Fascia Abstracts

For all Structural Integrators -- whether you are lucky enough to be attending the Fascia Research Congress in Amsterdam or not -- get ready to whet your fascial research appetites. Abstracts from the 2009 Congress are now available on line.

I've only had time to read the first abstract, about the crural fascia, and already my mind is expanded. My work is ready to be even further refined.

In summary, the crural fascia has two to three layers of mostly collagen fibers, separated by a thin layers of loose connective tissue. The fibers of each layer lie at about 78 degrees to the layer above/below. The loose connective tissue allows single layers to respond more effectively to different tractions.

So now, in session two or in any work on the feet and lower leg, I will change my focus from the crural fascia being a single layer (rookie mistake that I've been making for eight years) to create more freedom and ease of movement within the layers.

This abstract reminds me of the presentation at the 2007 Fascia Research Congress by Dr. Fourie about the function of the fascia lata. He supported the fascia lata as an organizer of movement between muscles of the thigh. The tugs and pulls on the fascia lata create a mechanical information network between the muscles. I assume this is true as well for the crural fascia, making this differentiation between layers a vital component of organizing movement of the lower leg.

Take a look at the other abstracts and feel free to write a summary to share with us.

Afraid of Elbows

As a structural integrator, it’s embarrassing to admit that I’m afraid of my elbows. I’ve always thought I was doing my clients a favor by using my fingers, knuckles or back of hand, since I felt more control and feedback from these tools. Turns out I was wrong.

The turn-around started when I received a great Rolfing session from Karin Edwards before a workshop I gave in Portland. Karin used her elbow to release the front of my neck. Of course, I use my elbow -— or to be more precise, the flat of my upper forearm -— on tougher tissues like the IT band, fascia lata, lumbodorsal fascia, or plantar fascia, but how would the delicate tissues of my neck stand up to the point of her elbow? Quite well actually. It was great release.

Back in my office, I decided to experiment. Each client for the next week received two neck releases, the first with the backs of my fingers and the second with my elbow. I asked for their feedback, and all but one felt that the second release was more profound and less pointy. You can’t deny the experience of 15 clients. I needed to employ my broad elbows more and my pointy fingers less.

The flat of my elbow has since given respite to my fingers many times. The point of my elbow is cleaning more bony prominences. I am able to engage larger layers of fascia with the flat of my forearm. My confidence grew, but yesterday I faced the biggest test.

A client remarked that my psoas work was too pointy. Too pointy? Obviously, my elbow was the answer. Could I get over my fear that the elbow was too powerful, too prone to cause damage? Fortunately I did. His psoas released nicely with more comfort and my elbow gained another experience of learning to feel and adjust.

As I’m employing this new tool, I’m trying to use both my left and right elbows equally. Ironically, my left hand receives better feedback, but my right elbow seems more in tune with the work. So I switch between hands and elbows when needed and am enjoying the process of improving my skills and client outcomes.

On what anatomical region does your elbow do the best work?

--Anita Boser, CHP

Anatomy Trains Dissection, Day Two

Forward Into the Past...

Today I'm thinking about the last day of my first dissection class and I was in up to my elbows and over my head. I’m lucky I didn’t sprain anything.

 

I was working on exposing and removing the upper portion of the Superficial Front Line (which runs from the rectus abdominus up the fascia along the sternum and sternalis and on up to the SCMs on both sides – do a simple standing back bend to feel this fascial line of pull ) in it’s entirety. I was carefully teasing up the sternalis muscle. It was delicate and thin, thin like carpaccio. Todd Garcia, director of the lab, came up and complimented me, telling me this was one of the best dissections of a sternalis in progress that he had seen. I felt ordained.

Tom Myers then came over, worrying at me like a fretful mother to be careful not to cut through this gossamer myofascial unit.

“Don’t worry, Tom, don’t worry,” I assured and shooed him away, hadn’t I just been ordained?  – but he was still worried, as I would have been if these were my theories.

In dissection you often use the blunt ends of things, like medical probes or the blunt side of the scapel, to tease and gently pull the tissues away from each other. That's because the sharp side of the scapel can so easily shred what you’re going after even when you are very careful.

So I carefully returned to my task. Gently hold the tissue up with foreceps, delicately tease away a little more. Hold the tissue up, tease away a little more. It gets quite hypnotic: hold tissue up, tease away more; hold up, tease away, hold, tease, hold, tease, hold, sh**...

