Mézières method

The Mézières method is a rehabilitation system designed by a French physiotherapist, Françoise Mézières (1909-1991). In the eyes of many professionals [who?], this method has revolutionized the re-education and brought a new vision of human mechanics. Decades after his appearance, she still debate and many critics.

The historical context

Should put the scientific work of Françoise Mézières in the medical context of the time.

Result of the second world war and the outbreak of poliomyelitis following the rehabilitation is emerging in 1945. This original physiotherapy approach is dictated by the recovery of muscle strength major injuries and are moved. But in the years that followed, this treatment option is transformed into thinking. Pains, dysfunctions are attributed to a hypothetical lack of force, deformations are caused by an unlikely inability to resist the negative gravity.

Common sense is scientific demonstration and the premise is dogma. Treatments are to strengthen. The differences between the different schools stating at points of detail, variations on the theme of constantly revisited the strength and gain strength. Françoise Mézières was educated at the Ecole Française orthopaedic and Massage rue Cujas in Paris, under the direction of Boris Dolto. She graduated of State on the eve of the evacuation of Paris to the advance of German troops. She learned the techniques of the time, in particular the “corrective gymnastics”, based exclusively on muscle building in the aftermath of the war, the school of rue Cujas found his mark and asked him to come and teach. In the spring of 1947, while it has just completed writing a booklet, a sort of compilation of medical gymnastics of the time, it is what she later called her “princeps observation.”

Princeps observation

“When a lavish 1947 spring morning, we saw enter our firm a patient with a superb”kyphosis”, we were well short of doubt us that our profession and the fate of Legion of patients would be changed.” It is a subject very large, elongated and lean. A leather corset and iron had caused, not control expected progress, decidedly inexorable, its wrong, but bruises on the hips and around the shoulders, and even seven vertebrae were high and the lower corner of the shoulder blades.

But the patient is complaining and it was because she could no longer lift the arm or work. We essayâmes, of course, “relief” exercises and the work of the dorsal to fortify the “extensor” back, but the stiffness was such that nothing was possible. Extending our patient, supine, then we appuyâmes on the shoulders and we saw, to our amazement, to produce a huge lordosis lumbar then that, standing, examined the patient was absolutely as a dorsal kyphosis. To avoid add harm to that which already existed, we basculâmes the basin back by bringing the knees on the abdomen, and to our new stupor, we saw the thus cleared lumbar hyperlordose refer to the neck, head to reversing back without that it was possible to bring the Chin closer to the neck. »

“The door to the truth was before us, large open but we refuse to engage us and, doubting our eyes, we renouvelâmes several times the experience and, finally, to a sister.”

“Our princeps observation was so unexpected, the facts found so surprising for a practitioner Petri dish of Orthodox theories, so admire to his teachers that he had, until then, for real scientists, that he did not wanted to believe his eyes.” But the insolent truth was so obvious that he sought then, desperately, to see an exception which would have confirmed the sacrosanct rule. He had to resign himself to sacrilege and reconsider the basis of orthodoxy. Was to identify the laws of this absolutely unknown Physiology, learn the mechanisms. Then followed the trials and tribulations of apostasy to the delights of heresy. It is indeed an ineffable joy to verify at every moment, and in a thousand ways, the validity of a theory, as she rightly explains the causes of all dysmorphismes and on what can be built to curative technology. »

In the years that followed, it verifies that its princeps observation has scientific value, that it inevitably breeds in the same conditions of experimentation. In 1949, she published “Revolution in orthopaedic gymnastics”, a founding article which receives a mixed, if not openly hostile, on the part of the medical world French. She left rue Cujas and settled in liberal to implement its principles and continue his research. Is that much later, in 1984, that it establish 6 laws that explain the phenomena observed at the princeps observation of 1947. It is a method that, although its infancy, already is in his eyes, more effective than conventional techniques that she taught herself little time previously. Or better, it gives his own name to its nascent method.

Scientific content

The basic laws

First law: many hindlimb muscles behave as a single muscle.

Second law: the muscles of the strings are too strong and too short.

