There are at least three ways, maybe even many more, to approach the practice of massage--as healthcare profession, as self-expression, and as business.
Of course, no one approaches it exclusively one way or another--even healthcare professionals, mystics, and artists have to make a living, professional ethics in business are a thriving area of exploration, and the feeling of self-actualization can be the key to a long and fulfilling career no matter what other aspects of massage you pursue.
These aren't self-contained monocultural boxes you find yourself in, so much as they are tendencies, one way or another. The interactions among those tendencies, and the choices you prioritize, will influence where you find yourself in the space of massage practice.
In this illustration, practitioners A, B, and C all find themselves in different areas of massage practice space, because of the different blends of healthcare professional, self-expression, and business orientations they bring to their practice.
Meaning, too, has multiple aspects, including:
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the ideas we have about the universe around us, and the feelings and reactions those ideas draw out of us;
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the words, or terms, that we use to talk about those ideas; and
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the material physical things in the universe that those ideas and words refer to.
Since all of these aspects interact with and influence each other, we can model them as a triangle, with the three connected corners representing concepts/ideas, words/terms, and material physical referents.
Looking at the relationships among components of the Semantic Triangle, it is easy to see how referents can influence concepts: for example, Wilma--a sun bear at Woodland Park Zoo in Seattle, who no one suspected was positively riddled with tumors, but who held on just long enough to wean her twin cubs onto solid food before suddenly dying from the cancer--is a real-life referent whose fortitude while suffering reinforces the concept of "bear as good mother".
Sometimes the referent’s behavior, in addition to influencing concepts associated with a term, can actually influence the chosen or constructed term itself: the Russian for bear, медведь (pronounced "myed-vyed"), comes from the linguistic roots for "honey-eater" (our word "mead" for honey wine, comes from the same root as "мед").
And, like in the English term "bruin" ("the brown one"), it's also an example of intentional misdirection, and an indication of the beliefs behind it--bears can be scary, especially way back in history at the time when we were first deciding on words to describe the world around us.
To the people who came up with these terms, it may well have seemed safer to use taboo avoidance, just to be sure. Taboo avoidance means, in this case, a kind of magical thinking where it seems more prudent to refer to bears by euphemistic terms like "honey-eater (Russian)", "honey-paw (mesikämmen: Finnish)", or "the brown one (English)", rather than to get this scary animal's attention by outright saying "bear" in one of those languages, and running the risk of summoning angry supernatural bears down upon the speaker.
It’s not immediately obvious how influence flows the other way—that is, how concepts and terms can affect real-world referents—but a little thinking about it provides some examples. If someone thinks of bears as dangerous predators, they may lobby for laws allowing bear hunts, with real consequences to the referent bears themselves. However, assigning the term "endangered species" puts bears under particular legal protections, which could prevent their being hunted, saving the lives of actual bears.
So words, concepts, and real material physical referents all influence each other in the meaning we make of this universe around us.
And that meaning that we make, and decisions based on that meaning, influence where in massage practice space we find ourselves.
Although we often think of anatomy as strictly scientific, that's not always how people use anatomical terms and concepts. Gil Hedley writes:
The superficial fascia is an organ: it is an organ of metabolism, an endocrine organ producing some 30 hormones and counting; a great lymphoid organ; a sensory organ; a sensual organ; an electrical insulator; a thermal insulator; a movement sleeve; and a great antennae... what else? Tell me!!
And people did tell him. Responses included:
"All is fascia."
Microtubulars of liquid light .....-:-
Information super-highway......pure communication.
It's a Gigantic "Soft Drive", information collection unit...completely unique to each host...only to exist for One Lifetime.
Non specific immune function, and groovy to to work:-)
And a information webcam
The "copper wire - like" conduction system for sub atomic vibration of photons and electrons in cell communication.
Hedley continues to engage in the comments, but he does not correct any of the factual errors that either he or his commenters make.
What, exactly, is this process? It's not anatomical science--most of the discussion is, at best, highly metaphorical and allegorical, and at worst, factually wrong.
Clearly, it's meeting a huge need among his commenters, though:
Yes!
Your fascia discoveries are inspiring :)
Thanks for continuing to inspire the bodywork field. Blessings!
We are amazing!
If it is not science that Hedley is carrying out, then what is he doing?
I think that, given the apparent unmotivated functions of self-expression evident in the original post, and the motivated functions, among others, of validation, reflected in the commenters' responses, it would be fair to say that Hedley is carrying out performance art, religious expression, or both--using terms and concepts from anatomy for those purposes.
I don't think he would object to this taxonomic classification, based on what he's said about his philosophy:
Science to me is another religion among many, whose dogmas I am attempting to shed.
He isn't particularly concerned about doing science for the sake of knowledge.
