Ep 415 - SEEING Anatomy: Your Practice in 3D with Rachelle Clauson and Nicole Trombley

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https://scribie.com/files/666de781b2fc44359e32274dee97446bb917c53a

 

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0:02:01.7 Rachelle Clauson: Hi, everyone. Welcome to the ABMP podcast, a podcast where we speak with the massage and bodywork profession. I'm Rachelle Clauson.

 

0:02:10.1 Nicole Trombley: And I'm Nicole Trombley. Rachelle and I are longtime massage therapists, and we write the Anatomy for Touch column for Massage and Bodywork Magazine.

 

0:02:17.3 RC: When we aren't writing or massaging, we're busy teaching. We're the co-directors of AnatomySCAPES, a continuing education company.

 

0:02:24.8 NT: In fact, right now we're gearing up for our next in-person dissection course, February 27th through 29th, called Journey Into the Matrix. It's our deep dive into the structure and organization of the fascial system, especially for hands-on body workers.

 

0:02:40.2 RC: Can I just say the thing that I love about teaching this workshop with you, Nicole, is how we make space for integration. Not only do our students get an amazing fresh tissue dissection lab experience, but we take it further by spending time talking about it in the classroom and applying what we've learned back at the massage tables.

 

0:02:57.9 NT: I know, I know. I love it. And I love digging into the research and helping therapists organize their thinking with gorgeous imagery, fun crafts, and 3D model making.

 

0:03:09.9 RC: It's such an easy way to learn really complex topics. And everyone walks away already knowing how to apply it to their practice and really understanding what they've touched and seen. Which leads us to today's topic, Seeing Anatomy. For most of us, seeing anatomy is the first step in understanding it. And anatomy understanding is an essential element of being a body worker. Today in this first episode in our three-part series, Your Practice in 3D, we want to talk to you about the challenges of seeing the body in three dimensions and why so many massage therapists are heading to the dissection lab to study. We start our conversation with a recent article in the New York Times.

 

0:03:50.3 NT: Okay, so the story begins at a Pilates studio in New York, where Danielle Friedman, a freelance journalist and regular contributor to the New York Times, tells her instructor, Kim Villanueva, about the article she's researching on the topic of fascia, because she thinks Kim will find it interesting.

 

0:04:08.4 RC: And as it turns out, Kim is very interested in fascia and knows a lot about it. She proceeds to tell Danielle that she's just gotten back from a week-long cadaver dissection course taught by Gil Hedley in Colorado.

 

0:04:19.7 NT: Love Gil.

 

0:04:20.6 RC: I know, he's amazing, right? But Danielle has never heard of such a thing. A Pilates instructor in a dissection lab? 

 

0:04:28.2 NT: Exactly. She had no idea that was even an option. Wanting to know more, Danielle, like a good researcher, went to find out what dissection courses are actually open to body workers and movement practitioners, and she made arrangements to be an observer at a workshop that just happened to be taught by one of our good friends and colleagues, Fauna Moore at Experience Anatomy in North Carolina.

 

0:04:51.9 RC: Danielle says in the article, I was both excited and nervous and keenly aware that I might not be able to unsee what I observed. During the next two days, what she observed first, however, was the great respect the students and teachers had for the work they were doing. And she listened to them as they described their experiences while they worked. It's so much more delicate than I imagined, one commented as she separated the long quadricep muscles. And looking at deep fascia, another student said in contrast, it's very flexible but really durable.

 

0:05:22.0 NT: Okay. And at one point a student handed Danielle the actual IT band.

 

0:05:28.4 RC: What an experience, right? 

 

0:05:29.6 NT: Right? I know. So Danielle notes that it felt strong, but surprisingly light and thin, almost like duct tape. So she had been aggressively foam rolling her own IT band for years, as do many of us, but she'd pictured it as thicker and with more knots. But when she held it in her hands, she made a mental note to go easier in the future.

 

0:05:48.9 RC: These kinds of comments are so common in the dissection lab.

 

0:05:51.7 NT: No, they really are, aren't they? We hear this constantly. What we see in the anatomy books is no match for the real thing.

 

0:05:58.2 RC: And I couldn't agree more. When it comes to understanding anatomy in three dimensions, seeing it for yourself changes everything. Okay, recognizing the irony of what I'm about to say, for me, being in the dissection lab brings anatomy to life. It helps us create the maps in our minds that guide our hands.

 

0:06:18.1 NT: Totally. Totally. Okay, so let's go back in time. How has anatomy been mapped for us in the past? Historically we've relied heavily on two-dimensional imagery to understand the invisible parts of us, the stuff that lies beneath the surface. So anatomy, art and medical illustration have rendered images of the three-dimensional body into a two-dimensional medium, paper, etchings, engravings, and paintings. This has been so helpful and essential that it's still at the heart of our anatomy education today. How many anatomy books and atlases do we even have on our shelves, Rachelle? 