Third law: any localized action, both elongation than shortening, instantly causes the shortening of the overall system.

Fourth law: any opposition to this shortening causes instantly latero-reflections and rotations of the rachis and the members.

Fifth law: the rotation of members due to spasticity of the strings is always within.

Sixth law: any elongation, détorsion, pain, any effort involves instantly respiratory blocking in inspiration.

Explanation of the fundamental laws

Analysis to the full

Medicine and chest physiotherapy define the spine a ship mast with his guys, represented by the muscles. According to this model: If the mast is not square, it slack guys. This is bedrock concept of medical gymnastics classic Mézières considers a doctrine. For her, this model is wrong. She asks to consider the individual as crushed by its own force, his own guys, too short. Although many, the muscles of the back of the body (the guys) behave as a single muscle, tense of the skull to the tip of the toes and fingers. For her, the model of the doll on which is based any modern chest physiotherapy is inadequate. On a doll, you can move independently a member or another, without impact on the rest of the body. This is not what we see on the human body. It is the model of the doll that the first law slashes at. Mézières replaced by the model of the puppet in which a Twine system links the members among themselves and to the trunk. The second law indicates that the string is far too low or relaxed. It is too short and too strong. And therefore, it is not possible to mobilize a segment without that the whole system is involved. Is the emergence of the notion of completeness. It is more arguable treat a part without taking all into consideration. The third law expressed the conviction of the analytical, dear principle to chest physiotherapy. Mézières sees that a derisory attempt of salami of the body.

The hypothetical weak to true shortening

The fourth Act offers an explanation for the three-dimensional deformations as famous idiopathic scoliosis. It would be due not not a weakness of the spinal obliques muscles (which for it do not exist!), but to a shortening of the muscles underlying the spine, the vrillant to like a staircase spiral staircase. The fifth Act, includes members to the general process of deformation. The sixth Act emphasizes the importance of respiration during rehabilitation sessions.


The static, the manner in which it is held, is a semi-automatic function: can intervene by the will, but only while you think. As soon as we think about something, it is habitus that takes over the top, which is managed by “unconscious” areas of the brain. The physiotherapy postulates that effective conditioning following, the fold of the salutary effort would be taken and the static corrected. Mézières is categorical: we have no muscles capable of us untwisting of détasser us, us délordoser let alone us grow. By the will, we cannot only Transiently move deformations. As soon as the decision of effort, they return to their place of choice. Stronger still. For this iconoclast, it is derisory attempt to educate to be better: there is no muscle to do so. “It stands as our muscles are”, she said. The only thing to do, the only relevant approach is to attempt to reduce the tension in the “muscle guys” because it is their tension, and no gravity, which distorts and we made suffer. This can be done any one. Education, awareness and parenting orders are of no effect. Only well driving rehabilitation can, gradually, have a favourable effect on the static, without even the subject is forced to think about on a daily basis.

Deformation and normal form

Talk of deformation, such as Mézières, implies de facto the assumption of the existence of a normal form. In the aftermath of the Holocaust, this concept is not politically correct, it is shocking. Physical medicine describes irreversible “morphotypes”: the longilignes, the brévilignes, etc. In each of these types, it assigns a preferred sport: race and jump for longilignes, weightlifting for the brévilignes.

Mézières enrolled in false and it is a fundamental, basic message element. She wrote: “If the circular wheels, it is that it does not work when they are square.” And describe human form perfect, a virtual model it calls Paragon. It is the difference between morphological perfection, by absolute, which goes hand in hand with an optimal function; and beauty subjective, relative and variable from one person to another, from one culture to the other.

“Nice is the enemy of the beautiful.” Fernand Léger

This dream polyathlète she described would be possible if there was systematic shortening of the muscle chains. We would all be “beautiful and perfect.”