That's perfectly fine, as long as we're all clear about what the process is about. If it's validation, or self-expression, or performance art that you're looking for, that's exactly what you're getting, and there's nothing wrong with that. Consenting adults, caveat emptor, and all that.
If it's anatomical science you want, on the other hand, not only is this not what you're looking for, but taking it at face value will get in the way of your actual understanding of the structure and function of the body.
This is where he makes an actually misleading statement:
I can do a much better job ripping into my own stuff than that particular critic [Paul Ingraham], and recently did so in front of 600 colleagues at the fascia congress in Vancouver, and will gladly do so again to move the knowledge base forward!
Propagating ideas such as that the superficial fascia is an endocrine organ, or that cells communicate with each other by means of photons and electrons, without correcting those factual errors, doesn't move the knowledge base forward at all. Instead, it sends a loud message to potential colleagues in healthcare professions that we aren't interested in, or are even actively hostile to, knowledge and reality.
This matters very much on an individual level, and on a professional level as well. One of the biggest obstacles to MTs becoming part of an integrated healthcare team is our inability to distinguish pseudoscience from science, and metaphor from literal truth.
If we remedy those problems, we can share in the common knowledge base of healthcare professions, and we can participate in sending a unified message to the client/patient.
If we don't, then we can't.
It's a decision we all need to make at the individual level, and those individual decisions will determine the fate of MT as an integrative healthcare profession, a siloed alternative medicine industry, or something else altogether.
What would an examination of these questions look like from the viewpoint of anatomical science?
The first, and most inportant, distinction between science and other human activities is that--rather than just operating in the realms of words and concepts--science has to do the work of connecting claims back to actual referents in the material physical universe.
So, for our claims, we will do that work as we go along.
A commenter on a different forum asked:
Why is Gil's comment so far fetched?
She's quite correct--I have made the claim that Hedley's work is performance art or some other form of self-expression, rather than anatomical science, and now it's my job to connect the dots and show why my claim is correct.
For the sake of time, let's just examine one part of the statement; it's representative of the same problems in the rest of it.
"The superficial fascia is an organ: it is an organ of metabolism, an endocrine organ producing some 30 hormones and counting"
What is he referring to? He clarifies that later on in the comments to his post:
"Adipocytes are generally classed as connective tissue cells with endocrinal function."
Fair enough--he gets the details right the second time. But he doesn't go back and correct his first statement to make it right.
By saying "superficial fascia...is an endocrine organ" there, he is confusing:
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structure (connective tissue versus glandular epithelial tissue) with function (protein secretion), as well as structure (endocrine) with function (secretion), and
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identity with parts/wholes: equating all of the superficial fascia (adipose tissue + loose areolar connective tissue) with only that part of it that actually secretes proteins (adipose tissue).
So he's at the wrong level of abstraction when he says superficial fascia--he means adipose tissue. Sounds like a picky little detail, doesn't it? And yet, it's a symptom of a lack of true understanding about anatomy.
This lack of true understanding about anatomy is a mistake that propagates among the MT community like wildfire--the very first thing you learn on the very first day of the very first anatomy class is the four kinds of tissue, right?
Epithelial, connective, nervous, and muscle tissue, right?
And yet, all over the web, you see people selling the concept that "body tissue can carry emotional memory", and MTs buying it, as though they had never heard of the distinction between epithelial and muscle tissue and nervous tissue. Those MTs can recite the names of those tissues to pass a multiple-choice test, yet they can't put the very first thing taught in anatomy class into practice when it comes to evaluating anatomical knowledge claims.
Being careless about the distinctions between different kinds of connective tissue, and what they are structurally, versus how they function, is exactly the same kind of error.
It prevents scientific understanding and real anatomical reasoning. As I mentioned previously, Hedley has been widely quoted as saying in his video that science is just another belief system, whose dogmas he's trying to shed.
The way he talks about anatomy, it is clear that he is not approaching it as science, nor bothering to get the scientific details correct. As a direct result, it comes across more as art or another form of self-expression, which is fine, as long as people know that that's what it is, and not anatomical science.
But I don't get the sense that people actually realize it; I think they think that's anatomical science they're doing, and it's a long way from it.
The "tell"s are comments like this one:
The "copper wire - like" conduction system for sub atomic vibration of photons and electrons in cell communication.
The words come from science, but they way they are strung together makes no sense. This is not a scientist nor a scientifically-trained layperson talking, yet salting the sentence with sciency words is, for some reason, important to the writer.
That indicates that the writer thinks they're making scientific sense, and really has no idea what science is and isn't.
Another, shorter way, to look at it is like this: confusing connective tissue with superficial fascia with adipose tissue and saying that connective tissue is an endocrine organ is the same kind of error as saying that mammals fly.
