For hundreds of years anatomists and artists have dissected dead bodies to gain a better understanding of how living ones work. In this 21st century the opportunity to study dead bodies is usually reserved for the medical researchers, but individuals are free to leave their bodies for medical education. And so it is with thanks to those individuals who chose to donate their bodies for medical education that last month I was able to take part in a fascial dissection workshop.
The workshop was lead by Dr Carla Stecco of the University of Padua who is an expert in fascia. The purpose was to illustrate some of the recent scientific research into the composition and properties of fascia.
A fascial dissection is very different from an ordinary dissection. Ordinary dissections are based on the idea that human bodies are made up of a collection of individual muscles and organs. A fascial dissection is based on the idea that bodies are created from a web of connective tissue that connects the superficial layers of the body to tissues deeper in, allowing them to shift and to influence one another. These are differences of perspective. It’s not that the body does not contain muscles and organs; it’s just that these are not the whole story. And it’s not that the existence of fascia is disputed by the medical community; it’s just that until relatively recently it wasn’t thought to be worth studying.
Now the success of techniques like myofascial release and the work of Dr Stecco and other scientific researchers has put fascia into the spotlight as the missing link that can explain the persistence of chronic pain in the absence of medical explanations.
In medical dissections, and in surgery, fascia is seen as something to cut through and to clear out of the way before starting the real work. In a fascial dissection more intricate care is taken to preserve the integrity of the fascia and to trace its connections. The results are illuminating.
In the fascial dissection of a female in her 70s I was able to see for myself:
• sheets of normal, properly hydrated fascia, like cling film wrapping around muscles
• the tiny ligaments that attach layers of superficial fascia to the skin
• the network through which these superficial layers connect deeper into the body
• the sliding mechanisms that allow unrestricted movement in properly aligned fascia
• the thickening of collagen fibres in fascia that had become dehydrated and stuck, and the resulting tangle of muscle fibres and connective tissues
• the solid mass of fascia surrounding a left knee replacement and thickening and distortion of fascia all the way to the subject’s right hip (specifically to her tensor fasciae latae muscle, AKA TFL, the main muscle used in hip rotation and walking)
These observations reminded me of several clients with whom I have discovered a connection between problems in one knee and pain in the opposite hip. They have also deepened my own understanding of the properties of fascia.
In having the opportunity to participate in a fascial dissection my overwhelming feeling was one of gratitude and respect to those brave donors who left their bodies for medical education.