What is the best birthday present a person can get? – Well, there are many facets to that, right?
First of all – I want to thank all of you – my Facebook page and e-mail were full of birthday wishes and cards. I really appreciate that and it means a lot to me…
But today I wanted to talk about a different and very special present. Finally I know the answer to what really is an incredible birthday present :-)
Obviously I can only speak from my own weirdo perspective – but this year I have really got treated to an amazing birthday present… a 2-day long 1-on-1 meeting with a person I consider a bona fide genius – Dr. Jaap Van der Wal.
His insights lifted me out of one of my deepest and longest standing frustrations (obviously without knowing it – I was just one of 100s of people in the audience when he talked from the stage).
What frustration am I talking about? – well, the one that is central to the entire medical and biological discourse of today.
You see, there are two camps out there and the rift between them is of a Grand Canyon size.
Sub-anatomical camp gave us drugs and surgery, which are the essence of modern ‘scientific medicine’. Modern medicine deserves a lot of credit for its ability to save lives and deal with injuries and infectious diseases – but at the same it is quite obvious that when it comes to the ‘big picture’ this “shredding” sub-anatomical camp has got it wrong – the continuity of the organism is lost in the feverish chopping into yet smaller parts... Chopping goes easy but the connection doesn’t come together very well.
That’s why when it comes to complex chronic conditions –modern medicine is in crisis – not only as extreme as Cerebral Palsy but even as mundane as common back pain, which presents and insolvable problem to modern day medicine.
As a parent of a child with Cerebral Palsy you have the misfortune of frequent communication with one of the most simplistic and aggressive clans within the sub-anatomical camp – orthopedic surgeons who drag your kids into hip, feet and spine chopping…
`On the other side of the divide CAM – Complementary and Alternative Medicine. This is the camp that calls itself –‘holistic’ camp. These people approach the human body from an encouraging starting point – ‘unity’, ‘integrity’, ‘indivisibility’ etc. Sounds really great But, unfortunately these beautiful words and elegant philosophies yield very little when it comes to practical work. The “holistic” CAM camp faces two immense problems.
First problem – they gave rise to all sorts of ‘distant healers’, obscure ‘energies’ or simply escape into the spiritual domain bypassing the earthly matters altogether.
Second problem – when CAM practitioners – from osteopaths to acupuncturists – get into physical contact with their patients they no longer remain holistic but end up borrowing the language and definitions from the sub-anatomical camp.
In other words, there is a lot of lip service around to the ‘holistic’ thinking – but such lip service unfortunately remains only a shell. Sometimes this shell is just empty (‘healers’ who deny the scientific method altogether) and sometimes it houses the same sub-anatomical content as mainstream science (osteopaths, chiropractors etc. ) – philosophies are ‘holistic’ but actions revolve around the same old sub-anatomical notions of organs, cells and molecules.
Don’t get me wrong – I am not mocking anyone –this is an immensely difficult matter to pin down. The ‘holistic’ people can’t come up with one truly ‘holistic’ science – because whenever they try to do ‘science’ they lose the ‘holism’. And the opposite is true – when the science people try to address the problems of a ‘whole body’ – they fail quite miserably – just look at the surging numbers of knee and hip replacements not to mention the inability to “win over” chronic conditions like Cerebral Palsy.
In short, many great minds tried to find the way out of this dilemma but failed...
Dr. Jaap Van der Wal was the first one who came up with the powerful enough paradigm shift allowing to lift the modern medicine out of this trouble of chasing the elusive ‘organismic level’...
First time I heard him speaking was at the 2nd Fascia Congress (Amsterdam, 2009) and his talk completely blew me away. It was exactly what I was so desperately searching for many years– a voice from within community of anatomists who actually rose above the keyhole thinking of his own profession and urging to move from sub-anatomical (the search of new and smaller parts) to trans-anatomical (new aggregates of well-known ‘parts’).
Now before I proceed to details – do not rush into looking at the recent list of Nobel Prize nominees – you are not going to find him there … Yet…
I am saying a hopeful “yet” rather than “it’s never going to happen for as long as the pharmaceutical and surgical cliques are at power suppressing anything that doesn’t fit their interests” because I think that we are on the verge of some major tectonic shifts in medical-biological sciences.
