Book Review: Guimberteau - Architecture of Human Living Fascia

Book Review: Architecture of Human Living Fascia

I have recently devoured the new book from Handspring Publishing by Jean-Claude Guimberteau and Colin Armstrong on the Architecture of Human Living Fascia.

Jean-Claude Guimberteau has become famous in the bodywork world because of a number of DVDs starting with Strolling Under the Skin that he released in 2005. These were incredible because he was using an endoscope to film the structures of a living human body whilst the patient was undergoing surgery. These films showed the wonderful and beautiful moving fibrillar network of collagen, elastin and extracellular matrix that is present in all of us.  I, for one, now can not hear the Blue Danube Waltz without thinking of fascia.

This book shares more information about the network of fibres that extends throughout the living human body from the epidermis down into the cells from which we are formed. This book looks at the level of the mesoscopic, which is the scale between the macroscopic (whole body) and the cellular microscopic. This mesoscopic is a level of the body's structure that some people feel has arguably been overlooked in anatomical study.  It is here, with the use of an endoscope during routine surgery, that Guimberteau and Armstrong find and examine the fibrillar network of collagen fibres, the micro-vacuoles that contain the extracellular matrix. Here the authors show how this network surround, permeates and shapes the different structures of the body from the tendons to the bones to the muscles to the organs.  This book is not just very clear about what is being discussed but it shows you  with incredible pictures and videos (more about that later) so you can see what is being discussed with your own eyes.

The authors structure the book in such a way that there is a logical progression from what this structure is, how it develops and adapts to our daily lives, how important this is for our efficient usage, what happens when there is injury and how manual therapy can have an impact. There are wonderfully insightful comments from a number of leading authors, scientist and therapists in response to the information shared in this book.  There is a great section about how the body responds to incisions of surgery, and also the exposure of the moist interior of the body to air. There is a great detailed description of scarring and the creation of interruptions the fibrillar network that reduce its ability to function smoothly.

What really sets this book apart from many of the others looking at the fascia are the sumptuous images and photographs in this book. They are clear and well described so you know what you are looking at (and where in the body) and through a wonderful use of QR codes (those square bar codes you can scan with a smartphone) you can get to watch new videos showing what is being discussed in the book. There is a DVD enclosed as well for when you can't get internet access, or do not have a smart phone.  These videos are locked with a code that you get with your copy of the book, and are well worth getting access to.

Overall I would say that if you like fascia then this book is well worth having. The videos and images really bring the body and fibrillar network to life and show how wonderfully chaotic and logical the whole thing is.  There is so much information packed into this book that I feel it deserves multiple readings (and viewings) to really get to grips with what has been so wonderfully shared.

Book available directly from Handspring Publishing here.

About me:
I am a Bodyworker based in the UK specialising in Myofascial Release and based in London (Clerkenwell and Stanmore). I have successfully completed the UK's first Advanced Clinical Diploma in Myofascial Therapy run by Myofascial Release UK. I have become completely fascinated by the fascia and attended the inaugural British Fascia Symposium. There is more information about me, where I work and the approaches I use on my website RelaxReleaseRenew.co.uk

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On starting a Scaravelli Yoga Course

You may or may not realise that I've just started a Yoga Teacher Training Course, and that this is going to take me until October 2017 to complete.  This week was the first time that my eighteen fellow students and I met,together we've and embarked on this rather wonderful course. 

The first weekend has been quite a challenge in some respects as there have been a lot of administrative discussions to have been had: being introduced to the online resources that will help us through the course; the homework assignments and deadline dates (and fines for late submission); the plagiarism policy; the ethics policy; the group behaviour policy and more.

This was quite daunting and I have felt slightly overwhelmed with the amount of learning I've committed to, and how much additional information I am going to have to digest.  I was thinking that I might have to spend today (my first day off for a number of weeks) getting myself organised as I was feeling a little panicked by it all. 

So on waking up, my plan was to spend time sorting things out, but first to check my social media. I was then taken by the following message that I saw on my facebook timeline from  Doreen Virtue:

The angels want you to know that they are watching over you, and they will guide you step-by-step as you release the old and welcome the new.Focus upon excitement about your new intentions, instead of fear about what may happen.Excitement energy will fuel your motivation and courage to make this important positive change.Hanging onto the old, for fear of what might happen, is not serving anyone. 

