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Muscle-Tendon Change, Marrow Washing & Fascial Training: Part 4 by Tom Bisio

This is the fourth 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 and their relation to recent fascial theories and research.

To read Part 1 CLICK HERE

To read Part 2 CLICK HERE

To read Part 3 CLICK HERE


Another aspect of fascial training mentioned by many of its proponents is called “rehydration.” Rehydration acknowledges the importance of fluid movement through the connective tissue matrix, and even within the individual fibers of the matrix. One common physical therapy device is the use of foam rollers to compress and “roll” muscle tissue. This is thought to push fluids out of tissues so that they will “rehydrate”, and many people advocate drinking more water to “hydrate” tissues. Both of these practices seem to often do more harm than good, and are at odds with both common sense and mechanisms of internal exercises like Marrow Washing and Muscle-Tendon Change. Drinking more water will not guarantee that these ingested fluids will go into the fascia and there are many indications that over-hydration can lead to a variety of health issues.

The foam roller approach also seems suspect. Studies on inflammation have shown that too much pressure and chronic pressure of low intensity can cause tissue hypoxia by squeezing water and oxygen out of cellular tissue leading to inflammation and cell degradation. Rather than re-hydrating, the tissues remain in flattened, un-hydrated, de-oxygenated state for some time. My personal observation from clinical practice is that compressing and “rolling” muscle tissue with a foam roller, instead of loosening muscles and improving circulation, often has the opposite effect of making muscles tighter and more congested.

The Marrow Washing and Muscle-Tendon Change approach is to use movement, breath and Mind-Intention to encourage circulation of Qi, blood, fluids through the body’s tissues and membrane layers. Additionally, in Marrow Washing saliva is gathered and internally transformed into a “mist” which is used to wash the organs and tissues. Daoist Masters say this directly influences the fluids of the body, improving their circulation, and ability to reach and nourish the tissues.

Because respiration drives the cardio-pulmonary system, breath cultivation is the simplest way to affect the movement of fluids globally in the body. Which raises the obvious question of why so few fascial “experts” even mention breath cultivation as part of the picture.

Numerous studies have proved that deep abdominal respiration (“Kidney Breathing”) and its variants have enormous effects on health, immunity, general circulation, mood, and cerebral circulation. All the diaphragm muscle is fascia.[1]

The diaphragm muscle not only plays a role in respiration but also has many roles affecting the health of the body. It is important for posture, for proper organ function, and for the pelvis and floor of the mouth. It is important for the cervical spine and trigeminal system, as well as for the thoracic outlet. It is also of vital importance in the vascular and lymphatic systems. The diaphragm muscle should not be seen as a segment but as part of a body system.[2]

It is no surprise that Daoist and Buddhist sages and Qi Gong masters very early on recognized the important role played by breath regulation in restructuring the body’s neural and fascial systems, particularly when paired with specific movements and focused intention. Regulated breathing plays a key role in the ability of Marrow Washing and Muscle-Tendon Change to transform the connective tissue, sinews, and muscles.


The work of Dr. Luiz Fernando Bertolucci and other researchers have led to a critical question. How do animals in the wild maintain musculoskeletal health? Animals do not perform stretching routines and yet still maintain their capabilities. Researchers noticed that animals perform spontaneous “pandiculation” – shivering, shaking and stretching movements that are largely involuntary, and do not involve cortical stimulation.

Pandiculation in animals involves involuntary deep muscle co-contractions, in which the soft tissue actively elongates against the bony structures as the joints are stiffened. The contractions and movements form a sequential pattern derived from a mosaic of reflexes, the sequence of which can neither be anticipated nor purposely performed, in the same way that a spontaneous yawn is different from a purposeful one. This is interesting particularly when we recall that Wei Qi, as it moves through the Sinew Channels, allows the individual to respond in a reflexive and spontaneous manner without volition or cognition, and that Wei Qi and the Sinew Channels generate an immediate ability to respond to changes in an individual’s environment.

Dr. Bertolucci goes on to say that Eastern martial arts and Qi Gong exercises appear to have a connection with pandiculation:

Qi Gong, for instance, requires the body to be fortified with automatic (involuntary) tonus in the deep postural muscles at the same time the superficial muscles associated with voluntary activity are relaxed. Under these conditions, the body is integrated as a whole and all its parts relate with one another in movement. These conditions cannot be produced by voluntary motor action, but emerge spontaneously with appropriate states of attention in which mechano-sensing is enhanced. A person in such state could take advantage of elastic potential energy stored in the body when performing a blow. This characteristic of Qi Gong suggests a tensegrity-based mode of action with a high pre-stress level. In fact, potentiation of performance has already been shown in pre-stretched muscles, due to their ability to store potential elastic energy.[3]

When practicing many of the exercises in the Muscle-Tendon Change, like Pulling Nine Oxen By their Tails or Pluck the Star Transform the Dipper, and Wei Tuo Presents the Pestle, one can sense vibrations moving through Dan Tian and connecting to the limbs. Similarly when performing Marrow Washing, one senses the subtle vibrations of blood, marrow and fluids moving through the body. These subtle vibrations not only forge connections between Dan Tian and the limbs, I feel they are part of what ultimately changes the tissue orientation, from the dysfunctional haphazard, multi-directional fiber arrangement with reduced elasticity, and reduced gliding and shear ability to the proper lattice-like fiber arrangement that produces maximum  strength, flexibility and elasticity.

