 3 by Tom Bisio

This is the third part of our discussion of the Muscle-Tendon Change, Marrow Washing & Fascial Training. This series of articles examines the efficacy of the Muscle-Tendon Change and Marrow Washing exercises on fascial fitness, bone health and marrow health, and immunity.

To read Part 1 CLICK HERE

To read Part 2 CLICK HERE

Fluids & Fascia

Fascial tissues also carry fluids. Interstitial fluids move rhythmically through the body and the fascia, driven by the respiration, which effectively creates fluid waves within the body. Cells in areas where there is resistance or restriction to this interstitial fluid movement are not getting sufficient nutrients and are not effectively disposing of cellular wastes. These areas become “dead spots”, places where the hydrodynamic fluctuation is not penetrating.[1]

Laboratory studies that localized inflammation is often due to mechanical pressure or compression that causes tissue hypoxia (low levels of oxygen in the tissue). Oxygen and fluids are squeezed out, and even after pressure is released the elasticity of the tissue does not rebound or “refill” and the tissue remains shrunk with diminished oxygen and fluids for a period of time afterward. Hypoxia may then generate inflammatory changes through the direct impairment of mitochondrially mediated anabolic (cell building) processes and consequent metabolic shift towards catabolism (cell tearing down).[2]

The movement of fluids through connective tissue can be seen in the amazing anatomical work of Dr. Jean-Claude Guimberteau. Guimberteau graphically describes the fractal-like alignment of the fibers of the fascial matrix, which creates a web in which all parts of the matrix distribute loads and forces. In Guimberteau’s videos of living tissue, one can see small pearls of liquid move through the tiny individual fascial fibers.[3]

Qi in the body is often likened to water running through a network of rivers (larger meridians) and streams, or to irrigation channels and their sub-branches (small network-like meridians) that supply water to crops. In order to keep the water running smoothly, the rivers, streams, and irrigation ditches must be clear and without stagnation. Liquid must be plentiful so that it can flow smoothly and continuously. There must also be an abundance of liquid in order to insure that the flow will be continuous and smooth. The body has “reservoirs” that store and help to regulate this flow. A very important reservoir for blood, body fluids and Qi is the bone marrow.

Some modern proponents of fascial training advise increasing fluid consumption. Unfortunately, these benefits have not been substantiated, and there is much evidence that excessive consumption of liquids does more harm than good. In Chinese medicine, excessive consumption of fluids is thought to overload the kidneys, and over time, can weaken them. And in the case of fascia, if the ground substance is dehydrated, shrunken, and solidified, it cannot uptake water and oxygen, so consuming more fluids will not necessarily change the situation.

The Muscle Tendon Change, particularly when performed in conjunction with Marrow Washing Nei Gong, improves the movement of fluids through the fascial network, which in turn nourishes the organs (which have their own special relationships with individual tissues)[4] and the tissues themselves. Jing and fluids are guided to the organ, bones, muscles, tendons, ligaments and fascia by employing, movement, visualization and Mind-Intention. This nourishes the tissues and bathes them in fluids.

Bone Marrow & Marrow Washing

Modern research has indicated that as people age bone marrow changes. Marrow cavities in all the bones of newborn mammals contain active hematopoietic tissue, known as red bone marrow. Over time the hematopoietic tissue, found mainly in the bones of the extremities, is gradually replaced by non-hematopoietic cells that accumulate lipid drops, known as yellow or fatty bone marrow.[5] Yellow bone marrow is involved in the storage of fats. The fats in yellow bone marrow are stored in cells called adipocytes. This fat can be used as an energy source when needed. Yellow bone marrow also contains mesenchymal stem cells. These are cells that can develop into bone, fat, cartilage, or muscle cells. Because yellow bone marrow starts to replace red bone marrow over time, bones in an adult body often contain a large amount of yellow bone marrow.