I'm not really into "angels" and things like that, but this caught my eye. I then laughed to myself because this is perfectly timed to remind me that I have started worrying over how much work I need to do, will I be able to fit it in with my current workload, and lots of other things that I do not need to let control me.

So with this insight and message, I decided to change my focus and enjoy the fact that:

1. I am embarking on a course that will let me learn more about myself, my body and push myself outside of my comfort zone.
2. I am going to make friends with the wide range of people that are also on the course with me.
3. I am going to learn from some amazing teachers about the wonderful style of yoga that has been inspired by Vanda Scaravelli and Mary Stewart.
4. I am going to have the opportunity to get over some fears and concerns that have had a hold on my life (like not talking clearly and standing up in front of people and telling them what to do)
5. I am going to become a yoga teacher.
6. I am going to enjoy the process and have a great time,
7. This is going to be so much fun.

So there are likely to be ups and downs in the time ahead, but I need to remember that this will ultimately be fun. I also need to remember that when things get tough that the thing to do is to get on my mat and do some yoga, talk to friends and remember it will all work out right in the end.

I just need to keep everything in perspective.

A matter of life and breath

Try this little experiment (and don't force it): You'll need to have a clock handy with a second hand to count how long you hold your breath.  Start by breathing normally for a minute or so, don't try to change anything just trying to be calm. Then breathe out and don't breathe in until you feel like you really need to (this is the bit you should not force) and time how long between the end of the exhalation and the inhalation.

The reason I'm suggesting you do this is inspired by a talk I went to on Breathing Pattern Disorders by Leon Chaitow (an Osteopath that has written the textbooks on virtually all techniques used by bodyworkers) and there were some real eye openers on how common this could be.

How long did you manage? 10 seconds? 20 seconds? 30 seconds? more? Apparently we should be able to hold our breaths for approximately 30 seconds with ease, however most of us find this difficult.  My own score this morning was 20 seconds. This means that we are breathing too much so we could be suffering from Hyperventilation Syndrome (HVS) and this is a problem as we are expelling too much Carbon Dioxide (CO2) from our bodies.

Most of us know that we breathe in oxygen (O2) and breathe out CO2 as a waste product, but the level of CO2 in our blood plays an important role in our systems as it helps to keep our body at a particular pH balance between acid/alkali (within a very specific range).  If this pH balance becomes took alkali then the haemoglobin in the Red blood cells struggle to let go of the O2 that our body needs to function properly. Symptoms can range from headaches, lethagy, neck ache, back ache, and anxiety amongst many others.

Some of the other things that were interesting from the talk were that this mostly affects type 1 personalities, it is more common in women (and progesterone raises women's breathing rate during their menstrual cycle), that this can have far reaching consequences on the quality of our life.

What happens is that we breathe into the top of our chests rather than using the diaphragm to fill the whole lung cavity.  This then has a knock on impact on the stability of the low back (through the "core" muscles of the obliques, transversus abdominus and pelvic floor) and through fascial connections to the limbs as well because we are not using things properly.
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Our bodies become habituated to the level of O2 and alkali in the blood so any changes to this can induce feelings of anxiety (which will then negatively feed back to more hyperventilation) and so trying to retrain needs to be a long slow approach: 5 minutes each morning and night as a focussed effort but forgetting about it and getting on with your life the rest of the time.

In his talk Leon Chaitow showed us a video of retraining (The Nutri Centre filmed the whole talk and it is available in its entirity on their YouTube Channel) but the first part is to focus on the out breath for short periods. This is done by using the pursed lips exhalation.  You put your lips together and blow a thin stream of air our, gently as if you were blowing out a candle about 1 foot away (put your finger there to feel it) and you empty the lungs as fully as you can.  Close your mouth and count for 1 second before you breathe in through your nose.  Do this for 20 cycles of breathing morning and night for a week and then try holding your breathe to see if there is a difference.

You can find the video on The Nutri Centre website here.

