Down There Where the Spirit Meets the Bone

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The 10 days I spent in Germany this November for a workshop and Conference on the latest in Fascial Research was astounding. The amount of information shared was enormous and over the coming months I will be reflecting on this experience as I find ways that it will influence what I do with clients, as well as how it will effect what I do for myself to promote health and wellbeing.

Meeting a colleague and travelling to Guben

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In Berlin I met up with Trina Bailey, a friend and colleague from Australia, and travelled by train to Guben, a small town on the German/Polish border. Here we took part in a three day prosection at the Plastinarium, where renowned researchers Carla Stecco and Andry Vleeming dissected the fascia of cadavers revealing the structure and relevance of the human fascial system.

Prosection is where you watch (and in some cases participate) as an expert dissects a human cadaver.

3 Day Prosection with Carla Stecco and Andry Vleeming in Guben, Germany

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The Plastinarium sits on a quiet street in a very quiet town in a large brick warehouse. This is where donated bodies are put through a process of removing all the water from the body to be replaced with liquid plastic in order to preserve the body. Plastinates are used in the BodyWorld exhibits that travel the world, or as teaching and training models for universities and medical schools.

Carla Stecco of Padua University and Andry Vleeming of the University of Ghent shared their knowledge of fascia through lecture and dissection with 26 very fortunate participants from around the world. Yoga Instructors, Phsyiotherapists, Massage Therapists, Chiropractors, Acupuncturists, Orthopedic Surgeons and others represented the wide variety of health practitioners interested in the evolving research on fascia.

Most dissections remove the fascia to “get to the good stuff” – the muscles, ligaments, tendons, organs, and bones. This dissection was all about the fascia which is becoming increasingly important as we discover its role in immunology, movement through force transmission, whole body communication (proprioception and introception), and pain.

In the words of Tom Myers author of Anatomy Trains: “There is plenty that science has yet to learn about how we sense the body in motion, and how our clients make sense of our work in themselves.

Fascia happens to be the most wired sensory organ in the body with more sensory nerves in it than you have even in your eye or your tongue, and it has maybe six times more sensory endings than your muscles.

That body you call me is actually a community of about 70 trillion hard-working cells, all surrounded by a fascial network—a kind of sticky, greasy fabric that runs around all those cells and holds them firmly together, yet miraculously adjusts to shape and accommodate our every movement.

The fascial network consists of fibers, made mostly from pliable collagen, stronger than steel, woven into ropes, nets and sheets. This web runs everywhere. It is very dense in your tendons and ligaments, and much looser in the breasts, cheeks or pancreas—but all your cells are wrapped into this weave.

The other half of the fascial network is a transparent gel of variable mucopolysaccharides. (More simply: snot.) Basically, your cells are glued together by this mucous, which is everywhere. These sponge-like gels take many forms—the gel in your eyeball, the synovial fluid in the joints, the chondroitin of cartilage—and is more or less watery (hydrated) depending on where it is in the body and what condition it is in.

Your various nerve endings—muscle spindles, Golgi Tendon Organs, Ruffini corpuscles and the rest, all modifications of stretch receptors—are woven and entwined into both the fibrous and the gluey parts of fascial matrix.

One of the primary benefits of massage therapy is that it stimulates these nerve endings in the myofascia, leading, of course, to less somatic amnesia and a more sensitive appreciation of the body, a more complete body image.”

Research is revealing how this awareness reduces our perception of pain and can alter function. How the fascia enables movement through the matrix and transmits force and recoil throughout the body is partially revealed through the study of its structure in dissection.

Here are some key concepts from the workshop:

  • Our body is a composite structure that relies on complex relationships.
  • Myofascial slings, both solid and soft have a major impact on pelvic and low back pain. Fascia is like a sail, adapting to muscular forces creating reinforcements where force is applied, giving us a strong yet light structural support.
  • Where fascia attaches to muscle and joints it increases our internal awareness as specific receptors are stimulated and relay this information throughout the nervous system. This allows for coordinated movement and inner awareness. Mindful movement helps strengthen our system and reduce our experience of pain.
  • The roles of form and force closure (closure due to anatomical structure and fascia/muscles/ligaments) were discussed in relation to the sacroiliac (SI) joint in pregnancy and low back/pelvic pain.
  • Force transmission affects adhesion and scar tissue remodelling. Movement enhances forces that stimulate fibroblast regulation of collegen fibre creation and structure within the fascia. Our fascia is constantly remodelling due to our movement. Move and move playfully.
  • Diaphragmatic breathing is crucial to activating our supporting fascial and core muscular system. Support can be reduced to 40% by shallow or chest breathing.