It's true that one kind of mammal--bats--do fly. But despite that one corner case, if you say that mammals fly, you'll be wrong most of the time.
If he is saying that adipose tissue is an endocrine organ, then he's using the term wrong, because adipose tissue is not an organ.
Superficial fascia, on the other hand, is an organ, but only one of its components has an endocrine function, so again, he's using terminology wrong: it's not an endocrine organ, although one of its components has an endocrine function.
It's the part/whole confusion, "bats fly, therefore mammals fly", logical error that he is committing there.
The questioner continues:
I did miss Gil's larger comment section and I am very glad you spent the time to explain the error and confusion of superficial fascia vs endocrine function of adipose tissue, which Gil is confusing with superficial fascia. Thank you.
But I must ask.... The primary function of the heart is circulatory yet it does have an endocrine function. I understand from Anatomy Trains, Fascia is highly innervated. Could it be possible fascia has more of a role than just stabilization? Especially when it is dysfunctional?
I think the role of fascia has not been studied well enough. Just a few years ago, science told us once a brain cell dies, it is gone forever. Now we understand neurogenesis better.
The questioner raises excellent questions, and I am glad they did so, as it gives us an opportunity to explore these issues in more depth.
It is true that sometimes scientific knowledge changes--so what does that mean for us here and now?
We'll examine these questions one by one, to try to figure out what is going on here.
Wikipedia: Neurogenesis, occurence in adults accessed 26 July 2012
"Considered": meaning they had the concept of the nervous system as fixed and incapable of regeneration, and they spoke of it in those terms.
The first evidence of adult mammalian neurogenesis in the cerebral cortex was presented by Joseph Altman in 1962, Wikipedia: Neurogenesis, occurence in adults accessed 26 July 2012
Joseph Altman questioned these concepts and ways of speaking about the nervous system, and as evidence for his claims, he introduced a material physical referent: the tangible new neural cells in the actual cerebral cortex.
followed by a demonstration of adult neurogenesis in the dentate gyrus of the hippocampus in 1963. Wikipedia: Neurogenesis, occurence in adults accessed 26 July 2012
Another material physical referent presented as evidence to counter the previous concepts and words: tangible new neurons in the dentate gyrus of the hippocampus.
In 1969, Joseph Altman discovered and named the rostral migratory stream as the source of adult generated granule cell neurons in the olfactory bulb. Wikipedia: Neurogenesis, occurence in adults accessed 26 July 2012
Yet another material physical referent: tangible adult generated granule cell neurons in the olfactory bulb.
Up until the 1980s, the scientific community ignored these findings despite use of the most direct method of demonstrating cell proliferation in the early studies, i. e. 3H-thymidine autoradiography. Wikipedia: Neurogenesis, occurence in adults accessed 26 July 2012
However, Altman and others' actual evidence with its connection to a referent was ignored in favor of the prevailing concepts and words.
The neuroscience community screwed up--that's not how science is supposed to work. Eventually, it did self-correct to more represent reality, but it took too long to do so.
But it didn't totally overturn their theories--if you're quadriplegic, for example, we still don't know how to make those nerves regenerate. And there are parts of the brain where they have observed neurogenesis, and others where they didn't.
So they were partly right, and partly wrong, and they held onto their theories for too long--but like the connective tissue example, and like the flying mammals example, you need to be very clear about the details of what exactly you are talking about--exactly what kind of connective tissue, exactly what part of the superficial fascia, exactly which nerve cells, in exactly what part of the brain.
Otherwise, you fall into unsound--false--conclusions like the "mammals fly" one.
That's the error that Hedley falls into--he gives names to things, and makes up explanations, without making any attempt to validate the connection of those names and explanations to material physical referents in reality.
It's perfectly acceptable in art or other forms of self-expression to not be constrained by any connection to a material physical referent. But science requires that connection, and since Hedley doesn't supply it, it's not science that he's practicing. Nothing more and nothing less than that.
The primary function of the heart is circulatory yet it does have an endocrine function.
That's correct. Does that make it an endocrine organ?
To answer that, we would need to clarify what an endocrine organ (a gland) is.
An endocrine organ is composed of glandular epithelium. Are the cardiac myocytes that produce the hormones atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP) made up of glandular epithelium?
What does the answer to those questions tell us about whether the heart is an endocrine organ?
When you answer that question, then you have stepped through the process of anatomical reasoning.
And you have generated a piece of new knowledge as well--the answer to the question "are glands (endocrine organs) the only anatomical structures that produce hormones?".
You were able to do that because you maintained the difference between structure and function, and between part and whole that is absolutely necessary if you are going to figure out correct answers about new anatomical questions that you do not already know the answer to beforehand.
Hedley's descriptions don't support anatomical reasoning to correct answers, because of the way he substitutes parts for wholes, and structure for function. He can make any statement he wants, but you cannot put those statements together and use them to reason with, in the way you did here.