Breast health myofascial workshop

I recently went to a Myofascial Release special workshop for Breast Health run by Linda from Myofascial Release UK. The day focused on techniques that work the soft tissues of the arm pit and upper chest area and that are especially beneficial for women, particularly for those that have had treatment for breast cancer, however everyone can benefit from them (as I was to find out for myself).

I was not entirely certain why I was actually attending the course; I had bought a block of workshops and this (in my mind) would be the least useful one.  I was wrong, very wrong with that idea.  In the weeks before the course I started to think about my clientele and realised that I have a number of clients who this would be really good for (some have recovered from breast cancer, others have had surgery in this area, a number have breathing issues and a lot have tightness in this or the immediate surrounding area) and I realised that I should have ways of treating the chest so that I truly can follow what the body wants treated (with the client's permission of course).

This is an area that is often not worked on in a "typical" massage/body work session, but think about it: these structures and the ones they connect with are central to the whole body: the pectoral muscles impact the arms, the latissimus dorsi connect to the lumbar fascia (and are frequently repositioned for reconstructive surgery after mastectomies), the fascia covering the breastbone connect to the abdomen, and there are deep fascial connections to the lungs, the heart, the anterior neck muscles and this is a gross simplification of the whole structure.  Linda talked about what she had seen on a dissection course that she had attended where one of the cadavers had had a mastectomy.  She said that there was a thickening in the fascia that spanned the whole front of the body, and it was like a web radiating out through the abdominal walls, deep in to the pericardial sack, the lungs and far farther than anyone expected.

The techniques look at the area from the armpit to armpit, from throat to diaphragm, but really in a true treatment it would be extending beyond this elsewhere into the body.  From my experience on working on the Myofascia in the rest of the body I can easily understand how beneficial these techniques and approaches would be for people who have suffered the physical trauma of surgery, and chemotherapy for treatment of breast.  The gentle work to release the adhesions and restore some semblance of normality to the soft tissue could have such a profound effect for people and probably a lot more that haven't really considered that this could be an area of tightness for them.  Three of the techniques worked directly on or below the breast itself, but they can be adapted or not used depending on how the client feels about them being worked on.

I am fortunate enough not to have had any surgery to this area, but I have had poor posture when using a computer for many years when working in an office.  I also enjoy yoga on a weekly basis (if not more) and spend a lot of time working to expand the chest area.  I was very surprised how much techniques we learnt working on the armpit, ribcage and breast bone areas had a profound affect on my body, particularly freeing up an on-going tightness in my left shoulder.  Going to yoga later in the week I could feel a vast improvement in what is normally my tight arm and shoulder, so great a difference that my "good" arm sudden became the one that needed more stretching.  The breathing techniques at the end of the session were fuller, more balanced and deeper than they had been before.

I have to say a big thank you to Linda (who ran this sensitive course) and my fellow students for running a very supporting course where I (personally) felt secure enough that I was able to unwind (where the body releases tension in a physical way) not once, but three times.  I can honestly say that that was the first time I felt safe enough to properly do it.  Thank you to the therapists who facilitated this for me, I am continuing to feel the work that you/we did and it feels amazing.

Introvert, quietly loud and proud

I read all the time: I always have a book on the go and love Fantasy Fiction (see my geek is coming out already) and I used to hate reading text books.  However when I started training and working as a massage therapist I realised that I needed to read around the subject, as there is a lot of information that I feel I need to know. I travel to my clinics by public transport so I have a lot of time that I could read. I came to the decision that I would read "work books" when travelling to clinics and courses during the week, and save my   reading for pleasure for other times that I read.  I worked out that this gives me about 500 hours of reading time per year (yep, I spend that much time on London Underground).  This might sound daunting, however I find it really worthwhile, and I can cover a large number of subjects in that time.  Some of these subjects will grace this blog as they are important.

I have just finished reading Quiet: The power of introverts in a world that can't stop talking by Susan Cain and I have realised that this love of reading is just one of the signs that I am an Introvert. This is a word that had got so many bad connotations in this world that it has become something to be ashamed of; this book will hopefully help us Introverts to reclaim it and quietly whisper it with pride.

