A visit to Guimberteau

Tuesday, September 8th, 2009

I paid a visit on Monday to Dr Jean Claude Guimberteau in Bordeaux. Dr Guimberteau did the research and made the video of Strolling Under the Skin, the first video of living fascia at work in the body. The images of the interplay of fibers and proteoglycans (ground substance) was so striking that it changes the touch of nearly everyone who sees the video. The ‘living matter’ as he calls it, was so responsive, so versatile, so strikingly alive, and so demonstrative of ‘biotensegrity’ at the cellular level that we simply had to make this DVD available to our students here in the States.

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Dr Guimberteau has a new video detailing further research he has done that carries the ’sliding system’ and the reach of the fascia out to the polygonal arrangement very dermis of the skin. You can buy the DVD here from us or follow his work at: http://www.guimberteau-jc-md.com/en

Fresh round

Monday, September 7th, 2009

Freshly ’round from the fresh and round faces of Mancunian physiotherapists with their fresh, round northern accents and their fresh, round-eyed unspoiled children, I dive into the jaded atmosphere of London to pick up my daughter and wing off to France.

In the midst of America’s discussion on health care, it was jarring to hear how discouraged these physios were / are with British National Health System. I have said ‘Bring it on’ when nay-sayers bring up the specter of ’socialized’ medicine as if this were an automatic disqualification - and I do think we need something similar to cover the poor and replace our ridiculously expensive and profit-driven system. But these people were complaining about exactly the bureaucratic inefficiency and niggling pettiness in the NHS that the town-hallers are warning us against.

New KMI starts in Oxford

Wednesday, September 2nd, 2009

Yesterday we started out a new Part 1 in Oxford England with a richly talented group of 23, from all across the globe - South Africa, Czech Republic, Scotland, Denmark, America, Germany, Poland, Spain, Italy - all in a little village hall in the English countryside.

James Earls and Tom are leading it, with Mike Doxey and Jeremy Pearcey helping out. Seems like a good start to me - looks like a challenging but very skilled group. Always a challenge, actually, to take a disparate group - some, like the physios, there for the techniques, some for the psychological development, some for athletic rehab, some massage therapists looking for the next step - and bring them onto the same page. It really happens in Part 2, but we’re laying the groundwork now.

SI Faculty Meeting

Sunday, August 23rd, 2009

Just coming home from a weekend of discussion with colleagues who teach at eight of the eighteen other SI schools. While progress in developing our profession is slow – and further slowed by recessionary forces – I feel hopeful.

Now I know hope is out of fashion just now, as we watch the Obama momentum seemingly fade, but I do - I feel hopeful on two counts. First, even though the meeting was of course self-selecting for those who want to promote community over isolation, I was impressed with everyone’s willingness to bring even difficult issues out on the table and consider the value of alternate ways of getting results. The sense from each of wanting to improve and clear a higher bar was palpable.

But most of all, I loved the collective ability to maintain a sense of humor in this arena where we all have epic investment, an unavoidable need to compete in the marketplace, and yet this distinct hunger to develop the profession and thrive together. I truly enjoy this fraternity / sorority with poised, observant, and adaptable people, whose passion is leavened with the ability to laugh at their foibles, even as they persist in the quixotic quest to pass on the gift of this extraordinary work. It is a relief to me that I still like hanging out with these my people.

Though the document to come out of this meeting may not shake the walls of Jericho, it was heartening to see the easy and assured agreement on the ‘70%’ of the shared core curriculum across the subject areas and across the various schools, as well as the spirited defense for those other 30% of unique emphasis.

Even setting aside any history receding in the rear view mirror (“Objects are closer than they appear …”), the biggest schools obviously have the most to lose in opening up to a larger umbrella organization. This leads to a reticence and a lingering conflict of interest between loyalty to the structure built up within each school versus the thinner ice of IASI’s as yet fluid organization and association with smaller, less fully-formed schools.

I am firmly convinced that, regardless of the philosophy or politics involved, the best strategic advantage for all – large and small - lies in the original meaning of fascia – ‘fasces’ or bundle. This comes from Aesop’s fable where the father, preparing to leave his farm to his three contentious sons, showed them how individual sticks could be easily broken, but a bundle of sticks tied together is much stronger. This is true for the bundled fascia in our bodies, and it is true of the profession. We either hang together or we will hang separately.

