Last week in Vancouver there transpired an amazing event:  The Third International Fascia Research Congress.   I’ll soon talk more about the Congress, some of its key findings, and what it means for nerve- and fascia-oriented bodyworkers.  But for starters, here’s a little poster submitted by me and Wil, summarizing some of our cross-sectional study of spatial relationships between nerves and fascial planes:

(Bonus points to the readers who can spot the typo.  Yes, I left it in.  For science.)

As we in the bodywork world begin to nerd out on a science literature that, for the first time, is being conducted with a knowledge of how we work, it’s important to ask how the onslaught of relevant information affects our treatment sessions.  So let’s take a look at another information revolution in medicine: the wound man.

Medicine in medieval Europe was no joke.  Anaesthesia, sanitation, antibiotics, and plain old soap were yet to be invented, and folks were no strangers to gruesome calamity.  Knowledge of anatomy was scarce, experiential, and inaccurate. Medical texts were expensive to reproduce.  In the case of treating an acute wound, you had to move quickly.  Doctors needed a compact guide for a whole variety of wounds.  And so emerged this very clever tool of medical texts.

Wound men are composites of medical information, showing human frames with a christmas tree’s worth of gory insult.  On a single page you find this unlucky guy, staring outward, gamely displaying a dagger in his ribs, a barbed arrow through his thigh, a cleaver to his foot, and twenty other hacks and stabs.  Adjacent to each wound is a short block of text  that communicates the essentials of treatment.  For all this rude specificity, it was a brilliant invention: a cheat-sheet for the doctor on the move.  It wasn’t pretty, but it worked.
Cool, right?   And thank goodness for modernity!  Medicine is now a more friendly enterprise, as practitioners strive for better patient care, more precise methods, and more accurate diagnoses.  Our training books are thick, and our information resources are effectively boundless. We don’t memorize short blocks of text but entire chapters.  We no longer turn the textbook page to see these wound men, suffering so stoically.

But are we really rid of them, or do they persist in our minds?  Think of diagnostic trees or muscle testing charts – we still try to imagine all possible problems before we investigate a patient’s body.  The danger with such thinking is that it’s easy to disconnect from the whole person standing in front of you.  Instead of a mostly healthy, mostly vital human being, the healer sees a wound man:  a collection of potential pathologies to be whittled down to the right one.

Bodyworkers and other holistic practitioners have a special interest in staying connected with the totality of someone.  We work in close collaboration with an internal healing force, and when we stop listening carefully to the body, we become useless.  So we pride ourselves in treating the whole person: our sessions are longer, our treatment rooms are disarmingly cozy, and in our examination we tend to look for systemic patterns.

But we are not free of wound men, either.  We see someone enter our room with a limp, and our minds fire off with a rush of possibilities.  (Foot / Ankle / Knee / Hip?)  (Acute / Subacute / Chronic?)  (Bone / Ligament / Muscle / Nerve?)  With practice, we can spot deviations, compensations, and limitations in our patient.  We begin to feel powerful in our assessment techniques, and these assessments often lead to better treatment.  Our patients are quite happy to hear a coherent story for why they are suffering — “Oh, so it’s my psoas?  Good to know.”

Deductive reasoning like this is essential for clinical bodyworkers, but it’s equally essential that we transcend it.  If all we see are broken things to be fixed, then we end up being glorified mechanics.  Patients leave our offices feeling comforted by information, but also hopelessly fragmented by it.  Their intake forms become a breathless litany of things wrong with them:  “Oh man, where to begin — my back is all messed up, my neck is out of alignment, my legs are the wrong length.”  Et cetera.

Even those bodyworkers using energetic, somatic, and shamanic methods are not immune.  They may fixate on more esoteric problems — the stagnation of Qi or the imprint of trauma – but they can fixate nonetheless.  And the effect is the same:  patients learn to view their bodies as malfunctional, untrustworthy, and dumb.

No matter what the model is that you apply, it’s still a trap if it’s all you see.   And that’s a shame, because it severely limits  the potential healing in bodywork.  Once we’ve made a session plan, it’s important to shake off the wound man.  If we friction some scar tissue on a cervical facet joint, can we also awaken a sense of strength in that neck?  When we treat misalignments, does our patient know what balance feels like?

This higher-order treatment requires us to do some things – make space, sit still, ask questions – that don’t seem exactly like treatment.  We may feel duty-bound to fill every moment of a session with some move or some intervention, lest we waste precious time and money.  But in fact the opposite is true: we are duty-bound to pause, to be curious, and to get out of the way.

If we attend only to fixing problems, then we have taken our eyes off the prize:  transforming a patient’s relationship to suffering.  And really, if that’s not your ultimate goal, what’s the point?

One of the most exciting aspects of present-day fascia research is the revelation that the nervous system is far more cognizant of the shakes, bounces, and torques of the fascia than we ever imagined.  This is due in part to the discovery of a whole new class of mechanoreceptors embedded within the fascia.  But we’re also finding that nerves are remarkably responsive to mechanical deformation.  Are there clinical implications here?  In most cases, it’s too early to be sure, but lots of folks are paying attention.  Count me among them, and if you agree, you should come down to the next Free Enrichment Seminar in Seattle:

This is the second in a series of three Enrichment Seminars.  We will explore the various innervations of fascia, the ways that cells and tissues perceive force, the best current explanations for acupuncture meridians, an updated understanding of movement disorders, of synaptic plasticity, and the limitations of a few methods for modeling the nervous system.

The idea with this 3-series of seminars is to provide an overview of the last 15 years of fascia science, to suggest why this matter for our work, and to give us the basic understanding necessary to discuss this stuff with physicians, patients, and colleagues.  It’s always, Enrichment Seminars are FREE and open to anyone.

From the Research section:

Mechanotransduction & the Nervous System

We used to think the nervous system didn’t care about its mechanical environment; that its physiology was more or less constant within a wide range of human movements and postures.  We don’t think that anymore.  Fascial structures like facet joints and retinacula, once thought “dumb”, may be important sensory organs.  Things like action potential, axoplasmic flow, and chronic neuroinflammation are all modulated by mechanical stress.  The question is, how much, and in what situations, and why should we care?

• Speed and temperature dependences of mechanotransduction in afferent fibers recorded from the mouse saphenous nerve (Milenkovic et al 2008)

• The relationship between the stomatognathic system and body posture (Cuccia and Caradonna 2009)

• Tensile stretching of cervical facet joint capsule and related axonal changes (Kallakuri et al 2007).

• Understanding Sensory Nerve Mechanotransduction through Localized Elastomeric Matrix Control (Lin et al 2009).