Recent research indicates that animals in the wild naturally release stress and tension from the body after a life-threatening event by shaking or shivering. Shaking seems to be a primal impulse to return the body to its normal homeostasis. Evidence indicates that shaking and vibrating internally helps to release muscular tension and burn off excess adrenalin and cortisol so that the body and nervous system calms down and return to a neutral state. This prevents the body from becoming habituated to a fight or flight state and where stress becomes internalized and chronic. Perhaps to some degree the internal vibrations that we create and perceive when practicing the Muscle-Tendon Change and Marrow Washing serve a similar function.

Talking about animal movement leads me to think of cats, animals that don’t “train” and only fully exert themselves when necessary. Without regularly training to maximum exertion and flexibility, they are nonetheless capable, in the blink of an eye, of exhibiting amazing feats of strength, agility and speed. This ties in with the training principles of martial arts masters who observed animal movements. In internal martial arts, one is advised to rarely train at maximum capacity. Instead one trains slowly and evenly at a maximum of 70% of one’s capability. Training at no more than 70% of capacity (and much of the time at less than 70%), maintains tissue integrity and capability without injury or impairment that often result from training “hard” on a regular basis. This is the opposite of training to maximal intensity in short bursts, an exercise method currently in vogue. While this may be useful for sports – I found 30 second maximum intensity interval training very useful more than 30 years ago when I was training to fight in Filipino Martial Arts full-contact tournaments, which required short all-out bursts of speed and power – it is not a sustainable or useful training model for preserving health.

The 70% approach requires patience and time. Change occurs little by little, at times almost impossible to perceive, but the benefits slowly accrue until profound changes occur. With the 70% approach, principles of correct movement and correct usage of the tissues become second nature, and one’s ingrained movement patterns change and become more graceful, more efficient and more “cat-like.” The “70% Rule” is an important concept in traditional Chinese exercises like the Muscle-Tendon Change and Marrow Washing that aim to transform the body and produce lasting effects.

Fascia – Too Tough To Change?

Many “experts” in what is loosely termed “Fascial Science” say that fascia is like Kevlar or steel, so tough that it is virtually impossible to alter its matrix by stretching or other means. This is interesting in light of studies that show that pressure, particularly if chronic or prolonged, can actually cause degradation of the cellular matrix by driving water and oxygen out of cells so that they become oxygen deprived, leading to catabolism. Therefore it would be logical to assume that the opposite would also be true, and that stretching, lengthening, contracting and expanding might also have a positive effect.

Fascia may be “as strong steel,” yet steel can be shaped over time under heat and pressure and this is exactly how Chinese masters describe internal exercises – “like forging steel.” Forging steel must be done slowly, over time and according to precise methods. Forging Steel is a balancing act of getting the metal just hard enough to do the job, without it becoming too brittle. A delicate balance of strength and flexibility is required to produce most tools and blades. And that balance must be adapted to each tool and its specific function. Training the body is very similar – in order to develop flexible, strong and adaptive tissues, one seeks the right balance of effort and relaxation, contraction and lengthening, breath and intention, stillness and movement, etc. This is a learning process that requires time, patience and attention to detail.

The idea that fascia cannot be changed and transformed also fails to take into account one of the most interesting properties of fascia – its role in proprioception. Sensory neurons (axons or nerve fibers) in fascia form an important part of the peripheral nervous system, which converts information about mechanical, thermal, and chemical states of the body, and transmits it to the central nervous system. Part of what allows fascia to change is the web of sensory information about tissue shear between fascial layers, mechanical pressure, stretch, etc. that feeds back through both the neuro-muscular system and the central nervous system. Research studies also seem to indicate that active awareness and sensing is required for this information to make purposeful changes in response to movement and loading patterns.

This brings us back to looking at the importance of practicing the exercises in an almost meditative state, in which one senses internally while performing specific movements that can be described and differentiated as “internal” and “external.” From the Chinese medicine perspective and the perspective of Qi Gong and Nei Gong, while the importance of the brain and nervous system is recognized, their functions are viewed as part of the larger Qi Dynamic. Sensing Qi internally allows one to sense the expression of the nervous system tied to all the other body structures. Through Qi we perceive the world around us and sense our own internal and external movements, proprioception, and all of the other things that may or may not be attributed to the nervous system. From a Chinese perspective our relationship to the outside world and to heaven and earth is perceived through Qi. So while we can recognize the importance of the nervous system and its connections to fascia, this knowledge does not really help us do the exercises correctly. A friend of mine in a recent email correspondence put this rather succinctly: “which is more useful – telling you to reset your gamma efferent neurons, or telling you to extend Qi?”