The strategic argument runs this way: There is far more to gain and little to lose from banding together, and little to gain and much to lose via going it alone.

First, what is left to be lost? The ten-series is common knowledge and some version is already taught in a substantial number of massage schools, and the telling phrase “I practice a little rolfing, too…” is too frequently heard. Deep Tissue, Myofascial Release, and other similar ‘structural bodywork’ forms are widely practiced within massage and physical therapy, while the word ‘core’ has been successfully appropriated by Pilates and personal training. And most SI practitioners are compelled to practice under a massage license, even if they regard it as a ‘flag of convenience’.

After all these years, are there really techniques or concepts that need to be kept secret? Write a book, own it, and move on is my advice – time is running out and we need to keep moving as knowledge and professional applications are rapidly progressing all around us. Staying holed up within our own castle moats leaves us standing still while the caravan moves on without us.

As for market advantage, all smaller schools of my acquaintance are perfectly content to concede the service mark and the term ‘Rolfing’, in favor of our preference for ‘Structural Integration’ as an unimpeded general term in which Rolfing, Hellerwork, Soma, KMI, etc. compete as brands in a friendly and respectful (but again spirited) way for students who want to share with us the exhilarating / sobering art / craft / science of Structural integration.

With little professional or academic status to lose, our tiny profession still has much to gain through cooperation. In the legislative and professional arena, even the small amount of cooperation we have been able to engender in the last few years has produced impressive results in regards to licensing or exemption in a few states, with the promise of more to come. While our very small total number precludes effective legislative action on a grand scale, these smaller victories prepare us for bigger opportunities when they arise.

But it is in the area of public education and marketing that we all have the most to gain from banding together. In a competitive market, one can succeed in two ways: by capturing more of a finite student pool from your competitors, or by expanding the market.

Since the primary motivation that brings students into our field is having a significant experience with the work itself that inspires the candidate to come aboard, the vast majority of those will simply seek the school from which their practitioner arose. I hear from a very limited number of potential students who are analyzing the various schools to find a good ‘fit’ among them. Even though this may be the best way of choosing a school, most students end up going with the inspiration of their ‘first contact’ school.

This method of market share distribution guarantees a steady growth for all schools, proportional to the number of graduates they have out there inspiring their clients to become practitioners, perhaps multiplied by a ‘Shazam’ factor of how inspiring the training or the individual practitioner may be. Really bad schools will slowly fade, while really inspiring ones might grow a little faster than the rest. But only a little.

The really big opportunity lies in expanding the available market, in which (how I hate to quote Reagan) a rising tide would lift all boats. Public and even professional awareness about SI is pitifully small and misinformed. The interest in the concepts and practices is actually very high, but the link between that interest – in a holistic approach, in fascia, in our ways of seeing and strategizing, a systemic approach to posture and movement, dealing effectively with chronic, distributed injuries, and effective shape-shifting technique – and our availability has yet to be forged.

While no one school can mount that effort successfully (and the Rolf Institute has been trying to do so for 30 years or more), the bundle can. By creating general and specific allied-professional awareness, we can create a larger student pool, which will come to all the various schools, largely proportionate to their size, though perhaps individual marketing efforts will also make some difference.

The point is that at the moment, the total combined graduates numbers runs only to the low hundreds each year. Public awareness efforts could easily double that number at a minimum. My own informal researches as a public speaker and CPD workshop presenter for several professions outside of SI (physiotherapists, personal trainers, Pilates teachers, yoga teachers, osteopaths, and massage therapists) would lead me to a much more optimistic estimate:

If we stopped turning our professional back on the rest of the world, and added the SI story, skillfully presented, to our already-in-hand advantage of excellent personal relations between our individual practitioners and their communities, we could have a pool of students five times that large - enough to satisfy all the schools’ needs – indeed, enough to put a strain on faculty development :-) - and provide the engine for further development into all the areas where SI can be valued – in sports, surgical and injury rehab units, in physical education, psych wards, in complementary and integrative clinics, and in change agencies worldwide, as well as the private practices that largely sustain us now.