THE Paragon “, if measures and calculations are tedious and sources of error, we have all means are simple and natural, we all of the eyes and also the meaning innate beauty (although the absurd methods distort the taste).” Similarly ear identifies the correct notes and false notes, similarly the eye must recognize the healthy shape and the dysmorphisme. And one verifies easily by examining the patient only: from the front, the clavicles, shoulders, nipples, brachiothoraciques spaces must be symmetric and same level; the lateral edges of the chest must be straight and diverge from the ischium to the crease of the armpit; Back, neck should be long and full (and not show two vertical projections separating three gutters). In addition to the symmetry of the shoulders, hips and shoulder blades, they must charge no relief and trapezoidal lower beam should appear (in a non-adipose subject) until the twelfth Ridge; In position before bending, the pending head, the backbone must be regular and total convexity and knees above lie on the astragaliennes heads (and not back at the back of the heels); Profile, the tip of the nipple must be the most advanced point, below which the earlier outline of the thorax and abdomen must be straight to the pubis. The contour of the back must be visible, the arm separating 1/3 chest back and 2/3 forward. Members below, examined, the feet being met heel after the first toe (station which must always be easy); must touch: the top of the thighs, knees, calves and ankles internal; must be higher than the external ankle. The axis of the leg must pass through the middle of the knee, the middle of the intermalléolaire line and the second toe. The foot must widen the bead toes to diverge and extend to the ground. The lateral edges of the foot must be straight, internal notched by the internal vault which must be visible. »

This Paragon becomes the guide and the purpose of his method: If deformations are the source of our pain, only a method able to restore normal morphology really takes the problem at its source, believe. If the deformation evolves spontaneously, and entire life during, to the aggravation, it is that it is not immutable, fixed. And so it is possible, provided you use the right tools to bring the patient “polydéformé” to the polyathlète. And, even if it takes years, even if it never reaches the perfection referred. The ugliness is never “normal” and it is never too late. “Typologies” described by conventional chest physiotherapy (and number of his former students) are, for Françoise Mézières, deformities frequently encountered, listed. They are accepted, wrongly, as normal, because believed innate (which is incorrect). Typologies are the antithesis of the message of Mézières. In her view, accession to this common place condemn therapists to a perpetual rustinage. Also, the subliminal connotations arising therefrom are obviously much more harmful than the concept of Paragon. She is dismayed to see some of his students to venture into the systematization of suspicious matches between “morphological typology” and certain psychological characteristics? She them close his door.

Pathogenic assumption

It explains the deformations and dysfunction by perpetual shortening of sets called “muscle chains.” It defines the muscle as strings to polyarticulaires muscle sets (over several joints), same directions and inserts overlapping like the tiles on a roof. It describes 4 muscle chains: the posterior chain (from the back of the skull to the ends of the toes), the anterior-domestic string (in the belly: diaphragm and psoas), the brachial string (of the front of the shoulder to the tip of the fingers) and the previous string of neck (3 muscles on the underside of the cervical vertebrae). In permanent retraction, these channels require the body to twist in the three plans of space, thus away from its normal form. These deformations, in worsening generate pain and dysfunction. This working hypothesis changes radically from conventional physiotherapy: it is no longer a question of weakness, but shortening. Morphotypes are distortions due to retraction of the strings. Their stretch is supposed to restore normal and morphology, restore the function and remove the pain.

The therapeutic technique

To address shorter strings, Mézières proposes a set of postures on a specific breathing. The postures are active. Even if the therapist is involved, there is help, guide the work of the patient. It is the eye and hand. It is essential.

Hunting offsets

The principle of postures: Mézières appointed him “isometric contraction eccentric”. It is to position the target in the most stretched position chain, to seek its contraction without allowing the shortening. The chain contracts, tries to reconcile his insertions, there can’t and thus elongates. This principle is not unlike that of Mitchell to the United States at the beginning of the 20th century. This work, uncomfortable, causing reactions of defence that Mézières calls “offsets”. The therapist must neutralize. Mézières endorse the shortcut to summarized his method as “a long hunting offsets”.

There is no bad breath, there is that affected breaths

A specific breathing, of the 6 ° Act, accompanied by this work. It is based on expiratory time. It is free (without brake and therefore silent), regular and deep. It cannot be said that it especially abdominal or chest, because it is adapted to each patient. In the eyes of Mézières, it is impossible to re-educate incorrect breathing without changing the mechanical parameters: “breathing is not rééduque, it is free.