There was no rewind, no undo – I had shredded right through the sternalis. I called Tom to my table, may as well face the music as fast as possible.

His green/blue eyes gazed at me from above his surgical mask. My mouth opened and words came out, but not any that formed a coherent sentence. My hands and arms recreated the scene of the accident for him.

Without missing a beat he asked me: “ So, what did you learn from this?”

“Um,” I stammered, “ That the strenalis is way to flimsy to do what we think it does in the Superficial Front Line?"

His gazed softened in its intensity and shifted to a look I can only describe as crestfallen: his beautiful theory had been shredded by an ugly fact.

Flash-forward 6 years later and KMI graduate Jeff Mahadeen does what I and others since have tried but not managed, he excised the upper SFL intact!

While the current wisdom is that most people don’t have a sternalis, and while Richard (remember, we name our bodies) had a very well-developed one, Todd believes that the sternalis has a tendency to be not only underdeveloped but that very few people have the ability to excise it properly.

I would tend to agree.

Great work Jeff !

Anatomy Trains Dissection, Day One

I knew it was going to be a good day the moment I keyed the ignition in my rental car. I expected a blast of hip hop from the always left-on car radio, instead it was Blue Oyster Cult’s “Don’t Fear the Reaper”.

I take these things as signs.

It’s a real privilege to given the task to document Tom Myers’ findings in video and pictures. It’s also real work and great fun. This is my third human dissection lab, the first was in 2003 and was totally overwhelming. The second was better because I understood so much more. This time I’m hoping I might actually see something, if you know what I mean.

While I’m now accustomed about what to expect in this environment, this was my first experience with a fresh tissue cadaver. When I walked into the lab I was stunned. Stunned because a first blush I couldn’t tell the embalmed bodies from the fresh one.

I once worked for 18 months on an embalming crew for a sizable funeral home chain in South Florida but I have never, ever seen such beautifully embalmed bodies as these two – Millie and Richard (yes we name them). I know their rosy glow comes from the embalming fluid, but embalming is a skill like any other and these were done by a master.

In short, these are the healthiest looking dead people I have ever seen. 

The fresh tissue cadaver, George, is a burly, hearty specimen and working on him is the domain of  Todd Garcia, Director of the Laboratories of Anatomical Enlightenment.  As the skin and fatty layers were removed to reveal the muscles and fascia I was fascinated by the size and thickness of both his latissimus and his lower trapezius. Looking for all the world like flank steak I found myself wondering: how is it that I believe that I actually can work through those in order to affect change in erector spinae beneath? 

Todd is quick to point out how even in this state the muscles and fascia  respond to the slightest push, pull and tug and how these forces are very visibly transmitted throughout the surrounding areas both in depth and breadth.

Tom Myers reminded everyone that Deane Juane said it best in his book Job’s Body: 

 “ To touch the surface is to stir the depths.”

For me much of the day is spent running sound and camera tests, procuring suitable photographic dropcloths –  I wonder what the folks at Joann Fabrics would have thought had they known what I was up to (as it was they wouldn’t cut the bolt into 2 yard lengths I needed due to liability issues *sigh*); and then getting the necessary hardware to build a makeshift platform over the fresh tissue cadaver so we could get shots from directly above when needed.

By the end of the day we got the first ever shots of a fully dissected Back Functional Line. The footage looks and sounds good, and Tom and I are pleased with the first day’s progress.

David Lesondak, CSI, KMI

The Benefits of Salt Baths

When clients leave my office, they usually carry a snack-sized zip lock® bag of salt, with a request from me to take a bath with them. Some consider it a good luck charm to continue the “looseness” created by the session. Others think it de-toxes their muscles. A few realize that it supports the body’s chemical balance. That’s actually the progression of my thinking through the years as I’ve been using Epsom and then Dead Sea salts.

My first introduction to salt baths was when I was in karate. After an intense workout, session of gumite, or test, our sensei would suggest (in that commanding way that Senseis make any suggestion) a bath with one to two cups of Epsom salts dissolved in the water. He didn’t know why, but would recommend it for every ache and pain. I sometimes wondered if I should just dunk my head in the bathtub when I had a migraine.

Then I became a Hellerwork practitioner and after a few years in practice suggested that a client see a local Rolfer, Kathy Porell, since I wasn't helping her make progress. Kathy gave her a bag of Epsom salts after the session. My client told me that every place that was in the bath didn’t hurt and every place above the water line was sore. So then I started giving my clients Epsom salts, too.