This is both the promise and the danger of our current situation: left idle we will surely lose the opportunity to establish our field as a distinct and valuable entity and continue being subsumed and marginalized. Seized, we can emerge from this lean period in a very healthy position to honor the legacy of Ida Rolf and all the work that so many have put into this inquiry.

In short, use this opportunity to declare ourselves to the world and build alliances – we need allies – and we will be repaid many fold.

IASI Faculty Meeting

Wednesday, August 19th, 2009

Heading off for Denver tomorrow to participate in the IASI cross-school faculty meeting. IASI is the professional organization for Structural Integrators. It has an important role in identifying and promoting the cause of structural work in society. For too many years, the conflicting interests among the SI schools (for students, for influence, for ‘being right’) held sway over the common interests, which has not been good for the legacy of Ida Rolf’s work.

This meeting and others like it are designed to provide a platform from cross-pollination among the faculty of the different schools - the Rofl Institute, the Guild, Hellerwork, Soma, KMI etc - where a common core curriculum can be identified, common interests in seeing structural work spread more widely promoted strategized, and leftover enmity banished in a warm fraternal glow.

OK< maybe that’s going too far, but we are a small group, behind the times, long over-involved in introspection, and we need to move to catch up if structural work is going to take its rightful place.

The Gathering

Wednesday, July 29th, 2009

The night before: The last of the heat lightning flickers in the nacreous clouds above; the lightning bugs echo in the gathering mist covering the cut hay below. Around me are the middle-size flickers of the cold LED flashlights everyone is using now: the campers have started to set up their tents as the KMI clan gathers for our summer event.

Noemi shows up with bagels from Montreal, Christoph with bottles of wine from Germany, Pilar from Mallorca via Santa Cruz. The next few days of Christoph’s perineurial class, with 26 students from all over will be followed by at least twice that for the weekend celebration. The gathering.

The next day: Took the kids out for an evening sail. Larissa jumped in and held on to a docking line, being towed behind the boat – very brave and gung ho! Ella stayed on the bow texting with her friend Amber, who is as full and open and kid-like as Ella is angular and mysterious – what a quick and strange transition from kid to teen! Ron Floyd is in, literally ‘learning the ropes’ on the boat as we maneuvered around the cove and river.

Fascia - a new book

Tuesday, June 23rd, 2009

For a nice summary on Fascia, check out ‘Fascia’ by Mark Lindsay, 2008 Delmar Press, ISBN 978-1-4180-5569-1.

Really good tour of the fascial dramatis personae, and good stuff on injury.

Dissection Final 2009 - the Lines!

Saturday, May 30th, 2009

One final picture - a teaser for those who share my hunger for ‘just the facts, ma’am’, a relief for those of you who have found these last few posts a trial of too much meaty reality.  Conceived by Todd Garcia, realized by David Lesondak, with some of yours truly in there for the actual arrangement.  There’ll be a video tour of this available later this year with any luck:

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These are the Anatomy Trains myofascial meridians we took from ‘George’ over the last six days.  To my students: can you identify them?

For you others, these abstracted shapes are an unfamiliar way of seeing the body in motion / stability.  From the left: Superficial Front Arm Line, Deep Front Arm Line, Superficial Front Line, Deep Front Line, Superficial Back Line, a bit of the upper posterior Spiral Line, the Back Functional Line, the Deep Back Arm Line, and the Superficial Back Arm Line.

Not shown (viva 2011!): Lateral Line, full Spiral Line, Front Functional Line, and the (new to the 2nd edition) Ipsilateral Functional Line.

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One final note: I have an arse-kicking moment in every one of these dissections; most people do - it’s just too out of the normal realm and confrontive not to.  Although I certainly felt like a proud father to see the concept laid out so concretely on the concrete floor of the lab, my mental sock drawer was rearranged by:

(Isaac Asimov says most scientific discoveries are not acccompanied by the equivalent of Archimedes’ “Eureka!” but a quiter, “That’s funny…”.)

