Every Morning

Each day starts with a circle time of around 50 minutes where we touch base with each other, check in, see how we all are and share any thoughts or experiences.  Show and tell if you like.  For some, myself included, there is an impatience to get in to the lab and start the process of exploring and time spent not doing that is time wasted.  It’s not, trust me.  These few minutes allow us to focus on what is going to happen during the day, as well as reflect on what has happened the previous day or days and gives us some direction as to where we want to be by the end of the coming day.  It can allow us time to ask questions about whatever has popped up and to deal with any challenges that any of us are facing.  In some cases we don’t realise that we are experiencing challenges until it’s raised by someone else.

Because the actual dissection process takes place in teams working on tables, this time also brings us together as people experiencing something together. Bring coffee and pastries if you like, but it’s not an optional extra and you will benefit greatly from it.

Day One. Skin and superficial fascia.

This is not an every day occurrence for most people.  I recognise that taking a step into a dissecting room is a brave one.  I will lead you in to the process gently and carefully and make sure that you are happy with each step.  There is no obligation to participate in anything that you do not feel comfortable with and no-one will make you do anything you don’t want to do.  It’s worth having a look at the FAQs page, which address some common issues people have.

After introducing ourselves to the facility and the forms we will be working with, we start the process of removing the skin and studying the superficial fascia, the adipose layer, beneath. This is a vital session for body workers as these two layers represent the interface that we work on when treating. The scalpel becomes dull when trying to remove skin from the underlying superficial layer, reluctant to loosen its grip.  It takes a determined effort to be able to see what lies on the underside of the skin and begin to understand its relationship to the body. At the same time, it gives us the chance to develop the skills required with the scalpel that we will need later in the week.

We will then reflect the adipose layer to reveal the deep fascia, studying its connective nature and its differentiated relationship to muscle and adipose.  There is some theory relating to the superficial fascia that is also important to have a knowledge of.  It’s often dismissed as a fatty layer and our relationship with it in modern society is complicated.

We will spend a short time addressing some of the make up of the superficial layer and how it attaches and moves around on the deeper layer of fascia.

Days Two and Three. Deep Fascia and Muscle. Where do the trains go?

This is the layer that so many people think about when referring to fascia.  The white, strong fibrous bands of tissue that wrap around and in between muscle and even bone.  We reflect the deep fascia to reveal muscle, dropping to the bony layer and examining whether our previous

understanding of muscle matches what we see. We will find ways of creating continuity of muscular tissues through fascia and other connective tissues and determine how structures relate to each other.

There are a lot of ideas, myths and misconceptions around this tissue.  It gets blamed and pointed at for a lot of things, but for the most part is pretty benign.  Here we can start to examine and question some of the statements that have arisen over the years surrounding fascia.  Are there specific lines as suggested by the Anatomy Trains concept from Tom Myers?  Can fascia be released, stretched or otherwise directly treated?  These questions may not be answered fully, but at the very least this session will give us some more questions to add to the questions!

Similarly the muscle layer has a lot of responsibility placed on it.  Often our primary understanding and focus as physical therapists is on the muscles.  Attachment, origin, insertion nerve of action and so on.  How much of this still applies after the third day?  The models we have been presented with over the years are often challenged over days two and three, enabling us to reconsider how we understand functional movement, what a muscle is or really looks like and how it relates to the other tissues we have already explored.

Again there’s a bit of theory to look at here in terms of some basic bio-chemistry and some break down of the various other connective tissue categories.