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shoulders as well as the ribs. The diminution of the
breathing in turn creates a different balance of chemistry
in the blood and body fluids, lowering oxygen and
raising Cortisol levels. Changing this whole pattern may
not be possible simply by changing the rate of serotonin
reuptake with antidepressant drugs, or even by chang-
ing the internal perception of self-worth, because the
pattern is written into a habit of movement, a set of
fascial fibers, as well as a set of chemical pathways in
the fluids.
In modern medicine, the neural and chemical aspects
of such patterns are often considered, while the 'Spatial
Medicine' aspect of these patterns is too often ignored.
Effective treatment considers all three, but individual
treatment methods tend to favor one over any other. The
old saying goes: 'If your hand is a hammer, everything
looks like a nail.' Whatever tool we are using to inter-
vene, we do well to remember all three of these holistic
communicating systems.
Fig. 1.30 Relationships among these holistic nets are complex.
Each of the nets has 'ambassadors' to the other nets to alter their
state and to keep the systems inter-informed and regulated.
The double-bag theory
in its rich diversity and proliferation of primarily stretch
receptors. 7 6 These sensory nerves frequently outnumber
their motor compatriots in any given peripheral nerve
by nearly 3:1.
There are a number of different types of receptors
within the interstitial substrate of the ECM, including
Golgi receptors, Pacini corpuscles, Ruffini endings, and
ubiquitous free nerve endings. 7 7 These specialized
endings pick up and pass along information concerning
changes in stretch, load, pressure, vibration, and tangen-
tial (shear) force. The free nerve endings are especially
interesting, in that they are the most abundant (they are
even found within bone), they are connected to auto-
nomic functions such as vasodilation, and they can func-
tion as mechanoreceptors or as nociceptors (pain). 7 8
Obviously, the nervous system is responsive, and can
change muscle tone in response to signals from these
sensory signals. We have previously described how the
fascial system has its own (generally slower) responses
to mechanical changes. Woven together, as they always
are in a living person, they point to a rich diversity of
modes of intervention to the fibrous body itself or to the
neurological web within it. The jury is still out on what
exactly causes both pain and its cure, but new avenues
are promising.
To demonstrate this interweaving of the three systems
with an example: the person who becomes depressed,
for whatever reason, will generally express that feeling
in somatic form as being stuck on the exhale - they will
generally appear to the observer as having a sunken
chest, without full excursion upward of the ribs on the
inhale. Put the other way around, few people with a
high, full chest go around saying, 'I'm so depressed.'
The depressive posture may start out as a perception
within the nervous representation of the self versus the
world involving guilt, pain, or anxiety, but that soon is
expressed out through the motor system as a recurrent
pattern of contraction. This chronic contraction pattern
is accommodated after a time by the fascial system,
often reaching out over the whole body - the pattern in
the chest requires compensation in the legs, neck, and
When the BBC asked the great British naturalist J. B. S.
Haldane if his lifelong study had taught him anything
about the mind of the Creator, he replied, 'Why, yes, He
shows an inordinate fondness for beetles.' (Haldane was
so fond of this answer that he arranged to be asked the
same question a number of times, so that he could
delight himself and others with minor variations of the
same reply.)
The modern anatomist, given the same question, can
only answer, 'an inordinate fondness for double-
bagging'. Two-layered sacs show up so often in connec-
tive tissue anatomy, often derived from embryology
that it is worth a brief separate exploration, before
returning to its relevance to the Anatomy Trains theory
per se. We also take the opportunity, while rummaging
around in embryology, to point out a few of the larger
mileposts in the development of the fascial net in
Each cell is double-bagged, the heart and lungs are
both double-bagged, the abdomen is double-bagged,
and the brain is at least double-bagged, if not triple-
bagged (Fig. 1.31). It is the contention of this section that
it is worth looking at the musculoskeletal system as a
double-bagged system as well.
If we return to the very beginnings, we find that
the ovum, even before it is expelled from the ovarian
follicle (Fig. 1.32), is surrounded by the double bag of the
internal and external theca. 7 9 Once released, like most
cells, it is bounded with a bilaminar phospholipid mem-
brane, which acts as a double bag around the cell's
The ovum expelled from the follicle at ovulation is
further surrounded by another membrane, a translucent
coating of mucopolysaccharide gel called the zona
pellucida (see Fig. 1.32), through which the successful
sperm must pass before reaching the actual membrane
of the egg. While we commonly retain a Darwinian
picture of fertilization, with victory going to the fastest-
swimming and most aggressive sperm, the fact is that
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