The following excerpts from the work of Bruno Bordoni and his fellow researchers give us exciting insight into the vast possibilities and the critical importance of fascial training like Muscle-Tendon Change and Marrow Washing:

A chronic deformation of the myofascial system causes the mechanoreceptors to turn into nociceptors, for example in the thoracolumbar fascia, simulating an idiopathic back pain syndrome. A decline in the sliding of fascial tissues causes a picture of local inflammation, as shown for some types of cervicalgia. An altered position of the collagen fibres, for example in a tendon, could change its mechanical function, creating pain but not inflammation. If the layers and fascial orientations of an anatomical area lose the ability to move between them, the vectors of collagen fibrils will change, there will be an implementation of collagen deposition, creating a metabolic environment of inflammation and anomalous mechanical tension of the scaffold cell and extracellular matrix. This fibrosis or desmoplasia is one of the stimuli to create and maintain a tumour phenomenon.

Maintaining an optimal position of the collagen fibres, adapted to a specific anatomical structure (muscle, joint, visceral capsule, meninges, etc.), means maintaining health.The fascial tissue has memory and awareness: “We are not dealing only with a tissue, but with awareness.”

The fascial tissue has memory, in order to adapt better and awareness, that is, the ability to prepare the cells in the presence of a stressor (internal or external), through varied and extremely rapid means of communication. In the solid tissue considered as a fascia, fibroblasts and telocytes can create branches to put more cells in contact simultaneously and for considerable distances. The Telocytes play essential roles in mechanical, metabolic, cellular and immune repair processes.

The fascial tissue is a network interconnected with other networks (collagen, cells, cytoskeleton, protein filaments) and immersed in liquids (blood and lymph, extracellular matrix, cellular liquids). When we think of fascial tissue, we should not imagine a network but a “wetwork”. The fascial tissue is compared to a biotensegretive complex, a term coming from a concept of architecture (tensegrity). Comparing the fascial continuum to a tensegretive structure when we do not yet have scientific elements to describe this concept in the presence of liquids, is like talking about the sky night without the stars: useless. Perhaps we should talk about the tensegrity of liquids in a solid context: fascintegrity.[4]

Time – Slow but Steady

Another factor in fascial training is sustainability. The fascial network requires time to change and renew. Fascial researchers Schleip and Müller talk about the “power of a thousand tiny steps” – a concept derived from Asian philosophy. They point out that in contrast to muscular strength training, in which big gains occur early on and then a plateau is quickly reached wherein only very small gains are possible, fascia changes more slowly and the results are more lasting.[5]

In Muscle-Tendon Change and Marrow Washing, progress appears slow even when tiny gains are being daily accrued. Improvement is cumulative, but one must be patient and persevere in order to achieve the desired results. It is generally thought to take 1-3 years to really transform the fascia (sinews). It may in fact be this cumulative, ongoing transformation that allows old Masters to exhibit strength and flexibility that belie their years.

My experience with the slow and steady approach is that one must embrace the small, yet ongoing discoveries that constantly change one’s perception of the exercise and of the body and its many interconnections. Embracing the idea that each day there is the possibility of discovering or sensing something new, keeps the exercises from becoming stale and automatic. Then Marrow Washing and Muscle Tendon Change, become an ongoing source of discovery, internal change and delight.

In relation to the Muscle-Tendon Change and Marrow Washing there is a traditional training regimen that illustrates the concept of slow and steady:

  • The first year of training restores physical and mental vitality
  • The second year enhances blood circulation and nurtures meridians
  • The third year restores flexibility to muscles and nurtures the organs
  • The fourth year results in the marrow being washed and the brain nurtured

This is definitely a training regimen that requires both patience and perseverance!


[1] Bordoni B, Simonelli M, Morabito B. The Fascial Breath. Cureus. 2019 Jul 23;11(7):e5208. doi: 10.7759/cureus.5208. PMID: 31565613; PMCID: PMC6758955.

[2] Bordoni B, Zanier E. Anatomic connections of the diaphragm: influence of respiration on the body system. Journal Multidisciplinary Healthcare. 2013 Jul 25;6:281-91. doi: 10.2147/JMDH.S45443. PMID: 23940419; PMCID: PMC3731110.

[3] Luiz Fernando Bertolucci, Pandiculation: An organic way to maintain myofascial health. MD (January 7, 2016)

[4] Bordoni B, Simonelli M, Morabito B. The Fascial Breath. Cureus. 2019 Jul 23;11(7):e5208. doi: 10.7759/cureus.5208. PMID: 31565613; PMCID: PMC6758955.

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