The two categories of manoeuvres

Mézières two types of manoeuvres:-those that correct to start a dysmorphisme given – those that make of at the outset a dysmorphisme given it favours this second category to declare “very effective.” If the first time aggravating posture is to badge a deformation, it goes without saying that, in a second time, things must return in order. We are pointing the responsibility of the therapist and we understand the requirement of competence of this woman for her students.

The treatment

The sessions are long (approximately 1 hour), individual (it is of course impossible for a therapist to manage several sessions at the same time) and manual (no equipment is used). Performed by expert practitioners who, in the spirit of Mézières, have an exclusive practice. The pace of the sessions (one per week) may come as a surprise, especially when we know that no work at home are requested.


With respect to the concepts

It is alleged Mézières easily generalize an observation to the whole of the case. Thus princeps observation: what she observed in 1947, could be transposed to the whole of the human species, in all cases? Mézières works to intuition. Some say that this was his genius. Others say that it was his weakness. It is true that this procedure is not compatible with the scientific approach and with medical research for which “the strength of the evidence” is law. His hypothesis about the pain is beaten in the face by some observations. Example: If the pain is caused by a deformation, how to explain that, for low back pain, it has never been possible to correlate pain pain with any body deformation. His explanation of the results is disputed: it argues that if patients are better is that it has stretched their muscle chains. But many scientists are in false. They show that it is impossible to stretch muscles on the living. The voltage in the stretching sensation is due to the tensioning of the fascia (fabric of muscles, richly innervated envelope). If results there (they have never been documented scientifically), they are therefore due to something else to unlikely muscle stretch.

With respect to the transmission

Educational poverty

If consensus to credit an exceptional gift of observation Mézières, is referred to as the happy visionary, it is clear that the Organization and education could have been better managed. Because of the lack of control of knowledge and diploma, there are almost as many different understandings of his message that they were students. Therefore, what wonder that this proliferation of parallel schools the best and the worst. The deficit of writings delineated and years passing message appears to know major distortions (group sessions, weight, work of inspiration, learning good posture, work on table). For the patient, as with the prescriber, it becomes difficult to distinguish things and whether such therapist says “mézièriste” is or is not in the right line of the teaching of the master disappeared. So many people to explain that the only person to have ever made the Mézières is… Mézières itself.

Sectarian functioning

It is also complains that Mézières of his aura of guru and the sectarian nature of his teaching. Even if it has all of an asceticism, his method has yet nothing mystical or esoteric: simply a relevant way to consider human mechanics. However, it is true that, for a few years, should be sponsored to follow his teaching. Similarly, it is not new that, for a time, she was sign to the students a commitment to practice the method exclusion of any other. This behavior that can shock was not, for her, a desperate attempt to preserve his work, to protect patients against the dilettantism and mercantile spirit that she exécrait and besieging it. It is in wanting to avoid Charybdis it rushed in Scylla. It condemned all parallel schools due to drift, which to the conventional physiotherapy, which to market psychology or techniques which had the wind as osteopathy. Notwithstanding, some associations and pharmacies claim yet “the spirit of the Mézières method”.

The particular case of the [non-neutral] Reconstruction Posturale

Founded in 1992, the Reconstruction Posturale is the only to be taught at the University. In its infancy, this school had ambition to rebroadcast as accurately as possible the teaching of Mézières. But quickly, the interdisciplinarity of the academia opened new horizons while requiring a scientific rigour which had no courses in the entourage of Françoise Mézières. So, 15 years after, the outside observer does distinguish, in the Reconstruction Posturale, as the remains of the original work. Drift or evolution? It remains that the Rebuilders are physiotherapists sorted on the component that require, after a three-year curriculum, reviews and a memory of University, to revalidate graduating annually. These recertification examinations are the entry ticket to be able to integrate the International College of practitioners of Reconstruction Posturale and appear on the directory of certified practitioners. This groundbreaking, unique approach in the medical landscape, reflects respect for patients and testifies to the difficulty of a complex and sensitive method.

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