5th International Fascial Research Congress, Berlin

Those tending to fascia are the dedicated environmentalists of the bodywork field. Clean air, fresh water, playful movement, supportive relationships, healthy fascia~ The “seeming spaces in between” teem with life, and are as relevant as can be. That’s the story I’m telling for now. – Gil Hedley, PhD Anatomist offers dissection videos, online courses, in person intensive dissection workshops, books and a whole-body, approach to anatomy, through his company, Integral Anatomy.

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During the two day conference we listened to plenary speakers, attended concurrent research presentations and walked through the poster presentation area and the Fascial Plastination project which featured sections of plastinated fascial tissue from the human body. There were close to 1000 people in attendance at the Urania conference centre.

In addition to the more formal research presentations and discussions, we saw two fascial movies, a dance performance, danced on the river boat dinner cruise down the Spree river, and viewed and participated in an art installation created by two Canadians entitled, Boxtape. This continually evolving sculpture, formed from rolls of box tape, resembled the structure of the body’s fascia. It was a big hit with participants and the public both inside and outside of the conference centre.

Here is a selection of research highlights:

  • Carla Stecco has discovered a new cell, called a fasciacyte, that regulates fascial gliding. Densification of fascia and the lack of, or increased viscosity of, the lubricant hyluranon has been implicated in myofascial pain syndromes including low back pain.
  • Sex hormones play a role in extracellular matrix remodelling meaning male or female sex hormones, pregnancy, and menopause will have direct effects on the structure of our fascia.
  • Paul Hodges presented a multi-faceted approach to the understanding of back pain through movement control, respiration, balance, neuroscience, and emotion.
  • Three researchers presented their research related to the fluid dynamics of the extracellular matrix and/or lymphatic system. Their research overlaps in interesting ways, and even challenges each other.
    • Neil Theise talked about the view of the body as an endlessly divisible fluid continuum. His research focused on pre-lymphatic channels in the billary duct.
    • Peter Friedl studies how fascia adapts to cancer and metastasis using confocal laser microscopy.
    • Melody Swartz spoke of the importance of fascia as it relates to lymphatics and fluid flow through our tissue.
  • Daniel Lieberman presented on the evolution of upright posture for walking (bipedalism). He emphasized the importance of strong feet and healthy fascia of the plantar surface of the foot, achilles, and IT band, and it’s role in the swing spring action that makes bipedalism so efficient.
  • A central message from all the research: Move more often and move playfully. To stay healthy we need to counter the fact that the human being is the most domesticated animal on the planet. We have largely removed ourselves from our natural environment and created a new one that restricts the quality and quantity of our movement on a daily basis.

How all this new research will influence clinicians in their work with patients and clients is an ongoing process. Researchers mentioned that the more we learn, the more complex it becomes. Research leads to more questions and exploration. I feel fortunate to be connected to this community of people exploring our understanding of our internal environment, and how we can use this to support the health and wellbeing of us all.

I have registered for another conference in Vancouver in March whose focus is on manual therapy techniques influenced by the latest knowledge of the human fascial system. Another learning experience to look forward to.

5 Comments

  1. Wow! You are full of it …. knowledge, that is! So glad you’re finding such success with your studies and enjoying yourself, too. -Jacqueline Kurmey

  2. Paul. Fabulous info! Must have been so interesting and exciting to meet the people who are discovering and working in this area; certainly a forefront in body research and so intergral and important to out general health! You are amazing!!!!

  3. It was an incredible experience to meet the leaders in the field. Having this connection with people who think outside the norm and dive into new territory is a true blessing for me; so inspiring. I am looking forward to the Vancouver conference in March where we take all the latest research and delve into manual therapy treatment approaches to incorporate into our practice.

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