Meeting the Human Body

by Julian Baker | Aug 22, 2017 | Uncategorized

by Jenny Wickford

I was privileged to meet physiotherapist Dr Jenny Wickford in 2016 when she attended a dissection with me in Newcastle.  Her enthusiasm and sheer passion for her subject, that of treating and studying the human form, has been humbling.

She recently attended the ten day dissection class in St Andrews undertaking some incredible dissection work on the female reproductive system which is her specialist area of treatment.

From Sweden she expresses herself he second language of English in a remarkable way and this piece is a superb tribute to her experience and to her belief in the importance of the dissection process.

There are many who will never understand the relevance of performing dissection to assist the understanding of therapeutic, body based interventions.  The idea that everything there is to know is already in many books, persists in the minds of therapists and anatomists alike.  There are however many ways to view a body, dead or alive, and by stepping to the side of what we consider ‘normal’ and looking at form in a way that takes us out of our existing and deeply held experiences, we can see new things in a new way.

I am grateful for Jenny’s thoughtful and detailed examination of this subject and hope you will enjoy reading it. You can download the PDF below.

Meeting the Human Body PDF

Treating Disease is Not an Option

by Julian Baker | Apr 25, 2017 | Uncategorized

It’s understandable that when someone presents with a specific problem, we want to try and come up with solutions that aim to ‘fix’ it.

Therapy forums on Facebook often feature questions along the lines of, “I have someone coming with –insert name of disease or problem here- are there any things anyone can suggest?”

People then of course suggest things.  These suggestions may or may not be helpful, but the motivation and indeed the question itself misses an important aspect of what holistic treatment is all about.  The fundamentals of connective tissue, suggests that the connected nature of everything in the body means that the possibilities for cause and effect on a wider scale are limitless.

I am not suggesting that for example the reflexology argument that there are zones in your feet that are related to your organs is one that holds true, just that you can’t chop your feet off and leave them with someone to fix, any more than you can your kidneys.  However vaguely they are connected.

Put another way, a human body is not a car.

If tomorrow morning you try and start your car and nothing happens, there is one reason and one reason only that this has occurred.  The variables are non-existent and if you reproduced the same fault in any other car the same thing would happen.

My knowledge of mechanics is something akin to zero, but I can be pretty sure that your car malfunctioning has nothing to do with it feeling depressed, unloved or fat.

I can also be reasonably certain that the rust on the side panel, the broken wing mirror and two under inflated tyres have no impact either.  Yet this is kind of how we go about trying to treat a human.

Every human has a a history and a wealth of circumstance that will contribute to their current experience.  A huge element of the presentation of any injury or illness, particularly chronic ones, will be influenced by patterns of learned behaviour.  How much of the pain is fear based?  How much of the nausea is responsive?  How much of what we are experiencing now has roots from deep in the past?

An understanding of how someone moves might point us towards looking at ankle work for a back pain or addressing the TMJ for a knee issue.  Again my implication isn’t that there the teeth have some mystical control over the joints, but that basic load bearing function is at play on a wide scale.

The basic rule of natural treatment, is that the body be treated as a whole, without referral to named disease.

Naming diseases is pretty straightforward and, let’s face it important when it comes to being able to treat life threatening problems.  For everything else, the rules change.

Back pain is the classic example.  Our human frame experiences back pain on a huge scale, second only to mental illness for work days lost to industry.  Yet medicine, for all its ability to conduct hear transplants and brain surgery, remains stumped by a good old fashioned back pain.

The trouble is that the back is subjected to a wide number of influences.  Physical work, emotional tension and just general movement.  Muscular structures all over the body will affect and change the way we use our back and learned patterns of behaviour and movement will give us postural patterns that will limit our movements.

Our environment and social situation, even our socio economic status will help to define how we sit, move, defecate and sleep and our back will bear the brunt of whatever and however we use it.

Even when we have a specific diagnosis of a bulging disc, this is isn’t a full picture and in many situations is an example of the diagnosis hindering rather than helping; most people with a bulging disc don’t have back pain and most people with back pain don’t have a bulging disc.

So next time someone presents with something you’ve never heard of, take a step back and ask, “what’s the problem?”

The problem with the client isn’t the same as the condition they are suffering and the two shouldn’t be confused.

Collagen and Fascia, Twist and Shout!

by Julian Baker | Apr 3, 2017 | Uncategorized

 

Twist and Shout!

When we look at or talk about anatomical structures or humans in general, it feels like sometimes that there is a disconnect between us and the rest of nature.

It’s as if the rest of the animal kingdom exists in separation to that of the human species.  Certainly we don’t seem to be ‘at one’ with our environment, as countless examples of environmental vandalism bear witness and it feels like we set ourselves aside as different or special in some way.

The  human condition strives for a desperate sense of order.  Straight lines and linear ideas rule our thinking and understanding and we cut swathes of rod like structures out of surroundings where nothing is ever in a straight line.

Nature abhors a straight line however.  In straightness there is weakness and angles that will instigate collapse more readily than support.  When we see a tree, a plant, a bush or a bird flying, we are seeing movements of spirals and curves in action.

Humans are no different.  A skeleton (as much as a skeleton exists by itself), is a myriad of curves and offset angles with thankfully absolutely no horizontals that would cause us to dislocate our joints.

The structure of the tissues that hold us together, connective issues, are prime examples of non-linear tissues.  Collagen is the most common protein in the body and the collagen fibres that form our fascia and much of our connective tissue coiled and spring like, giving our bodies the elastic recoil that allows us to absorb forces and tensions.