And sound and complete logical reasoning is absolutely necessary in anatomy, because there are so many facts that you cannot memorize all of them by rote. You have to learn enough anatomy to form a basis, and then use that basis for drawing correct conclusions as you need them.
So how do I know my definitions are 100% right, and his aren't?
First, I don't ever know anything 100%. But the way I am using anatomy, I am not only drawing on centuries of actual anatomical history, and distinctions that we can empirically detect with microscopes and other instruments (referents), but I am drawing on an integrated whole with other sciences and logic as well.
The fact that it works so well in generating new knowledge through reasoning is an indicator that this way of dividing up hormone producers between endocrine glands and things that are not endocrine glands, is more likely to be 99% right--and thus, not to change abruptly out from under us--than it is to be 60% right, and we'll have to make massive adjustments someday.
I understand from Anatomy Trains, Fascia is highly innervated. Could it be possible fascia has more of a role than just stabilization? Especially when it is dysfunctional?
Yes, it could be possible. You could form a hypothesis with that question, and you could test it, and you could accumulate evidence that backed up that hypothesis. And you would be carrying out science when you did that.
And when you have done that, and you have shown that your hypothesis is backed up by the evidence, then we can consider that it's part of our knowledge--how certain we are about it will depend on the evidence, but at least we trust it to some degree.|
But that only counts after it's been done. Before it's actually been done, and repeated, and other explanations for what we see have been ruled out, then it's really just marketing hype.
That can change, if the work is done to back it up. But fascia research is very preliminary right now.
Have you ever driven really fast at night, so fast that your stopping distance got ahead of where your headlights could see? That's called "overdriving your headlights".
Metaphorically, to speak of things with certainty before the work has been done to back those things up with evidence is like overdriving your headlights. It's great for ginning up enthusiasm, but you can't really use it to base anatomical reasoning on.
But it's a good question, and maybe the evidence will back it up someday. We just can't act as though we're there already, because we've just started learning so much.
To finish my thought I must say, Instant Ice and Kinesio Tape boggle my mind neither works directly to effect the muscle, yet tissue responds positively to them. Why do these techniques work?
You're right that something happens that creates a response of some type, yet the muscles are too deep for them to be directly effected.
What kinds of anatomical structure communicate both with superficial layers of skin, and with muscles as well?
Fascia is one kind of structure; can you think of any others?
That would be a very good candidate to begin looking at for answers.
'"What kinds of anatomical structure communicate both with superficial layers of skin, and with muscles as well?"
Sensory / Motor nerves come to mind, capillaries... As well as fascia.'
Good answers.
We know, from centuries of anatomy, that sensory nerves can carry pain signals, and that nerves can be blocked in various ways from carrying them, while capillaries don't carry pain signals.
Hedley says that superficial fascia is "a sensory organ", but he doesn't offer any explanation of why he says that.
It is a poetic metaphor, but it is not a fact that anatomical reasoning can be based on.
It is a similar error to the part/whole of adipose tissue/superficial fascia--as you observed, fascia is highly innervated.
Why would fascia duplicate that function itself, when it already contains tons of nerves doing that same job?
"Okay, that can explain the instant ice, but kinesio tape? Primarily effects fascia, or others thoughts...?"
I would say that, since:
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those modalities are directly contacting nerves, while the epidermis stands completely between them and the superficial fascia, blocking it from them,
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we know that nerves have that functionality, while there is absolutely no evidence that connective tissue does, and
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fascia already contains lots and lots of nerves, and there is no anatomical need for fascia to duplicate that function,
that the evidence up till now, plus our anatomical reasoning about the anatomy we know, indicates that it is much more likely that the mechanism involves the nervous system to a much greater degree than it does the fascia.
Now that we have an idea that is consistent with the anatomical evidence, we could do a literature search to see if others have investigated this question, or we could design a study of our own to test it.
That doesn't mean that nobody will ever show any interesting properties of fascia. But from what we know now, to a very strong degree of certainty, it doesn't make sense to speculate about new properties that fascia might have, until and unless the research actually shows that that is true.
It's up to you where you locate yourself in massage practice space. If you find self-expression or business to be your more natural fits, there is absolutely nothing wrong with that fact.
If you find healthcare professional to be your more natural fit, then--for the sake ultimately of your clients--you have a higher obligation than others do to get the knowledge and the facts as close to correct as you possibly can.
Anatomical science is crucial to the core of massage as a healthcare profession. If you are seeking anatomical science, then make sure that that is what you are actually getting.
There is nothing wrong with seeking other things instead of anatomical science--you just want to make sure that you are very clear on what the difference is, and that you know yourself and what you are looking for, and know for sure what you are getting.
