Healthcare and Medicine Reference
In-Depth Information
more clinically minded may wish to skip this antipasti
and go straight on to the main course which begins in
Chapter 3.
While everyone learns something about bones and
muscles, the origin and disposition of the fascinating
fascial net that unites them is less widely understood
(Fig. 1.1). Although this situation is changing rapidly as
increased research broadens our knowledge, 1 the vast
majority of the public - and even most therapists and
athletes - still base their thinking about their own struc-
ture and movement on the limited idea that there are
individual muscles that attach to bones that move us
around via mechanical leverage. As Schultz and Feitis
put it:
The muscle-bone concept presented in standard
anatomical description gives a purely mechanical model of
movement. It separates movement into discrete functions,
failing to give a picture of the seamless integration seen in
a living body. When one part moves, the body as a whole
responds. Functionally, the only tissue that can mediate
such responsiveness is the connective tissue. 2
In this chapter, we set a context for the Anatomy
Trains by making a run at a holistic understanding of
the mechanical role of fascia or connective tissue as an
entirety (including, in this second edition, more recent
research on its responsiveness and ability to remodel in
the face of injury or new challenges) and interactions
between the fascia and the cells of the other body
DVD ref: The arguments made in this chapter are sum-
marized in less detail on: Fascia! Tensegrity, available
Please note that this chapter presents a point of view,
a particular set of arguments that build toward the
Anatomy Trains concept, and is by no means the com-
plete story on the roles or significance of fascia. Here,
we go long on geometry, mechanics, and spatial arrange-
ment, and drastically short on chemistry. We concern
ourselves with the healthy supporting role of fascia in
posture and movement, totally avoiding any discussion
of pathology. Other more diverse and excellent descrip-
tions are referenced here for the interested reader; the
'Blessed be the ties that bind': fascia
holds our cells together
Life on this planet builds itself around a basic unit - the
cell. Although we can easily imagine great globs of
undifferentiated but still highly organized protoplasm,
they do not exist, except in certain obscure tree molds
or the minds of science fiction writers. For about one-
half of the 4 billion years or so that life has existed on
this planet, all organisms were single-celled - first as
simple prokaryotic Protista, which apparently combined
symbiotically to produce the familiar eukaryotic cell. 3
All of the so-called 'higher' animals - including the
humans who are the focus of this topic - are coordinated
aggregates of these tiny droplet complexes of integrated
biochemistry contained within an ever-flowing fluid
medium (we are still about two-thirds water), sur-
rounded by constantly shifting membranes, all managed
by stable self-replicating proteins in the nucleus. In our
case, on the order of 10 1 3 or 10 1 4 (10-100 trillion) of these
buzzing little cells somehow work together (with a
vastly greater number of enteric bacteria) to produce the
event we know as ourselves. We can recognize bundles
of these cells even after years of not seeing them or from
several blocks away by observing their characteristic
manner of movement. What holds all our ever-changing
soup of cells in such a consistent physical shape?
As in human society, cells within a multicellular organ-
ism combine individual autonomy with social interac-
tion. In our own tissues, we can identify four basic classes
of cells: neural, muscular, epithelial, and connective
tissue cells (each with multiple subtypes) (Fig. 1.2). We
could oversimplify the situation only a little by saying
that each of these has emphasized one of the functions
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