Susan Cain describes herself as an introvert and in this book examines the way that our current, western culture is focused on and celebrates the Extrovert Ideal (loud, brash, "popular", bigger/better/newer, "confident") and is geared to force all western people into this one mould from childhood schooling onwards.  However, some of us don't fit: we like to have quiet, recovery time.  We like to read, think about problems, formulate answers and solutions, and when we think we have it right we will present it with passion (if we truly believe in it) and we are the introverts.

This isn't just a life-style choice, according to research presented in the book there are some physiological differences between us, so no amount of training will change who we fundamentally are, but we might become better at giving a speech.  These include the way that our brains actually function when presented with new stimuli such as meeting new people or being introduced to new concepts.  Introverts' bodies and minds react differently to Extroverts'.

According to the book, many of the greastest minds and business leaders (e.g. Bill Gates) were/are introverts , and they are universally accepted as being "successful", so it seems surprising that introverts are shunned as being lesser creatures that need to be changed to "fit in" and be successful.  Susan Cain provides examples of  numerous experiments that show time and again that under certain circumstances Introverts out perform Extroverts.

Many creative types (e.g. writers) are also highly Introvert and would not be able to function if forced into a brain storming group (great evidence that group brainstorming  is detrimental to both extroverts and introverts).  The book also looks at the evidence that putting Extroverts in charge can lead to a cycle that can spiral out of control (as they can overlook warning signs that an Introvert would heed), but that Introverts are frequently ignored because they don't have the best presentation skills, even when what they are saying is better than what the extroverts come up with.  However, extroverts can get the messages out there with flair and panache, can push for the beneficial risks and are good leaders.

It is one of the key things discussed in the book (although it is blindingly obvious) : Introverts and Extroverts have different strengths and they should be celebrated and encouraged, as together we will be the better for it.

Some people think I am a shy extrovert in that I can talk to strangers, will stand and give a speech at a Wedding or run courses. Yes, I can stand up in front of a room and talk or talk easily with people I've just met,  but I have to feel secure (for example they've approached me and are asking for my help or I'm hosting the party/event) and confident in what I am going to be talking about (I will have spent a lot of time thinking about what I'm going to be talking about, rehearsing what I'm going to be saying). So, I have a mechanism that helps me to do this, but it has its limitations.

I know that I need time away from people to be able to recharge my batteries so I can continue to interact (I will often disappear for a quick walk alone at lunchtimes, not only to get a breath of fresh air but to have a bit of down time), I know that I will find it easiest to concentrate in a communal area with headphones on listening to some music to drown out the rest of the world, which is something I developed to survive Office life. I really do detest open plan offices, and I think there should be a special circle in hell for the person who came up with the idea.  Open plan offices are less conducive for creative work that they are meant to foster, and this book reports on research that shows that both Introverts and Extroverts don't work as well in these environments.

This book has given me the confidence to say that my feelings are valid, that I do not have to be the life and soul of the party the whole time, that I can be me.  It also makes me accept that my clients are also a mix of extrovert and introvert and I will need to adapt my approach to suit them, similarly the advice that I give will also have to be adapted to suit them too as not everyone wants the peace and quiet that us Introverts crave.

So I am an Introvert, and I will whisper it confidently.

Don't have the scars to prove it - Myofascial Abdominal scarring workshop

In the middle of June 2013 I did two workshops with the wonderful Linda of Myofascial UK, the first looking at the Spine & Sacrum (read my thoughts about here) and the second was on Abdominal Scarring.

Most of the people who were on the course had been there the day before, so there was less of a having to get to know everyone feel to the start of the day, and we basically got started straight away.  There were some laughter to start with because one of the leaders running a course in the room next door to us was wearing a T shirt saying "Powered by Orgasm" on it (no, I have no idea what the course was but everyone appeared normal).  

This laughter typifies the day, there is an atmosphere of easiness to the courses, with little anxiety about doing the techniques (once you've got yourself correctly positioned) and more about experiencing them and seeing what happens.  It is part of what makes the courses a joy to attend.