Various blood deficiencies increase with aging, including anemias, reduced responses to hematopoietic stress and myelodysplasias. One study showed that as the content of bone marrow fat increased with age, the number of bone marrow stem cells decreased, and this decrease correlated with changes in cytokine levels.[6] This same study also found that osteoporosis is increased in areas of bone marrow fat, and fractures of bones containing yellow marrow were slower to heal. This might in part be due to the fact that aging reduces skeletal blood flow.[7] Studies have also confirmed relationships between higher Bone Marrow Fat, lower bone density, and increased prevalence of vertebral fracture in older men and women.[8]

Outside of the spine, the proximal femur is the most common site of osteoporotic fracture and is also an area prone to avascular necrosis, fracture and nonunion. Another study showed that osteoporosis and osteopenia of the proximal femur and acetabulum is associated with reduced bone perfusion (bone blood flow). As bone marrow perfusion decreased in the proximal femur, there was a reciprocal rise in marrow fat content. Marrow fat content increases with age and osteoporosis. This study showed that proximal femoral osteoporosis is associated with reduced marrow perfusion and reciprocal increased marrow fat content.[9]

Marrow Washing Nei Gong, especially when combined with Muscle-Tendon Change Exercises, leads Qi to the marrow. This increases circulation in the marrow and modulates the marrow, preventing red marrow from converting to fat. Through this increase in circulation to the marrow and the membranes between the bones, tendons, ligaments muscles and fascia, Marrow Washing is said “clean” the marrow, restoring it to a healthy state. To achieve this one is required to correctly activate the internal Qi Dynamic and to know how to guide Qi to the marrow. Bone Breathing is part of Marrow Washing, and is one method of leading Qi to the Bone Marrow. The other method is Marrow Washing Nei Gong. These methods can be used in tandem.

Marrow Washing also helps regulate the fluids of the body which are themselves an expression of the Jing-Essence stored in the kidneys. Jing has a direct connection with the bones and marrow. Regulating fluids, blood and Qi promotes the storage of Jing, and increases the ability of the bone marrow to produce blood, and the ability of blood and body fluids to nourish the entire body including the internal organs.

Marrow is produced in the bones, but it also fills and nourishes the brain and spinal cord. Marrow Washing Nei Gong is therefore said to aid the nervous system, strengthen the brain and improve one’s mental capacity. This rejuvenates and improves the overall functioning of the body. Circulating and concentrating Qi and blood in the bones and marrow, increases the body’s vitality and strength. The brain is washed by a constant flow of cerebrospinal fluid, which plays the important role in flushing metabolic waste products from the brain, including harmful proteins and excess water.

Researchers have found that the fluid flows into the brain along the small spaces around the arteries and washes away waste material through the brain tissue itself. Recent research by Vegard Vinje of the Simula Research Laboratory in Norway indicates that deep breathing has a profound effect on cerebrospinal fluid circulation in the brain. Vinje said that, although the pressure pulse cycles are dominated by heart pulsations, the velocity of the fluid is as much affected by the breath as by the heartbeat. The amount of cerebrospinal fluid volume that pulsates in and around the brain is far greater for a breathing cycle than for a heartbeat.

Vinje found that the longer waves that result from deep breaths can carry more volume and therefore have a much greater effect on flushing the brain of waste products. Vinje compares this to ocean waves hitting a beach – bigger, longer waves go farther and remove more clutter from the beach than shorter, smaller waves.[10] This research helps to underscore the importance of breathing and intention, both of which are of paramount importance in the Muscle-Tendon Change and Marrow Washing Nei Gong.

The original text of the Muscle-Tendon Change Classic[11] puts this succinctly: the practitioner must do it with a focused mind; otherwise it is only the postures of the body, but not the three regulations [regulation of mind, breath and body] integrating, and there is no point in doing it.[12]

Fascial Fitness Training, Muscle-Tendon Change & Marrow Washing

Currently there are many theories about fascial fitness and methods of fascial training. Specific training is thought to enhance the fascial elasticity essential to systemic resilience. An influential article on fascial training by Schleip and Müller[13] states that, the intention of the proposed fascia oriented training is to influence the matrix renewal via specific training activities which may, after 6-24 months, result in a more injury resistant and resilient ‘silk-like body suit’ which is not only strong but also allows for a smoothly gliding joint mobility over wide angular ranges. This is very much in line with the purpose of the Muscle-Tendon Change and Marrow Washing Nei Gong as proposed by ancient Chinese Martial Arts and Qi Gong practitioners.

Schleip and Müller propose that principles of fascial-oriented training should employ elastic recoil, preparatory counter-movement, slow and dynamic stretching, rehydration practices and proprioceptive refinement. Elastic recoil and preparatory counter-movements are part and parcel of the Muscle-Tendon Change and many Qi Gong exercises. Proprioceptive refinement is also mentioned by Thomas Myers, author of Anatomy Trains, who adds that part of fascial training involves “feeling” the skin and tissues move.[14] This increases kinesthetic sense and proprioception. This idea ties in very closely with Chinese ideas about learning to sense the subtle internal Qi and sensing minute changes and movements within the body.

