Summary of Articles Written by Françoise Mézières

Summary of articles written by Francoise Mezieres

This is a summary of the writings of Françoise Mézières and the principles she described in support of her method.

These principles originate from her observations and intuitions about the musculoskeletal system, which were ahead of their time and demonstrated her brilliance.

Many of the observations and "laws" stated by Mézières would only find scientific explanation much later, mostly from the physical-mathematical field with theories about the behavior of systems both in linear and nonlinear contexts.

Francoise Mezieres

Françoise Mézières was born in Hanoi on June 18, 1909.

In 1937, she graduated as a physiotherapist from the Ecole Francaise d'Orthopedie et Massage in Paris.

Starting in 1947, she began studies that led to the construction of her method.

From the 1950s, she began training physiotherapists.

She died in Noisy-sur-l'Ecole on October 17, 1991.

First observations

The Method was born from the observation of an unexpected phenomenon by Mézières in 1947.

The phenomenon was observed in a patient suffering from dorsal hyperkyphosis and bilateral scapulohumeral periarthritis, treated for two years with a leather and iron corset.

This not only brought no improvements, but caused abrasions.

Françoise Mézières, after unsuccessfully trying while seated to make her pull her shoulders back by pressing on the apex of the kyphosis, found no other solution but to lay her on her back (figure 1) and apply pressure on her shoulders (figure 2).

     

This maneuver, ineffective for the shoulders, immediately caused marked lumbar hyperlordosis (fig 2).

By preventing it with posterior pelvic tilt through flexion of the knees on the abdomen, the hyperlordosis immediately shifted to the neck level (fig 3).



Mézières repeated the experiment several times and the phenomenon continued to present itself, providing clear data on the state of the dorsal muscles examined. From this she deduced that the lordosis moved along the spine like a ring along an axis and therefore that:

1. The numerous dorsal muscles behave like a single muscle;
2. They are too short;
3. All localized actions, both in stretching and shortening, instantly affect the entire musculature;
4. Efforts, stretchings, detorsions, pain immediately imply a diaphragmatic block in inspiration. Therefore, the diaphragm is not only a respiratory muscle but also an accentuator of lumbar lordosis through the action exerted by its pillars on L2 on the left and L2-L3 on the right, an action in which the pillars of the diaphragm are synergistic with the psoas, which exerts an anterior traction on the spine from D12 to L5.

Retracted muscles

Muscles composed of longitudinal bundles or myofibrils show a periodic transverse striation consisting of alternating light bands (I bands), dark bands (A bands), intermediate bands (Z disks) and additionally Hansen zones (H zones) that appear only during muscle contraction.

The sarcomere is the unit from one Z disk to the next.

When muscle action causes the approaching of its insertions, the muscle performs concentric work, which mainly results in sarcomeres in parallel and thus bulky, short muscles resistant to stretching.

During all motor activities, man uses contractions that approach insertions; this produces over time a progressive and constant shortening of the musculature which in turn will cause morphological changes, i.e. alteration of the physiological articular sequence.

Muscles work together

From the description of the first observations, it emerged that the dorsal muscles behave as a single muscle; this gives rise to what Mézières calls kinetic chains.

A kinetic chain is a system of multi-joint muscles that overlap and influence each other like roof tiles.

All elements of a kinetic chain are linked, so that all localized actions (both stretches and shortenings) cause the shortening of the system, by flexion or rotation.

Kinetic chains are hypertonic and retracted by the sum of muscular forces.

Mézières defines four chains:

• anterior of the neck
• brachial
• antero-internal
• posterior

The posterior kinetic chain extends from the occiput to the toes, rises anteriorly up to the knee and is constituted by the muscles called "statics".

These ensure with their tone and fibro-elastic tension the stability of the various elements and balance.

They are also responsible for maintaining balance through postural reflexes when it is threatened.

They also have a greater amount of fibrous connective tissue and tend, more than others, to fix shortenings and retract.

