Sunday, August 26, 2012

Looking forward and back, post San Diego

I feel rested now, and able to sort through most of the impressions from the San Diego adventure. I always come back from such glaring exposure feeling a bit raw and undone. This never has had anything to do with the teaching itself, which goes well enough, usually, or the hosting which has always made me feel very well-cared for. It has to do with me, and with the fact that my favorite thing in the world to do is sit quietly at home, reading and thinking, not physically jostle up against hundreds of people in unfamiliar airports, or stand up in front of a group pouring it out for a couple days straight, or make dozens of new friends, or see the world. 

I realize that 'what doesn't kill me will only make me stronger' (exercising has taught me that); I've adapted quite well, I think, considering that the number of times I've taught can still be counted on fewer than two hands: Still, I have to factor in that traveling around and teaching sucks a lot of life out of me; this isn't a life I'd ever choose - it's chosen me somehow, and I'm trying to respond to it, comply with it, because the feedback I'm getting is warm and positive, and I figure it must be important to people even though I still scratch my head, wondering, "why me". 

Anyway,  remarkable things do happen at these encounters sometimes. They have a way of emerging all on their own once a set of logical ideas are laid out in a logical way. I'm not saying remarkable emergences are consistently predictable, or expected. Just that there is something about collective human interchange that sparks something, in people, in real time, in groups, that just doesn't spark outside of real time. 

Something which happened as a consequence of this encounter, is a reflective, thoughtful blogpost by one of the attendees, Walt Fritz, a teacher himself, What I did on my summer vacation. In it Fritz lays open a view of his cognitive shift over the years and some back history on SomaSimple. He mentions a thread in which a battle occurred (virtual only, no actual blood was drawn). 

Here is a link to Myofascial Release: The Great Conversation, from 7 years ago. Warning: it's long. Very long. 

I've yet to read any "conversation" about manual therapy, about ideas associated with it, both good and not good, before or since, that covers as much territory from as many angles so passionately or thoroughly. We finally had to lock the thread to stop it: the observation was made by the administrators and moderators that the topics were circling/repeating endlessly, orbiting entrenched, immovable positions. It was deemed time to move on to other topics. 

Bernard put it on the front page of the forum that we might never have to go over any of its content again. Presumably, MFR enthusiasts who might be drawn to the forum find it easily, and after reading it, either stick around because they are interested in learning what else there is to find out, or they find their beliefs too challenged, are repelled, and leave before trying to engage members in pointless debates about fascia, its supposed magical properties, and how great their own hands are at "releasing" it. Anyone who joins the forum and doesn't happen to see the link, and starts to talk about fascia, is quickly provided with it, asked to read through the "great conversation", and get back to us afterward with any thoughts they (might still) have. 

I met Walt in person last weekend, and am reasonably sure that he's a nice, reasonable, genuine, caring therapist, who, although he took some virtual lumps, did so graciously, and appears to have come through the last 7 years right side up.  He has moved away from most of the memplexes of MFR, it would seem (except for the name itself, which is a memeplex all its own.. and I disagree with a commenter who suggested putting the letter "N" in front of the letters "MFR" - sticking neuro in front of a tissue-based operator treatment concept won't help rehabilitate it into being a more ectodermalist, nervous system-friendly, interactive one, I'm afraid).  

Walt has distanced himself from his previous mentor. It seems he has become his own mentor, which is is what the profession needs - people who learn to think for themselves, who choose to not readily buy into crazy, completely off-base ideas promoted for profit by charismatic people.  

SomaSimple actually owes Walt a debt of gratitude, for without that "great conversation", we may not have reached as many minds as we have so far. So, on behalf of SomaSimple, thank you Walt. And welcome back. 

Thursday, August 23, 2012

Back from San Diego. Pleasantly exhausted.

I was gone 6 days, two of which were spent air traveling/airport stress, two of which were spent teaching nonstop, and the other two were spent visiting Sea World, the San Diego Zoo, and the Birch Aquarium with my very congenial hostess, Rajam Roose, who also co-organized the workshop, so I could introduce dermoneuromodulation to massage therapists.

We also walked the halls of the university in La Jolla, where Ramachandran roams. We didn't want to disturb him, obviously, but we saw the door to his office, and quite a thrill it was, I must say.