Muscle-Tendon Change exercises, create changes in body’s exterior (skin, sinews and muscles) by sensing deeply inside the body in order to promote the exterior sinews and muscles. The Muscle-Tendon Change begins with the internal Qi, and Muscle-Tendon Change exercises focus on deep relaxation, in which muscular tension is removed from the equation, thereby allowing Qi to penetrate deeply into the fascia and sinews. The practitioner uses Mind-Intention, breath, and specific postures and movements to infuse the fascia and connective tissues with Qi. This is the opposite of doing cardio and weight training exercises, where the focus is on developing the external musculature.

Another important aspect of fascial training is the recruitment of long chains of muscle, tendon, bone, and connective tissue running from head to foot, rather than isolated exercises that work only locally.

Some examples from the Muscle-Tendon Change:

  1. When performing the three postures of Wei Tuo Presents the Pestle, Qi is guided through the Arm Sinew Channels and the Main Meridians of the arms.
  2. In Uphold the Heavenly Gate, the fascial chain from the bottoms of the feet to the top of the head is engaged, while internally the Ren Channel (on the front of the body) is gathered inward, while the Du and Bladder channels on the back of the body open. This engages various fascial chains that go from head to foot.
  3. In Pulling Nine Oxen Backward by Their Tails, the arms and torso twist like a rope from head to foot while the breath and subtle internal and external movements create vibrations that pass through the torso and the arms.
  4. In Three Plates Fall to the Ground, the whole body compresses like a spring and then expand like lifting a heavy weight as one squats and then stands upright. This engages the whole body in a dynamic, elastic action.
  5. In Green Dragon Stretches It Claw, the hands go in and out, driven by the waist and low back, so that the tissues and the meridians that wrap around the waist (Dai Channel) are trained to become “as flexible as silk”.
  6. Lying Tiger Pounces on Its Prey starts with an elastic cat-like stretch the stretches long facial chains from the bottom of the foot through the back and torso to the fingertips. This is followed by a version of undulating pushups often called “Hindu Pushups.” These dynamic actions engages the strength of the whole body from the feet to the fingertips.

The postures and movements of the Muscle-Tendon Change store Qi in the body, while simultaneously stretching and engaging the sinews and fascia in chains that pass through the whole body and connect to the body’s center (Dan Tian & Ming Men). This is a kind of neuro-muscular reprogramming that changes the nervous system and the patterns of muscle engagement and relaxation, thereby encouraging the development of elastic and springy connective tissue, so that the muscles themselves act more like a connective tissue, which should have a springy, elastic quality. The Muscle-Tendon Change Classic elaborates on this as follows:

Inside the body, Qi, blood and spirit are not themselves the masters. The intention makes them move; the intention makes them stop. Keeping the intention on the center, the intention Qi is underneath the palms and the form unites. When the intention is in the arms and legs, then Qi and Jing follow and disperse. Then the outside is strong, but strength does not accumulate inside.[15]

Proprioception is an important component of this type of training. Thomas Myers gives the example of a weightlifter scrubbing himself with vegetable brush before competing to increase fascial proprioception. Marrow Washing takes this idea quite a bit farther, by training the practitioner to sense within the bones, the space between the bones and surrounding tissues, to sense between the skin and flesh and to feel even the hairs on the skin moving. Later one lightly “washes” the body with the hands. Every moment and movement of Marrow Washing and Muscle -Tendon Change involves “sensing” inside the body from beginning to end. In addition the Muscle-Tendon Change includes patting and stroking exercises that help the body to “pack Qi” into areas that are perceived as empty so that the body. The Yi Jin Jing text describes this as follows:

When we keep the mind on the midpoint of the body, the mind is focused there together with the spirit and Qi underneath the palms. When the mind goes to the arms and the legs, the essence and the Qi follows the mind there and the result is strong outside the body but not inside. So how can it be beneficial to massage the midpoint of the body without keeping the mind and Qi there?

The third principle is to wait for abundance. Massaging and keeping the mind on the midpoint of the body are for accumulating Qi.

Massaging for a long time, Qi will focus on the midpoint of the body and not be scattered. Accumulated Qi leads to increased power (Li), and abundant Qi leads to greater power.[16]

Wang Huai Qi, a researcher and practitioner of traditional Chinese exercise methods writing in China’s Republican Era (1912 and 1949), reiterates these training concepts in relation to the postures and moving exercises of the Muscle- Tendon Change.

