Fa$cination

A flexible and chemically inert-as-possible containment system holds our human antigravity suit together, and keeps it from being a pile of juice&bones lying on the floor. It is the fascia tissue system. So, this is a fact of being in a living body, I guess. I mean, if you have to be alive for awhile as a blob of conscious awareness, I guess it's good to have a container for same. But my fascia is not my conscious awareness. People in comas with no conscious awareness still have fascia. So, the question is, why is fascia so fascinating for so many people in my apparent peer group? Mostly, one suspects, as a make-work/make-$ project for interest groups.

For all sorts of reasons, a large branch of the human primate social grooming community keeps itself entranced with information derived from research on this tissue. It helps promote and maintain such research, sponsoring and encouraging attendance at events like actual fascia conferences. In doing so, it inadvertently or deliberately acts as an echo chamber or microphone feedback or some other sort of step-up transformer, to maintain a mesodermalist attitude toward manual treatment instead of helping to evolve a more (in my own opinion) enlightened ectodermalist attitude; as an example of the latter, I'd like to refer to a wonderful story recently in NYT: Giving Alzheimer’s Patients Their Way, Even Chocolate.
Imagine that. Creative adaptation of caregiving for people whose frontal lobes don't work so well anymore, in order to keep them less stressed and thereby harmoniously and socially integrated into the land of the alive and sane, instead of deciding on a system which is "efficient" and "obeys rules" and thereby coerces disintegrating nervous systems to adapt to it. I'm way more in favor of the former, not the latter. The systems management types are not pleased, for now, but maybe later, should their own personal nervous systems happen to fail, they might get what this is about.

There are all sorts of layers to fascial "thinking" just as there are in fascia itself. I explored a few of them in this post recently. It's no wonder I'm not particularly drawn toward considering my work as a human primate social groomer as having anything much to do with this context for it.. I find myself instinctively repelled by most of the definitions and derivations of the word itself. It seems to boil down to externally imposed boundaries/supporting structures, at levels simultaneously physical and social and symbolic. Everything from religious vestments to political movements to architectural components to car parts to anatomical structure. Mostly it seems to be about superficiality, or placement of a barrier, or confinement imposed from without. Not that this isn't useful from a physics perspective, in terms of mechanical leverage. But I doubt it's any sort of ultimately therapeutically useful way to let one's own mind, as a groomer, be corralled, at the symbolic level, or social level, if your intention is to help other nervous systems outside your own to be freer and feel less confined/stressed. Like, by pain. For example.

The only way forward (really!) is to learn what the nervous system is and does. Trying to understand what makes the human antigravity suit tick by learning about fascia will forever be like trying to learn to fly a plane by deliberately ignoring all the dials and gauges and indicators on the panel, in favor of being overly/mistakenly fascinated by the moulded material of the panel itself.

Taking stock

A convergence of sorts has occurred in the new year: today a friend sent me a link to this excellent essay, written by Frank Wildman, on the sad, rather shabby, rather scientifically disjointed state of PT. He was thinking of U.S. PT, I think, and he had his Feldenkrais goggles firmly duct taped to his head while writing, but I'll forgive him for that, because he makes many many good points. I like the way he compares the state of PT to the state of general science before Darwin came along with the unifying theory of evolution. This essay still seems topical, even though it is 22 years old: Learning: The Missing Link in Physical Therapy.

Lately, a New York Times article by Gina Kolata, Treat Me, But No Tricks Please, provided the reading public with a glimpse into the hall of distorting mirrors that is current, American at least, PT. This story has raised comment on a few PT forums/blogs:
1. NY Times: Physical Therapy Useless?
2. Yes, Gina you can tell if your physical therapist is "voodoo less"

There isn't a whole lot to come back with, though.. Frank is still right, I'm afraid.

This short video, "Myofascia," was constructed by a PT student, determined to be a PT who embraces rationality. It's very succinct and immediately was shared by several Facebookers. Facebook really is a networking site, because through it I met a fellow who wanted to counter the video and share that he is helping to organize an entire conference about fascia. He seems like a very nice guy. We struck up a conversation, shared who we are and what we're about. I won't divulge anything about him, as that would be improper, but I'll put here what I told him about me:

"Your enthusiasm for the topic (fascia) is palpable! [/manual_therapy_joke].

Congratulations on helping organize a conference! That's no small task!

I'm a manual therapist too, born and raised in Canada, of physiotherapy descent. ...

Anyway, I moved (grew up in Sask), now have colder weather but WAY more sun, which at my age I need. My interests include deconstruction of faulty treatment concepts, passion for the neuroanatomy, physiological function, understanding, and care and feeding of the human nervous system, and writing. I helped start the Pain Science Division of the CPA. Currently I am on the exec. and run the coast to coast online directory for PSD members/PTs who want to be in it, and for patients who want to find a pain therapist. In my private PT life I have taken what I know about manual therapy, and what I know about neuroscience, and have called the result, "dermoneuromodulation." It's basically skin stretching but with an entirely neurological treatment construct, no mesodermal derivatives involved whatsoever. I've done a pilot research project on this, along with Angela Busch at U. of S, not yet written up. I've done an initial cutaneous nerve dissection (at UBC), took lots of pictures, wrote it up but have failed to have it accepted so far. I'll be talking about dnm, and about Neuromatrix model of pain, at a congress for manual therapists in Brazil in May. Then (hopefully, don't know yet) in St John's at CPA Congress. My life goal is to help develop vast crowds of rationally thinking, compassionate PTs/manual therapists who care deeply about pain and choose to help their patients overcome it in ways and with treatment constructs that are scientifically bullet-proof. Down with woo, IOW. To help that happen my next ambition is to get ensconced in an anatomy lab somewhere and map out the entire cutaneous nervous system so that therapists of the 21st century can realize and visualize and develop treatment constructs around what they are actually touching, and what's actually responding, in the person/body they are handling. I call this an 'interactor' model rather than an 'operator' model. Many therapists learn to do this, but implicitly rather than explicitly. I want self-aware consciousness AND scientific impeccability AND simultaneous, seamless treatment construct. Not too much to ask, is it?..

I run a page here, Neuroscience and Pain Science for Manual Physical Therapists, if you'd like to check it out some time. I also help admin a skeptical PT site/discussion forum called SomaSimple. You are welcome to come, join, discuss there too! We welcome everyone who wants to learn to think more clearly about what we do or who might have light to shed.

Diane"