I was taking a postage-stamp-sized window out of the leg’s interosseous membrane to examine under Eric’s microscope.  Before I could even get it out of the leg it turned into gossamer, curled up and shrunk and went all wispy. We put it on the slide, and were able to roll it out a little, but this was true all over the body.  We took a scar from George’s leg, but by the time Eric had tomed it for the microscope, it had disappeared, reorganized out of being a scar.

Conclusion (these conclusions to spiritual events are always banal, but here it is): Structure is contextual, and only contextual.

The scar is only a scar when it is in its milieu of forces around it. The interosseous membrane is not the sturdy fabric we see in Clemente unless it is strung between the two bones.  Long live biotensegrity, and thank you Dr. Stephen Levine, and Tom Flemons, and Phil Earnhardt for sticking to your guns. I have a new appreciation for bones after this and their role in shaping the tissues.  But a strong new appreciationfro the whole, the pattern in its entirety, and its malleability in consciousness, so thanks to Ida for sticking to her guns also, and what the hell, thanks to me for sticking to mine.

But this week, thanks to Todd, David, Eric, and all the other students who supported our work with theirs.

Dissection 3

Friday, May 29th, 2009

This continues as the most successful dissection in which I have been fortunate to participate in terms of the learning obtained.

• Fabulous group of students who are doing great work (special mention here to Daphne Mosko, who unraveled the foot for all to see).

• Luck with the condition of the cadavers (although Todd may have something to do with this, even though he says he can’t control what they send him).

• Todd’s focus and consummate skill at the table, not to mention his willingness to set aside the conventions of dissection to patiently entertain my ignorant fumblings for a new order.

• David Lesondak’s skill with the cameras, allowing us to retain the memory for ourselves and share it with others

• Eric Root’s microscopic explorations of the interaction between fibers, glue, capillaries, lymph vessels at various levels of stretch and at various levels in the body, giving us a whole new dimension between gooey and Guimberteau.

• And I am not forgetting Penelope’s informed guidance of the students, Michelle’s slaving over a hot sink to wash away the blood, poop, and fat from the towels, J.C’s willingness to lean over a stinky mass of guts to reveal the mesenteric tree, and everyone else’s cooperating to stop what they are doing to let me video the results of all our work.  Thanks to everyone!

Yesterday the traditional calvarium cuts were made to reveal brains and dura; today will be largely show-and-tell as we bring things to a close, so here are a few of the pictures from the last couple of days:

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Fascia, fascia everywhere, nor any drop to drink…

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The lower half of the Superficial Front Line (SFL) - this guy had some quads on him!  Very hard to retain the fascia going over the tibia on this specimen - it was there and came up fine and clear, but as soon as you bring it away from the underlying bone, in seconds it curls up and dyes like a hairdresser.  Even the interosseous membrane between the tibia and fibula - surely a strong, bilaminar, tough-stuff structure - almost disappears into gossamer as soon as it is removed.  Long live biotrensegrity! (This is a convincing correlate of the tensegrity concept - funnily, it gives me new appreciation for the role and shape of bone in stretching the tensegrity into shape - Grandma’s orthogonal rack, I believe Ron McComb callled it, referring to Ida Rolf.)

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The upper Superficial Front Line from the pubic symphysis (left) up through the rectus (and yes, he had a diastasis - spreading of the linea alba - like a pregnant woman, but this fellow was ‘pregnant’ with overeating) to the SCM on the right.  The kicker for me came in the middle, which we preserved on his right side only.  Some of my readers will know I have puzzled over the connection between the rectus and the SCM in the SFL, searching through sternalis (which despite the great example in the pervious post is often too flimsy to serve) and the sternal fascia (which works, but is too narrow to convey the full mechanical force.