On the one hand, it is true that the pharmaceutical and surgical industries have a tight grip on where the mainstream science goes; but on the other hand, the new ideas are no longer limited to the ‘new age’ gurus or alternative ‘wackos’ denying science altogether and obsessed with conspiracy theories.
For example, the International Fascia Congresses – these are proper scientific gatherings bringing together 100s of researchers and clinicians. Of course, their profile and budgets are miniscule comparing to the ones that are held on, say, genetic research, or vaccination – but nonetheless these are legitimate if marginal channels that are emerging.
For example, Dr. Van der Wal was a main stage keynote speaker (45 min) at a Congress that held over 400 scientific presentations. In academia world – that’s already quite a badge of honor. It takes a significant credibility weight to get to the keynote speaker position.
On the other hand, there are 1000s of medical congresses that are held around the world every year and there are tens of thousands of keynote presenters – so the public attention is still mainly focused on the mainstream sub-anatomical medical science.
Nonetheless, I am confident that the tide has started to change and within a few years what today is still seen as marginal is going to become a recognized frontier of science…
Dr. Van der Wal’s presentation at 2nd International Fascia Congress was titled: “The Architecture of the Connective Tissue in the Musculoskeletal System.”
Are you disappointed with a non-flashy title? After all of my introduction – you probably expected something more flashy and indicative of the immense breakthroughs?
Well, that’s what scientists do very well – make exciting things look boring …
Have you looked forwards for the title being “Transanatomical Breakthroughs and how they kick the butt of the old crappy sub-anatomical paradigm?”
Well, that wouldn’t have worked at a serious scientific conference – and that’s the main reason I am taking the liberty of re-wording some of the original ideas of Dr. Van der Waal into a more user-friendly format and providing some context and narrative -– because the original lecture was so jam-packed with amazing insights that it makes one's head spinning…
In essence, he spoke about the most fundamental shifts that the ‘connective tissue -centered’ approach requires – need to start thinking transanatomically instead of ever smaller sub-anatomical digging.
Dr. Van der Wal is researcher – not a clinician. He approached the problem entirely from the position of clear uncluttered reasoning:
Step 1. As classical anatomists we used to call most of the connective tissue (fascia) non-specific and peel it away when dissecting with scalpel and creating the definitions and names for specific anatomical parts (ligaments, muscles, bones, internal organs etc.).
Step 2. We have now realized that connective tissue (fascia) has to be taken into the account at all times and everywhere throughout the body– not only in some specific locations where anatomists used to pay attention to it (aponeurosis, ligaments etc.) Connective tissue has to be seen as the active one – not a passive envelope.
Step 3. BUT – since connective tissue is present everywhere throughout the body whilst being ‘the same’ in its built and since it also has significant plasticity that depends on external conditions – sub-anatomical reasoning is a dead-end road. Sub-anatomical 'chopping' of the unique localized organs/tissues into smaller parts (physically by slicing or virtually via the imaging devices) – made at least some sense because division down to the cell level maintained that uniqueness and specificity.
However, for the universal connective tissue this dividing approach doesn’t make sense. Why? – because cutting a universal tissue into smaller elements reduces specificity – the smaller the parts we get, the less organ- and role- specific they are.
Putting it simply – a cell that belongs to a liver is a unique cell – you can’t confuse it with, say, a cell that belongs to the lungs or kidneys or muscle... But for the connective tissue that’s very different – by looking at its constituents (collagen and other fibers, fibroblasts, hyaluronans etc.) – we cannot say where they belong : to the head or to the toes or to the kidneys…
That’s why the connective tissue/ fascia is special. It doesn’t yield itself to sub-anatomical understanding. It’s an inconvenient tissue. In the past – for many centuries anatomist used a simple way of getting around this “oddness” of fascia – simply by ignoring it an scraping it away.
But now – if one says: “A” –“Yes, we can’t ignore connective tissue any longer”; then one has to say: “B” as well – “We are going nowhere with sub-anatomical methodology”; and then: “C” –“Khhm, we need to change the entire way of our thinking about tissues and functions of organism..”