The tourist destinations involved miles and miles of walking. The zoo in particular is huge. We walked steadily, for  four and a half hours, with lots of hill and stair climbing. Together we estimated we walked about ten miles at the zoo alone.

But it was soooooooo worth it! We saw the baby jaguars, the huge silverback gorilla, and... well, everything else that lives there, actually.

No wonder I'm absolutely exhausted today.
Good thing I booked myself off a hermit day today. I'm too tired to even unload pictures I took. Maybe later..

Monday, August 13, 2012

More from Raven

I feel vindicated.

"Having worked with this anatomical information issue for some years now, I can assure everyone that it's not really as bad as Jacobs suspects.

"It's much, much worse."

..... from Raven's latest blogpost on this annoying and confounding anatomy mis-labeling: 

It all depends on what the meaning of "is" is: 05-Augean Stable Song, part 1 (#12/31)

Also see:

ADD: August 23/12:
There are a couple more of these blogposts by Raven, #13/31, and  #14/31.
I asked her privately if she agreed that just using the term "superficial fascia" (instead of a more appropriate term, such as hypodermis, or subcutis), just contributed more hole to the hole in the hull, to a deepening of an undesirable meme, and she said she did. 

I consider this topic now successfully dealt with, and closed.

Sunday, August 12, 2012

Here's Raven - again!

Ravensara Travillian continues to dig deeply into developing her answer:

It all depends on what the meaning of "is" is: 04-Pandas and raccoons and bears, oh my! (#11/31)

Raven has dug in her shovel, and is carefully unearthing, then brushing into relief, all sorts of archeological strata in order to design the most meaningful and careful answer to a question that anyone has perhaps ever provided anyone else ever. Read her answer closely. Learn about philosophy. Learn about ontology. Learn about taxonomy. 
She likes investigating layers, and not just anatomical layers - layers of knowledge!

This shouldn't come as a surprise to anyone, necessarily, but here we have an actual trained educator talking (not just an amateur who reads a lot and has many opinions, like.. oh, myself for example...), and... AND, she is showing us the inside of her very well-appointed mind
And she's doing it for free. 
And I'm in awe, because a very very tidy mind it is; it appears to be organized into beautiful little coloured bullet points! 


Saturday, August 11, 2012

Heeeeeeere's.... Raven!

Ravensara Travillian has kindly responded to my blogpost from yesterday, Hole in the Hull!, with a set of posts on her POEM blog:

It all depends on what the meaning of "is" is (#7/31)

It all depends on what the meaning of "is" is: 02-What a wicked game we play (#9/31)

My understanding is that she intends to flesh these posts out more. Stay tuned - give the woman space so that she might explain how this whole fascia thing seems to have gone so sideways. 

Update: New blogpost by Raven:

It all depends on what the meaning of "is" is: 03-Are we even talking about the same thing at all? (#10/31)



This looks promising, like it could turn into one of the most fruitful conversations I may have ever had on the internet. If so, I hasten to get all my ducks lined up in a row, fuelled by anticipation. 

1. I want to include this observation I wrote a long time ago, reflecting on the difference I perceive between operator and interactor models of manual care. 
Manual therapy and its models

2. Also, see Treatment Continuum, a series that added visualization to the operator versus interactor ideas in the previous link. 

3. That series is linked into DNM in a Nutshell, a compilation of compilations in one simple link that I send to people who are interested in learning about the underpinnings of dermoneuromodulation. 

Well, these aren't all the ducks I have, but they're a start. 

If anyone can get to the bottom of the dilemma, I'm sure it will be Raven. She comes complete with scholastic heavy artillery, academic acumen, and a heart large enough to embrace all the foibles that have ever arisen in the world of human primate social grooming. Until later. :-)

Friday, August 10, 2012

Hole in the hull!

Lately on Facebook I've had the opportunity to peer into the abyss of determinedly persistent mesodermalist confusion from several angles:

It all started when I read a post by Ravensarsa Travillian, Finding your space: Anatomical reasoning and our relationship to realism. 
In it, she discusses comments made by a currently popular anatomy teacher in manual therapy circles, and deconstructs them.