Clients asked me why they should use the salt baths. It didn’t seem professional to say “I don’t know” or “It’s a good luck charm,” so I did a little research. At first, my queries led me to believe the salts helped flush toxins like lactic acid from the muscles. For a while, I misled my clients with that information. While that is one small part of what Epsom salts do, they are more important for what they add to the body rather than what they take away.

A friend who is an acupuncturist, Susan Froelich, (by the way, I met her at the 2007 Fascia Research Congress) extolled the virtues of Epsom salts in a conversation one day. She also recommends it to her clients. Doing a little joint research via the internet, we found the Epsom Salt Industry Council’s website. Epsom Salts are made of magnesium sulfate, MgSO4 and according to the Council, magnesium aids in chemical reactions, especially those of muscles and enzymes, and sulfates flush toxins and improve the absorption of nutrients. The U.S. National Library of Medicine credits magnesium with:

* Contraction and relaxation of muscles
* Function of certain enzymes in the body
* Production and transport of energy
* Production of protein

A Rolfer colleague in Portland, Karin Edwards, also recommends Epsom salts. She finds the results are significant for people when they are very deficient in magnesium and sulfates, which is why the first bath is usually most noticeable.

One day I was very sore after an intense session of yoga and went searching in the bathroom cupboard for Epsom salts. There were none. Oh no. Would sea salt work? After all, swimming in the warm ocean is therapeutic; perhaps because of the salt. However, the main component of sea salt is sodium chloride with trace minerals. A bit more searching under the sink produced a small bag of hand-mixed bath salts given to me by a client. This ½ cup of salts was better than nothing so I tried it and was amazed. Amazed!

This small bag of salts was much more effective than two cups of Epsom Salts. They were Dead Sea salts, Bokek brand. I’ve been buying them ever since from Saltworks in 55 pound bags to give away at the end of each session. I buy two bags at a time so they are $80 per bag and that lasts me (actually my clients) 3-4 months.

The chemical composition of Dead Sea Salts is more complex.

Magnesium Chloride (MgCl2) 33.3 %
Potassium Chloride (KCl) 24.3 %
Sodium Chloride (NaCl) 5.5 %
Calcium Chloride (CaCl2) 0.2 %
Bromide (Br-) 0.5 %
Sulphates (SO4) 0.15 %
Insolubles 0.03 %
Water of Crystallization 36.4 %

Is magnesium chloride more easily absorbed than magnesium sulfate? Is the addition of potassium and the trace of calcium what make the difference?

Recently I have new client with fibromyalgia who has been using Epsom salts mixed with fresh ginger. She finds that more effective than plain Dead Sea salts. We haven’t tried to add the ginger to them yet.

This makes me wonder if a mixture of Epsom and Dead Sea salts wouldn’t be a good choice, or perhaps giving my clients a bag of each to try.

I’m interested to know what observations and experiments have been made by others. Please share your experiences in a comment.

-- Anita Boser, CHP

20 Questions, One Answer?

Do you remember that game we played as kids called "20 Questions"? Well now there's an electronic version called "20Q" which won the coveted Toy of the Year Award for 2004. Apparently it utilizes some rudimentary form of AI, Artificial Intelligence.

20Q is small, egg-shaped, has a read-out screen and 4 buttons: "yes" , "no", "sometimes", "not sure". It also speaks! ( that feature can be annoying, fortunately that option can be switched off.

It's also really, really smart.

Or should I say its very well programmed?

I was introduced to it at my friend/KMI Grad Bob Vinson's house during the first Fascial Research Congress at Harvard. He and his son find it ideal for car trips. so we played with it for a while. The way it works is just like the game, you think of something and then answer the questions the machine asks, the first one always being: Is it animal vegetable or mineral?

Thinking I could out-clever the machine I tried: "spaceship". Yeah, that little plastic egg will never get that. Well it did.

It also guessed "wineglass" and "sandbox". So I tried "rose" ("flowers" being too generic). The 20th question from the magic egg read: "Is it a rose?"

Then the obvious hit me – fascia, no way will the eerily magic 20 Questions machine guess that. I proceeded to answer the questions as best I could.

"Animal?" No. "Vegetable?" No.

"Can it be washed?" – Well, no, not really.