This art derives from Buddhism, emphasizing meditative concentration. When you wish to practice, you first have to close your eyes and empty your mind, seize control over your thoughts and eliminate confusion, calm your emotions and regulate your breath, focusing your spirit and energy. Then when practicing the sequence of postures, you have to have intention coursing through, not just make shapes. If your mind is moving randomly, your spirit scattered, intention distracted, you will be laboring in vain with these postures and gain no meaningful results.[17]

All of this is the opposite of common strength building exercises like weight training with big muscle push off actions. In fact is quite well known that intensive weight lifting causes several microscopic tears to form in the fibers and connective tissue of muscles. The idea is that upon the rebuilding of these fibers, size and strength are gained. However, too much of this tear-down and rebuild activity without adequate recovery and proper nutrition, or performed incorrectly, can eventually lead to adhesions or restrictions within the fascia surrounding the muscles, joints, ligaments, blood vessels and tendons. The joints and tissues can then become weaker rather than stronger.


[1] Ligamentous Articular Strain: Osteopathic Manipulative Techniques for the Body. Conrad A. Spence D.O. and William Thomas Crow, D.O. (Seattle: Eastland Press, 2001) p. 27-28.

[2] Definition of Inflammation, Causes of Inflammation and Possible Anti-inflammatory Strategies, Srdan V. Stankov* The Open Inflammation Journal, 2012, 5, 1-9

[3] Strolling Under the Skin. Dr. Jean-Claude Guimberteau. SFRS: service du Film de Recherche Scientifique 2005.

[4] In Chinese medicine, the kidneys are directly linked to the bones, the liver to the sinews, the lungs to the skin, the spleen to the muscles and flesh, and the heart to the vessels.

[5] Gurevitch O, Slavin S, Feldman AG. Conversion of red bone marrow into yellow – cause and mechanisms. Med Hypotheses. 2007;69(3):531-6. doi: 10.1016/j.mehy.2007.01.052. Epub 2007 Apr 11. PMID: 17433565.

[6] Cytokines are small proteins that are crucial in controlling the growth and activity of other immune system cells and blood cells. When released, they signal the immune system to do its job. Cytokines affect the growth of all blood cells and other cells that help the body’s immune and inflammation responses.

[7] Tuljapurkar SR, McGuire TR, Brusnahan SK, Jackson JD, Garvin KL, Kessinger MA, Lane JT, O’ Kane BJ, Sharp JG. Changes in human bone marrow fat content associated with changes in hematopoietic stem cell numbers and cytokine levels with aging. J Anat. 2011 Nov;219(5):574-81. doi: 10.1111/j.1469-7580.2011.01423.x. Epub 2011 Sep 16. PMID: 21923862; PMCID: PMC3191309.

[8] Schwartz, Ann V. “Marrow fat and bone: review of clinical findings” Frontiers in Endocrinology. Review Article published: 30 March 2015 doi: 10.3389/fendo.2015.00040

[9] Griffith, James F. and Yeung et als, David KW, “Compromised Bone Marrow Perfusion in Osteoporosis” Journal of Bone and Mineral Research Volume 23, Number 7, 2008 Published online on February 25, 2008; doi: 10.1359/JBMR.080233

[10] “Breathing can affect the cleansing of the brain” Ann Lise Stranden., thursday 26. September 2019:

[11] Most scholars agree that the text of the Yi Jin Jing has been edited more than once.

[12] Chinese Medical Qi Gong, Liu Tianjun – Editor in Philadelphia & Chief (London: Singing Dragon, 2010) p. 595.

[13] Schleip, and Müller, D.G. Training Principles for Fascial Connective Tissues: Scientific Foundation and Suggested Practical Applications. Journal of Bodywork and Movement Therapies (2012)

[14] Myers, Thomas, Fascial Fitness: Training in the Neuromyofascial Web IDEA Fitness Journal, Volume 8, Number 4 April 2011

[15] Translated by Tom Bisio

[16] Chinese Medical Qi Gong, Liu Tianjun – Editor in Philadelphia & Chief (London: Singing Dragon, 2010) p. 594.

[17]易筋經十二勢圖說A Handbook for Twelve Posture YiJinJing, Wang Huaiqi (王懷琪) (originally published by 商務印書館 Merchant Publishing House, Oct, 1917) translation by Paul Brennan, Nov, 2017.