This statement (from Ravensara's post) was pointed out in a conversation I was having with another manual therapist, a fascia-based reasoner by my reckoning;
"Superficial fascia, on the other hand, is an organ, but only one of its components has an endocrine function, so again, he's using terminology wrong: it's not an endocrine organ, although one of its components has an endocrine function."

What the???? First I kicked myself for having not seen it. Then I thought maybe Ravensara had made a mistake. So I asked her about whence it had come. She kindly supplied the reference. A verifiable source. She even brought in an anatomist from there to clarify. That's just the sort of careful, kind, even, responsive and generous scholar she is. He verified it, although there is still a bit of an open question about whether superficial fascia is an "organ", or just an "organ part".

I thought to myself.. must investigate this statement a bit further. How can a "tissue" be considered an "organ"? Organ part maybe, but "organ"??

I dug around in Gray's Anatomy online. Here's what Gray's says:

"Fascia is a term applied to masses of connective tissue large enough to be visible to the unaided eye. Its structure is highly variable but, in general, collagen fibres in fascia tend to be interwoven and seldom show the compact, parallel orientation seen in tendons and aponeuroses. 
"Superficial fascia is a layer of loose connective tissue of variable thickness that merges with the deep aspect of the dermis; it is thus also known as the hypodermis. It is often adipose, particularly between muscle and skin. It allows increased mobility of skin, and the adipose component contributes to thermal insulation and constitutes a store of energy for metabolic use. Subcutaneous nerves, vessels and lymphatics travel in the superficial fascia"

My bolded italics.
This is depressing news. 
I had no idea that "fascia" meant, or was synonymous with, anything other than some sort of gluey stuff extruded from sparsely located cells, barely metabolically active except for cranking out vast amounts of sticky molecules, a trick that comes in handy in a heterogenous organism which has some parts hugely expensive to maintain (e.g. nervous system, only 2% of the body but requiring 20% of all the fuel), important for keeping an organism from falling apart, and for giving its more active contractile elements a place to anchor.
My idea of superficial fascia was that it was that fine filamentous spider-webby areolar stuff adhering the hypodermis on to the outside of the body, and to the dense fascia that overlies it. I confess, it was my conjecture, based on what I think is logical.

Now here is Gray's, saying it means hypodermis. Something is definitely wrong on the internet. Something might be seriously wrong in anatomy!

It seems to me Gray's is calling all animals in this layer cows, instead of just some animals. I look at this with jaw resting on floor. I really do think it amounts to a taxonomic error on the part of anatomists. I'm calling them on it, right here.
I think the term "fascia" should be left as a description of a particular connective tissue type, not an assemblage of tissue types that obviously comprise an organ, hypodermis, that has a particular function, i.e. thermoregulation, and through which passes indisputable neural structure which can't be classified with fascia no matter how hard you try to stretch it! ( pun intended.)

The world of manual therapy is like a spaceship. And I feel like I just discovered the conceptual hole in the hull.

Because of this one single factual misnomer, countless generations of manual therapists have been sucked out into space, have had their minds snapped shut while simultaneously being made to contemplate the bogus idea that they have magical hands that can somehow overcome the logical purpose of fascia, which is to keep the body from coming apart, all because of a careless slip of taxonomic nomenclature stemming from the dissection habit anatomists have of slicing this blubber layer right off so as to get to viscera etc., useless and hindering as it is in a cadaver specimen, not investigating it from the perspective of how it might respond in a living human when touched from the outside, say by a manual therapist, who clearly cannot get his or her hands past the barrier of the heavily innervated outer dermis (not without introducing infection, at least), or past reflexive motor guarding by spinal cord function via autonomic and somatic motor efferent, and visceral afferent neurons. And it has been replicated, as a meme, as an error, by anatomists, apparently with high fidelity.
So, based on this careless anatomical overlook, manual therapists have been taught, carefully, in a stepwise, apparently anatomically acceptable but logically impossible Argument from Authority, a tissue-based myth that they can manually impact "superficial fascia", from the outside in!

To add further insult, this mistake (according to me at least!) has been allowed to sit there uncriticized, confusing generation after generation. When will the madness stop? It could stop immediately, if anatomists, or whoever is in charge of producing anatomical information, would just correct this one tiny assertion/conflation. It would be a necessary and sufficient hull patch.