I am fortunate in that I have not had any abdominal surgery (and I hastily look round for something wooden to touch) so do not have any scars that would benefit directly.  However I have already come across and worked with a number of people with scars and know that they have a far reaching effect on the body, and also be a store for repressed emotion.  With the abdomen this can lead to digestive issues, and postural issues (just think of what your favoured position is if you have a stomach ache)  .

In fact the curling into a foetal position , with a 'collapsed' (i.e. shortened) front is an exageration of the slumped position we can easily adopt sat behind a PC/in the car/in front of the TV. So working on this area can be beneficial for so many people who lead sedentary lives.  It is an area that is also frequently overlooked as the pain is on the back of body, but might be because the body isn't fully straigthening up.

The first technique we learnt was skin rolling, and I'm pretty sure that every single person on the course had areas that were restricted (possibly adhered) somewhere in the abdomen.  It was quite an eye opener for me on actually how much of my stomach area needed work, and it was very different for each individual. I do tell my clients that I have had everything done to me that I do to them, so I know what it is like to some extent.  So yes, this is a painful technique (think chinese burn/rippy-burning sensations) but the end result is great.

We learnt a lot of other techniques to ease the abdomen from the diaphragm down to the bladder and pelvic floor and each one was quite remarkable in how effective it was in someone who thinks they stretch well and isn't too restricted in this area. It was very common for releases in the stomach to be felt/accompanied by releases in areas of the back and shoulders, so the abdomen could play a large part in people with back problems and this is something that I will be including with more of my clients when it is necessary.

The direct work on the scar was interesting in that it can be applied not just to scars but also to the belly button (and it can be remarkably, exquisitely painful) and I had two people working on me whilst we were practicing this.  One worked on my belly button and the other on the only scar I have (on my left knee from when I was aged 8 or so and I thought it was fully healed).  The belly button was really quite tender in places, but things felt great afterwards, but I've worked with people in this area so know that it can have a large impact on the digestive system.

I was really surprised about what was happening with the 30 plus year old scar on my knee, I could feel tension down into my big toe whilst it was being worked on and afterwards the texture of the scar was very different (smoother, more pliable and a different healthier colour) and it was a pleasant surprise.

Working on the stomach can have a big impact on people who've had surgery (e.g. appendectomies, caesarians, investigative endoscopies) and this workshop provided me with a number of really useful approaches that I can and will use with my clients.  It has reminded me that I also need to pay attention to what is going on towards the front of the body when people come to me to treat the back.

Since the course I have had a couple of clients who have really benefited from the techniques I learnt over this weekend.  They have all felt a reduction in pain and an opening sensation in the areas that I've been working on.

So next up is the long anticipated unwinding course in September, which should be great fun.  I just need to learn how to fully relax before then, so I can get the most out of it.

Put your back into it, or not - Myofascial Spine & Sacrum workshop

Last weekend I had the joy of going to a couple of workshops run by Linda from MyofascialUK On Saturday I went to the workshop that focused on the Spine and Sacrum, with Sunday focusing on Abdomen (Scarring and adhesions, read about it here).  Having been to their TMJ workshop before I vaguely knew the format: meeting new people and learning techniques that enhanced what I already knew to help in this area.

One thing I do love about these workshops is that they're attended by a loyal group of therapists.  You meet a large number of people that you met at previous courses or workshops. So beforehand and during the breaks it is nice to catch up with how they're doing, what they've been up to, and what courses they've been on and have they been to America to study with John F Barnes (whose style of Myofascial Release we're taught by Ruth & Linda and something I would love to do, Sedona sounds great) There was one lady who I knew, as I walked from the Tube station, that I was going to see again (the last time I'd met her was at the MFRUK stand at CamExpo in October 2012) and there she was sitting waiting to go to the other course that was being run.  We still had a good chance to have a quick natter as we were waiting for the workshops to begin (and she's doing really well, been the US and loved the courses)

So back to the course that I was going to: Spine & Sacrum.  I work at two chiropractic clinics so I see a lot of clients who have back, neck and spinal problems so increasing the number of techniques that I can use makes perfect sense.

