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Fig. 1.72 'The fibrils, made of collagen and elastin, delimit the
microvacuoles where they cross each other. These microvacuoles
are filled with hydrophilic jelly made of proteoaminoglycans.' What
a still photo cannot convey is the fractal and frothy way these
microvacuolar structures roll over each other, elasticize, reform,
blend, and separate. (Photos (and quote) courtesy of Dr
Guimberteau from Promenades Sous La Peau. Paris: Elsevier;
2004.)
A
B
Fig. 1.74 The 'microvacuolar collagenic absorbing system'
diagrammed from skin to tendon, showing how there is no
discontinuity among fascial planes, just a frothy relationship of
polygons that supports the vascular supply to the tendon while
still allowing sliding in multiple directions. (Photo courtesy of
Dr Guimberteau.)
Fig. 1.73 The microvacuolar system of Guimberteau synthesizes
the predictions made by tensegrity geometry with the pressure
system concepts from visceral manipulation proffered by another
Frenchman Jean-Pierre Barral. This picture demonstrates how this
system can respond to all the forces under the skin - tensegrity
and optimal use of space/closest packing, osmotic pressure,
surface tension, cellular adhesions, and gravity. (Photo courtesy of
Dr Guimberteau.)
This kind of tissue arrangement occurs all over the
body, not just in the hand. Whenever fascial surfaces are
required to slide over each other in the absence of an
actual serous membrane, the proteoglycans cum colla-
gen gel bubbles ease the small but necessary movements
between the skin and the underlying tissue, between
muscles, between vessels and nerves and all adjacent
structures. This arrangement is almost literally every-
where in our bodies; tensegrity at work on a second-by-
second basis.
There is little to add to these images; they speak for
themselves. To see this system in motion, Dr Guimber-
teau's video is available from www.anatomytrains.com.
The photo here shows the complexity, but not the diver-
sity in how the microvacuoles and microtrabeculae rear-
range themselves to accommodate the forces exerted by
internal or external movement. The trabecular 'struts'
(actually parts of the borders between vacuoles) shown
in Figure 1.75, which combine collagen fibers with the
gluey mucopolysaccharides, spontaneously change
nodal points, break and reform, or elasticize back into
the original form. Also not visible in the still pictures is
how each of these sticky guy-wires is hollow, with fluid
moving through the middle of these bamboo-like
struts.
Guimberteau's work brings together the tensegrity
concepts on both a macroscopic and microscopic level.
Pictured here (Fig. 1.73), the skin of these bubbles is
formed from elastin and collagen Types I, II, IV and VI.
The bubbles are filled with 80% water, 5% fat, and 15%
hydrophilic proteoglycoaminoglycans. The fern-like
molecules of the sugar-protein mix spread out through
the space, turning the contents of the microvacuole into
a slightly viscous jelly. When movement occurs between
the two more organized layers on either side (the tendon,
say, and the flexor retinaculum), these bubbles roll and
slide around each other, joining and dividing as soap
bubbles do, in apparently incoherent chaos. 'Chaos',
understood mathematically, actually conceals an impli-
cate order. This underlying order allows all the tissues
within this complex network to be vascularized (and
therefore nourished and repaired), no matter which
direction it is stretched, and without the logistical diffi-
culties that present themselves whenever we picture
the sliding systems the way we have traditionally done
(Fig. 1.74).
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