So this time we left the proximal portion of the pectoralis major in place.  This created a great connection, but would break the Anatomy Trains ‘rules’ since the muscle fibers of the pectoralis run counter to the direction of the line (expressed by the rectus and SCM).  So imagine out surprise when we turned the specimen over and found plenty of vertical fascial fibers embedded into the posterior side of the pectoralis.  Anatomy Trains rules may be made to be broken, but this was victory enough for me: Anatomy Trains rules! (maniacal laughter echoes down the corridor…)
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The Superficial Back Line from a fresh-tissue cadaver.  This specimen, relaxed, measured 81 inches; the cadaver, relaxed, stood at about 5′ 7″ or so.  Fromt left: Epicranial fascia from eyebrow to nuchal line, erector spinae (and some transversospinalis) to sacral fascia, the isthmus of the sacrotuberous ligament leading to the hamstrings intertwined with the gastrocs and around the calcaneus to the plantar aponeurosis.

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And finally, a first: The Deep Front (core) line from a fresh tissue cadaver.  Deep toe flexors at the bottom, joined across the back of the knee to the adductors across the groin with the psoas complex (from here on up we have both sides) to the diaphragm and mediastinum, and finally up to the bat ears of the temporalis muscle joined to the jaw.  The mandible and hyoid are the only bones in this specimen, and there are no breaks from the inner ankle to the underside of the skull. This ancient creature lives inside us, one and all.

Thanks again to one and all.  This was such a team effort.

Dissection 2

Wednesday, May 27th, 2009

We have now finished four days of the dissection project, and I am very pleased with what we have got.  The students have been great, Todd has been a steady worker, following my crazy ideas and making them real, and David Lesondak has been literally on top of things (often atop a swaying stepladder) to document both process and product in video and in photos.

It is very interesting how some things are possible in one cadaver, and impossible in another.   Bodies are so variable.

Here’s an example of the upper posterior Spiral Line we were able to dissect out of George (we name the cadavers, not their real names - it’s amazing what affection you have for them as you learn about their lives through the ‘track’ they have left - their physical form.  Millie is heartbreaking with her painted nails but no uterus; drooping transverse colon and a wicked-looking plate in her head that resulted from a brain surgery we haven’t been able to expose the cause of yet.  Richard has bad dental work and a twisted spine and a collapsed chest, but strong legs.  George has no teeth at all, but this seems not to have dimmed his appetite; we had to flense the fat off from him, and his guts were very full.  He is without a gall bladder, an operation which left many adhesions in his belly.):

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On the left is the splenius capitis and cervicis, the gap in the middle shows where we were able to dissect a connection between the splenius capitis and the rhomboid minor, but were unable to get a clean fabric connection between the cervicis and the rhomboid major - a connection we were able to get easily (well, not easily but cleanly) on our previous encounter with a fresh-tissue cadaver.

On the right is the many fingered serratus anterior.  Please note the strong connection between the rhomboids and the serratus - here is a clear picture of the rhomboserratus muscle.  Here’s the kicker: the scapula has been removed from this specimen, and it does nothing to separate the rhomboids from the serratus.  Note please that I am not saying that the rhomboids or serratus don’t connect to the scapula; it’s just that they also have a strong (strong! literally) fascial connection behind the scapula that is seldom if ever listed in the books.  The scapula could easily be moved 1.5 inches either way on the rhomboserratus without the profoudn side of this connection being moved.

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Here is a brilliant (I can say so, Todd did it) dissection of the Superficial Back Line from toes to nose up the back of the body - planter fascia to the left, epicranial fascia to the right.  This specimen measured 81 inches (206 cm) when laid out relaxed.  George measures about 5′7″ (67 inches, 170 cm).  This increase of nearly 20% is partially due to the addition of the plantar fascia to and epicranial fascia to the length, partially due to the straightening of the primary and secondary curves this line traverses.

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Finally, the Superficial Back Arm Line.  In this case we included the trapezius on both sides (easily dissected together, though you can see the holes in the very thin aponeurosis  between the middle trapezii), with the rest of the line running down the right side only: deltoid, lateral intermuscular septum, and his strong extensors (maybe he rode a Harley?) leading to the backs of his fingers.

Everyone is punch drunk on this fourth day - the initial enthusiasm worn down by the smell of formaldehyde, the vague aroma (and accoutrements) of a butcher shop, the bending over the table, the exacting and slowly progressing work.

Meanwhile, in the background, we are working toward my goal for this workshop: the Deep front Line from ankle to jaw in a fresh tissue extraction.  Stay tuned.