The posterior kinetic chain, given its extension, intervenes in all movements both as a motor and as a brake of the movement and is implicated in all dysmorphisms.

The other chains, antero-internal (iliac muscles, psoas and diaphragm), anterior of the neck (from the basal apophysis to D3), and brachial (arm muscles) are synergists of the posterior chain.

Ineffectiveness of localized actions

A localized action produces muscle retractions upstream or downstream of the interested zone and therefore the "total length" of the musculature is not modified.

Another factor of ineffectiveness of localized actions is represented by the fact that any dysmorphism is never the expression of a local muscle shortening, but it is the expression of the shortening of the whole and the morphological alterations are distributed micro or macro on all joints.

From this it follows that, whatever the problem is, it is necessary to look at the body as a whole observing all compensations and, subsequently, treat it in its entirety.

Dysmorphism

The contracture and subsequent muscle retraction organized in kinetic chains causes a modification of the normal body symmetry.

For Françoise Mézières this is the cause of all orthopedic pathologies (except those of congenital or acquired origin).

The retraction of the kinetic chains causes the deviation of the spine (scoliosis, hyperlordosis, etc.), a shoulder higher than the other, a rotated pelvis, varus or valgus knees, etc.

It is therefore the musculature that influences and modifies the normal skeletal relationships; the resulting pathologies are all resolvable by lengthening the musculature.

In scapulohumeral conflict pathologies, for example, the muscle contracture causes a displacement of the humerus within the shoulder joint.

The head of the humerus loses its central position, comes into contact with part of the articular cavity of the scapula and causes an inflammation from rubbing.

This will cause, in addition to a functional impotence, a morphological modification: the affected shoulder will be, compared to the healthy one, higher or lower, more anterior or posterior; the head may tilt to one side; the pelvis rotate; etc.

In this example the treatment should not use mobilizations but, on the contrary, it is necessary to look for the muscles which, by shortening, caused the displacement of the humerus (and the other asymmetries) in order to lengthen them.

In this way the humerus will return to its central position inside the joint.

By doing so, working on the causes that produced the onset of the pathology, the shoulder will stably recover its correct symmetry and functional capacity.

Reference biotype

According to Mézières, man has his optimal shape and all deviations from this perfect shape are nothing but the expression of the body imbalance in progress, which will lead to the onset of pathological processes, seen no longer as accidental phenomena, but as the product of several factors operating over time.

For Mézières, all dysmorphisms that are not caused by a congenital or acquired structural alteration are always correctable, regardless of the patient's age.

In the upright stance, with feet together, the reference biotype has the following characteristics:

• seen from the front: the two body halves are symmetrical with the hips and shoulders at the same level and free of rotations, the lower limbs have the big toes, malleoli, calves (upper third), knees and thighs (upper third) in slight contact;
• seen in profile: along an imaginary line perpendicular to the ground, the heels, calves (upper third), glutes, spinous process of the fifth thoracic vertebra and occiput will be aligned.

Global work

According to Françoise Mézières, it is the musculature organized in chains that influences the skeleton: (therefore) by acting on the first one can correct the second.

From the principles exposed so far, a technique has been derived based on the need to avoid the analytical increase in the force of each muscle.

This technique provides, on the contrary, the stretching of all the muscles in the chain.

During treatment, the morphology of the patient will be continuously compared with that of the reference biotype and with the progressive approximation of the parameters, the pathological problem in progress will be solved.

The work will be simultaneous on all four chains because localized actions do not modify the total length of the musculature.

The work will be done in expiration because during the inspiratory moment or apnea, the diaphragm, acting on its pillars, causes an accentuation of lumbar lordosis, therefore shortening.

The work will make use of isometric contractions in maximum physiological or relative stretching of the muscle fiber, because they are the only ones able to increase the number of sarcomeres in series, making the muscle gain length, elasticity and strength.