Massage & Bodywork

SEPTEMBER | OCTOBER 2016

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58 m a s s a g e & b o d y w o r k s e p t e m b e r / o c t o b e r 2 0 1 6 material filling the spaces between the organs, facilitating sliding between anatomical structures, and providing a link between structures such as bones, muscles, and nerves. Descriptive anatomy all but stopped there. Then came the era of the microscope, using optical, electronic, slot, scanning, and transmission techniques to explore human tissue, but at a very different level—that of the cell. It might seem strange to have to discuss this concept of tissular continuity, but in the past, anatomists have tended to compartmentalize the body. However, connective tissue plays far more complex and important roles in the body than previously believed. GENERAL ANATOMICAL CONCLUSIONS Tissue Continuity: No Layers, No Empty Spaces To the naked eye, connective tissue seems at first to be fairly uniform, unimportant, and of little interest to the anatomist. But as the camera slowly approaches the area between distinct muscle groups, a real entwining and interweaving of opalescent fibers strikes us, dissection, a living organism is not simply a conglomeration or assemblage of separate parts. MAINTAINING FORM: EARLY THEORIES OF TISSUE ELASTICITY When we massage, stretch, or pinch and lift the skin, we feel a little resistance to traction but the skin does not tear. When we let go, it returns to its initial position, as if from memory. The tissues respond instantly to the forces imposed on them by the manual therapist and then return to their initial state; the overall shape of the body is maintained. This ability of the body to restore form and maintain its integrity is important, but its significance often goes unnoticed. In the past, physicians described this phenomenon using the terms elasticity, flexibility, and plasticity, but without providing a satisfactory physiological explanation. In the 20th century, authors of anatomical texts tried to explain it from a strongly mechanistic point of view by alluding to notions of virtual space and stratification of tissue. At the time, it was thought that the role of connective tissue was simply as packing or padding A world of glistening fibers exists in every nook and cranny within the body. (65x magnification) and we see that these fibers create links of total continuity. During surgical dissection, these images transform into displays of sparkling, scintillating mobile mirrors and ephemeral lights, disappearing almost immediately only to be replaced by others (Image 4). What are these reflections? How and why are they produced? Why do they exist between muscular structures and under the skin? During surgery, often without realizing it, the surgeon needs to separate, lacerate, and destroy this amalgam of structures that do not seem to be part of the organs and often hinder access to them. To expose the area that is to be worked on, the surgeon has to create a route of access and, in the process, must break through this mass of dense, heterogeneous fibers that appear to surround and wrap around all the internal organs, binding them together. This continuum of fibers, present in all spaces throughout the body, is what we commonly call connective tissue. It is important to emphasize that this so-called connective tissue is present everywhere within the body, linking separate structures from the muscular depths to the surface of the skin. This continuity of a fibrillar network throughout the body is in accordance with the holistic view of many manual therapists. Contrary to conventional teaching, we now discover that there are no empty spaces, no separate layers of tissue sliding over each other. The global nature of connective tissue within the body is evident. But is this tissue solely connective? Is this really its only role? 4

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