The spine is made up of all the vertebral bones (from the coccyx to the cervical vertebra that sit just beneath the skull) and sits around and protects the bundle of nerves that form the spinal cord.  Problems with the vertebra and spinal muscles can impact on the nerves that exit between each vertebra (which is why problems in this area can be quite so painful)

The sacrum is the wedge shaped bone (made up of 5 fused sacral vertebrae) that forms the back of the pelvis, sitting between the 2 ilia (that I refer to as the 'wings of the pelvis,).  These three bones form the pelvic girdle and whilst we often consider that these are a single fixed bone there is some movement between them each time with move the legs, and indeed the sacrum can become stuck put of position which can cause major painful conditions.

During the day there were some great techniques that focused releasing the erector spinae (the group of muscles that sit either side of the spine), pelvic muscles as these interact with the ilia that have a direct impact on the sacrum and some delightful new ways to reach specific muscles that have a key role in the health of the spine (I'm thinking of the Quadratus Lumborum and Psoas here).  Also a couple of rather lovely whole spine techniques that relax everything all the way up.  I'm not going to go into the specifics of the techniques (you'll have to go to the course to find out or have a treatment from me)

One of the key things that this workshop reminded me about is that less is more: if I'm straining then I'm pushing too hard and in fact some of the greatest and most profound releases happen when I exert little pressure.  It is a lesson that is worth learning again and again, as coming from a massage background, it is hard to remember that deep pressure is not always needed.

I feel like I came away from the workshop with techniques that I will use immediately. As I learnt things I could feel myself drawing up a list of clients that this technique would be good for, and they will hopefully benefit from them the next time I see them. In fact I've seen and worked on two regulars who liked what I had done and saw the difference in their life.

There can always be more ways to treat the spine (as there are so many things that can go wrong) so this workshop could probably be a week long course and we'd still want to know more.  In fact I already know I will be signing up for more workshops (The Advanced Upper & Lower Body 2 day courses come to mind) with them next year, after I've done the ones that I have already signed up for later this year.

TMJ fascial workshop

Those of you that I have seen and worked with are probably very bored of me talking on and on about Fascia, but I find the subject fascinating. It is even more fun to work with, especially using the techniques taught by the lovely people of Myofascial UK who ran the course I attended on the Tempro Mandibular Joint (TMJ) back in February. I have used the techniques and information that I mention here with a number of people all with great success in relieving pain around the jaw area.

The TMJ is where the jawbone meets the skull and can be an area we hold a lot of tension in and this can lead to a number of issues including chronic sinus pain (as I personally have suffered from), head aches, jaw misalignment and TMJ Dysfunction (TMJD).

There are four main muscles that work in this area are the:

• masseter, temporalis, and medial pterygoid, which closes the jaw
• lateral pterygoid, which is the only muscle that opens the jaw.

The day started off with introductions within the small group and assessments of each others jaws.  Apparently my jaw was slightly swollen on the right side, and moved to the left and had a couple of popping noises as it closed (which caused some squeamishness from one of the follow attendees)

The fascial techniques are all very slow and seemingly gentle, though they can take you through some very tender moments as you reach, release and move through binds and adhesions.  It was a great group to work with, though trying to keep a straight face and not laugh when someone was working on you sometimes proved harder.

The intra-oral (inside the mouth) work on the pterygoids was a case in point, I found it very hard not to laugh nervously as my partner for approached snapping on a pair of latex gloves.  The laughter did not last very long as once her finger was working on releasing my pterygoid muscles the pain took over (this is, in my humble opinion, one of the most painful techniques I know) The basic technique was something we’d learnt on the Level 3 iMFT course, but with some added techniques to work with the sphenoid at the same time.

The other most peculiar thing that day, which followed the rules of the John Barnes style of Myofascial Release of following where the body leads, was having my hair pulled to release something because my forehead had flushed with a red flare that is one of the signs we look for, it felt weird but much better afterwards.

At the end of the day, my jaw felt much looser and was better positioned.  Though I did have some rather unusual red marks around my face from some of the techniques. The marks have now faded (thankfully) but the relief and freedom is still here 3 months on and that feels great.

Next up for me is the Spine & Sacrum and Abdominal Scarring workshops in June. I really can't wait