Collagen is a triple helix structure.  Three thin strands wind themselves together to form a spiral type structure which, when fully formed, is stronger pound for pound than steel rope.  These helices don’t follow the line of muscle travelling around the body, but instead criss cross muscle and bone in a myriad of different directions.

Where muscle has a start and an end point, the collagen based fascia doesn’t.  Overlapping standard muscle insertions, the fascia invariably carries on from the end of one muscle and into the beginning of another. Can anyone say if 10mg of Tadalafil has the same effect or the effect is shorter and weaker? Because I took 20mg, and the effect was super, but then the effect still continues the next day and I have light pain in the pelvis.

This picture shows the adductor longus fascia as it traverses the pubic symphysis and continues in to the fascia of both the rectus abdominus and external oblique.  The temptation is to assign function or meaning to this kind of continuity and whilst it can be fun to do, there is little to be gained except to appreciate fascial continuity.

Adductor Longus Fascia overlapping the pubis

This kind of relationship is not unusual in the body and is not just surface tissue either.  It dips and dives into the pockets of muscle tissue, creating divisions; ceilings and walls that give the muscle a container in which to operate.

Muscle relies entirely on fascia for its integrity. Without the fascia, the muscle would have no form and no integrity and would be unable to function.

What’s it like to attend a cadaver dissection?

by Julian Baker | Feb 14, 2017 | Uncategorized

I’d finally decided to do it. After a long time thinking about it and talking about it with my partner, this was it. A 6 day dissection class. With real cadavers.

Ascending the lift, I was apprehensive. I had dissected animals as part of my degree but I had never seen a cadaver, let alone used one as a teaching tool.

In a locker room, with other students, we were all quiet. Some were returners, others were, like me, new to this. After locking our phones and valuables away, and putting on our white coats, we were led into the lab.

As we walked into the lab, it was impossible not to notice all of the 5 shiny humidors that contained our bodies. The lab was large and cold, with specimens persevered in formaldehyde on workbenches.

We sat on stools in a circle, introduced ourselves and were off on an incredible journey.

Once we had discussed what was about to happen, we gloved up and were led over to the humidors, which were now open, revealing linen wrapped forms. The coverings were removed and we were invited to look carefully at each and make a choice as to the one we were drawn to work on. I chose a man – I couldn’t honestly say why. He was an elderly gentleman, well built.  He was lying face up. There was a line of stitches in his groin – the closure of the hole to get to the femoral artery to input the embalming fluid. His head was shaved and his arms and legs were freckled.

Now it was crunch time. You think about death abstractly. You know that it is the absence of life. You know that there will be no warmth. You’ve heard about rigor mortis but nothing can prepare you for actually laying your hands on an embalmed cadaver. I was, oddly, surprised by how stiff and cold it was. Note here that I say ‘it’ and not ‘he.’ My initial reaction was that whatever had made this form ‘human’ was no longer there. This thought would change as the dissection progressed.

Having been shown how to use the forceps  and scalpel, we were now asked to remove the skin. Yes, you read that correctly, remove the skin. This conjures up pictures of flaying, of Silence of the Lambs but no, it was nothing like that. Skin is attached very firmly to the superficial fascia layer beneath. At one point we had to turn the body over to remove the, much thicker, skin on the back. I now appreciate the term “dead weight.”

Many blunted scalpels later, we could look at our form without his skin – barring his hands, feet and face; the superficial fascia or adipose layer is so thin in some areas, that it takes a degree of skill to dissect it beautifully.  The colour was most shocking – yellow – especially when all 5 of the cadavers were placed side by side on their gurneys. But they were still recognisable as male or female, the rounded curves of the women, their breasts and hips given form by this superficial fascial layer.

Day 2 was the removal of this layer. It was soft and oily – a result of the fat cells breaking down as we cut through them with our scalpels. Careful not to cut too deep and hence into the deep fascia underneath, we began to peel back this blanket. One group of more experienced dissectors managed to remove the whole of the superficial layer in one go. They laid it on a gurney next to the body from which it was removed – a woman.  Apart from her genitals, she was no longer recognisable as a woman; this covering had given her form and now it was gone.

The  layer of deep fascia is one of the most difficult to dissect. It clings to the muscles, wrapping around each, separating them. It is strong, pliable, criss-crossed like a matrix and it is everywhere!

Muscles next; now we were into more familiar territory, but even this was far removed from the conventional anatomy in books like Netter or Grays. Each muscle was wrapped in superficial fascia, but when this was removed, the muscle just came apart in our hands. It made us realise that what we think of as knots in our muscles, couldn’t possibly exist. So what are we doing when we massage or treat someone as a therapist? Bearing in mind the layer of superficial fascia over the top of the muscles, are we actually doing anything to them?

Nothing about this experience is normal, yet it has become routine. On into the viscera; I held the heart in my hands, shone a light through the diaphragm, watched as the teacher used a bag to inflate the lungs, amazed as they ‘pinked up.’  One group removed the brain and the central and peripheral nervous system, laying it out like an ethereal skeleton.

And finally, when our week was done – there was not enough time I can tell you now – we laid everything in a body bag in a coffin and held a moving ceremony where we thanked the donors for what they had allowed us to see and learn. I admit, it was emotional and I shed a few tears. The camaraderie in the room had been fantastic and we had participated in something very few people have had the privilege to do. I would be back!