"Is it black?" Definite no.

"Is it flexible?" Yes.

"Is it something you bring along?" – Well, sort of, but Bob pointed out that the correct answer as far as the machine's logic was "no" , its not like going to your friend's house for dinner and bring flowers (or a rose), so "no" its not something you bring along.

The sarcastic prompts it sometimes gives between questions were starting to diminish. This little computer was one the ropes now, I could sense its electrons giving off the equivalent of digital sweat.

Finally we got to the 20th question, the guessing question. Certain that it was stumped, we were all floored when 20Q asked:

"Is it the soul?"

-- David Lesondak, CSI, CMT

Explaining Our Fascia to Our Clients

Structural Integrators are often the first to explain fascia and tensegrity to our clients. Not only are these concepts new to many people, they can conflict with (mis) perceptions of how bodies work. It can be a challenge to help someone understand the interconnectedness of their being, but with the right tools, we can help fascia become as well known as core muscles.

In the recently released International Association of Structural Integrators’ Yearbook of Structural Integration, there are a couple of articles that give metaphors for tensegrity and fascia: A Fresh Look at Tensegrity, written by Sherri Cassuto and Helping Clients Understand Their Fascial Network, written by us. Here are a few of the highlights from these articles.

Anatomy Atlas
Not every anatomical atlas really gives fascia its due, but the Wolf-Heidegger Atlas of Human Anatomy is unique. What's notable is that it features side by side illustrations that are virtually identical except one includes the deep investing fascia overlaying the tradition muscle picture. In addition, a more detailed atlas of the head, neck, thorax, and pelvis is available, as is one for the body wall and limbs. These books are not inexpensive, but since a picture is worth 1,000 words you might find them worthwhile.

Tensegrity Models
A fundamental part of tensegrity is synergy between components, where push and pull have a win-win relationship with each other. Anatomical tensegrity models are available through Intension Designs. A basic pelvis model starts at $125, vertebral masts are $250, and a full body model is $2,000. In addition to showing the complexity of relationships between parts to clients, these models also help the practitioner visualize the three-dimensional workings inside our clients.


Jello (R) Anyone?
You can use gelatin to show the difference between healthy and unhealthy fascia. Make a batch and put it in the refrigerator for a month to let it dry out and become just like unhealthy, sticky and dense connective tissue. Then make a fresh batch, so you can show your clients both at the same time. This somatic experience makes real the stickiness that binds their tissues together and contrasts it with the juiciness of healthy tissue. Along with that can come an understanding of the nature of transformation, not from short muscles to long muscles, but from dehydrated and inert to alive and organic.

Movie Time
The 2007 Fascia Research Conference showed a film taken by French hand surgeon, Dr. J. C. Guimberteau, that showed how the fibers of living connective tissue remodel themselves moment to moment based on the surrounding structure’s tension. If you have a TV in your office and your clients aren’t squeamish, they may delight in the aliveness and interactivity of connective tissue. We know Structural Integrators love to watch it. His DVD “Strolling Under the Skin” is available through Anatomy Trains for $60 or from Somatics for 45E.

Tensegrity, a Design for Structures in Motion
Sherri’s article, as the title suggests, takes a fresh look at tensegrity with the focus on dynamic, moving structures. Her eloquent metaphor of a bicycle wheel demonstrates how design can facilitate movement with the ability to adapt to changing environments. For example, a wheel temporarily changes its shape and distributes the force throughout the structure when going over a curb.

Sherri’s fishing rod metaphor, which articulates the relationship between muscles and connective tissue, is unique and useful. She then takes the fishing rod image into an intricate exploration of the body in motion, including the concept of bone bending.

The articles in the Yearbook give more in depth analysis and examples. Please feel free to share your ideas. What fascia and tensegrity metaphors do your clients relate to? Do tell by posting a comment.

Welcome!

We find fascia and all the various flavors of Structural Integration to be endlessly fascinating.

The goal of this blog is for our professional to become as cohesive and enmeshed, but still independently mobile, as the interwoven fibers that make up the fascial matrix of our body. We'll be posting our opinions and impressions of "the Work" (as Ida Rolf called it) and our notions about the wider world of fascia health.

Follow our blog or check back often for a regular source of fascia-nating information. We welcome you to add to the conversation with your comments.

Join our community of Structural Integrators and Fascial Fanatics and share your thoughts, feelings, ideas and insights.