Step 4. Recognition of connective tissue role is not simply an expansion of sub-anatomical scope (“we did not look at it before – now we will”) but requires much more – the complete reversal of reasoning: getting back to the starting point of gross anatomy level (“big” , “obvious” parts – muscles, bones etc.) but instead of going into sub-anatomical division – start thinking “trans-muscular”, “trans-articular” etc. – in other words thinking in a ‘trans-organ’ way – thinking ‘trans-anatomically’ …
How big is that? – Absolutely huge. Effectively in a short presentation Dr. Van der Wal turned the entire medical quest inside out… Because transanatomical architectural thinking is exactly the way that allows to bridge that Grand Canyon of divide between the sub-anatomical camp of modern medicine –that accumulated lots of knowledge about parts but lost the integrity of the organism along the way – and the ‘holistic’ camp – that has great intentions of complete ‘organismic’ approach but fails to show much of the practical outcome for it.
Transanatomical architectural approach of Dr. Van der Wal is the one that integrates both – allows us to use the knowledge about parts accumulated by mainstream medicine but at the same time put it into proper ‘organismic’ context…
Frankly, I can’t think of many intellectual achievements that could be ranked higher than that…
Let me highlight this once again – most of the Fascia researchers are the sub-anatomical thinking people who are excited by the study of yet another type of tissue, which was overlooked for a long while. They tell their fellow researchers: “Look this substance is worthy of studying as well – not only the neural cells or muscular cells or blood cells or whatever other cells that you guys have been studying…”.
Sure, that’s great – but these ordinary Fascia researchers are not awake to the fact that fascia /connective tissue is not simply ‘yet another’ tissue that can be “studied with sub-anatomical tools of doing lab experiments and observing them though electronic microscopes..” They are so used to the inertia of sub-anatomical thinking that they apply it to the connective tissue as well without realizing how different it is…
Only Dr. Van der Waal was actually able to see that the recent inclusion of connective tissue / fascia into the anatomical discourse in the new status of a “first class citizen” instead of an “underprivileged cattle class pariah” it used to be – changes the entire game... It’s more than just an inclusion of a new member– it’s the inclusion that is going to require the complete revision of the medical reasoning…
Fortunately, I am not the only one who ‘felt the Earth trembling’ and realized the massive consequences of Dr. Van der Wal ideas.
For example, a famous fascia visionary Tom Myers whose “Anatomy Trains” started the ‘fascia revolution’ was among the first ones to react:
Tom Myers Dynamic Ligaments: The Revolutionary Re-vision of Jaap van der Wal. 2011.
Whitney Lowe Does Fascial Research Alter Assessment? 2011
In short – mark my words – in a few years from now Dr. Van der Wal is going to be seen as an absolute giant of medical and biological sciences for this transanatomical realization alone – not to mention his amazing breakthroughs in embryology.
Well, I guess after such a long pre-face I should be allowed to drop few words about the rendez-vous itself…
Actually it was Diane Vinsentz of ABR Denmark who made this private meeting with Dr. Van der Wal possible – for which I am incredibly grateful. In November she attended Dr. Van der Wal’s 3-day course on embryology for bodyworkers and manage to intrigue him enough with the descriptions of ABR approach to entice him to meet privately.
The meeting went absolutely fantastic – we discussed lots of things ranging from methodology of observational studies to the role of embryological knowledge in interpreting the musculoskeletal challenges of children with Cerebral Palsy. Obviously, we had the opportunity to get over some essentials of ABR techniques and the fascia re-modeling concepts that ABR is based on. I know that I sound like tooting my own horn – but I’d dare to say that Dr. Van der Wal was quite impressed… Well it looks like the beginning of some regular collaboration in the future – for which I am both extremely happy and proud of.
Simply watching his lectures in the last couple of years gave me huge insights in the understanding of the human body architecture and hence improved my ability to help your kids with new focus areas and techniques – I am quite sure that the luxury of having a first-hand personal replies to tailored questions is going to bring even more…
Well, I guess that’s it for now… as I said – I had my best and most influential birthday present ever.
Here a couple of pictures to give you the taste of a relaxed atmosphere of the meeting..
P.S. here are the links to Dr. Van der Wal’s article and lecture:
- Jaap Van der Wal. The Architecture of the Connective Tissue in the Musculoskeletal System - An Often Overlooked Functional Parameter as to Proprioception in the Locomotor Apparatus. International Journal of Therapeutic Massage & Bodywork. 2009;2(4):9-23.
- Jaap Van der Wal Transantomical Architecture of Connective Tissue in the Musculoskeletal System: http://vimeo.com/35667719
P.P.S. I really appreciate the Facebook Likes and Comments :-) -- creates a much better sense of interaction and encourages writing ...