 

0:06:52.3 RC: While 2D images have limitations, it's immensely convenient and has allowed for the sharing and widespread dissemination of anatomical information. And anatomists and artists have always known that. Great Renaissance anatomists like Vesalius worked with artists to draw his dissections as if the body was alive or on their feet and in motion. Sometimes performing their own dissections. I mean, for example, everyone knows that image of the man like holding his own skin.

 

0:07:21.6 NT: Yes, the one by Gaspar Becerra.

 

0:07:23.7 RC: That's the one. The three-dimensional aspects were conveyed by both the postures and reflected also in layers or by windows, allowing you to peek through to the deeper layers.

 

0:07:35.7 NT: Vesalius also used to draw serial cross-sections, slices through organs like the brain. It was almost like our modern MRI and CT scans. You know, but by the 1600s, medical schools were making wax models of dissections, rendering the anatomy in three dimension, but without all the problems of working with cadavers before air conditioning was invented.

 

0:07:58.7 RC: [chuckle] Right.

 

0:08:00.3 NT: But still, artistic renderings in two dimension have been the primary means of recording what was seen in the dissection labs.

 

0:08:07.4 RC: I think it's super easy to forget about how all the modern inventions of refrigeration and electricity have impacted medical studies.

 

0:08:16.5 NT: Totally.

 

0:08:16.5 RC: And throughout the historical development of the discipline of anatomy without photography, the challenge to get it right primarily rested on the shoulders of two individuals to educate the medical field, the dissector and the illustrator. Unless you were in the lab yourself, the only lens you could look through was created by someone else who chose what to show, how to dissect it, and how to represent it.

 

0:08:41.1 NT: Funny enough, we're still pretty much faced with the same challenge today. And for therapists who massage bodies every day, the maps we have made in our minds are almost entirely formed based on somebody else's 2D depiction of anatomy.

 

0:08:55.0 RC: But what about the newer inventions? Like a few come to mind right away, photography, like I just mentioned, and video. And what about the new three-dimensional visual apps? 

 

0:09:05.3 NT: Fair point. And I know you know we love that advancement because we use ours all the time.

 

0:09:09.5 RC: We do. [chuckle]

 

0:09:11.0 NT: Even in the dissection lab, right? So yes, we've come a long way, but we aren't there yet. For the same reasons some information was lost in the past, the apps are also based on someone else's choices for what to show and how.

 

0:09:25.9 RC: That's so true. So let's get really specific now. How does being in the dissection lab help you see anatomy in 3D? 

 

0:09:33.3 NT: Right. Based on our experiences personally and from the descriptions of many of our students and colleagues, we've come up with four major ways being in the lab changes the way you see anatomy. And seeing differently means understanding differently, which affects the way we touch.

 

0:09:48.9 RC: First of all, studying in the lab adds depth beyond the measurements of length and width of a flat drawing. In the lab, the donor forms have the added dimension of depth, just like the clients on your table. So you don't have to translate 2D images into the 3D reality of your practice. They already are in 3D at the start, and that makes a huge difference, which instantly also adds the sense of volume. Seeing the structures in the human body in person, the sense of volume is crystal clear. Not to mention the 360-degree view that lets you see everything from all sides.

 

0:10:25.3 NT: And don't forget, there are things in the body that have really weird shapes, like the scapula, the pelvis. Really understanding them requires spending time with the real thing, in my opinion.

 

0:10:35.6 RC: Same here.

 

0:10:36.3 NT: Well, second, human cadaver anatomy is to scale. Now, this might seem super obvious to say, but it's actually a really big point to be made. So many students get in the lab and say things are so much bigger than they expected, like the sciatic nerve or the aorta. Oh my gosh, the aorta. We hear them say things like, wow, I knew the aorta was a large vessel, but seeing it like this, I really realized the volume of blood that flows through it. Or once we get down to the muscle layer, even though they literally just saw the whole form and noted its size, once we've cleared the skin and the subcutaneous fat, it really seems to impact them how thin those muscles can be.

 

0:11:16.5 RC: For sure. Because there's one muscle chart man that we all know and love, and he's a really strapping beefcake.

 

0:11:25.4 NT: Right? Now, don't get me started on that one. We would never see a muscle chart that looks like your average 75-year-old woman. Wouldn't that be cool, though? 

 

0:11:32.0 RC: I mean, it would, considering how many of my clients are in their 70s and female. Like, I personally would love that. That, however, brings us directly to our third point. Working in the dissection lab helps you better mind map and see anatomy because of the anatomical variation you will see there. Every donor we learn from is a real body that had a real life with real postures and activities that makes them unique, just like the clients on your massage table. They're formed differently because of a number of factors. But so instead of having your anatomy knowledge based on the drawings or likeness of one body, who we can call the anatomical man or woman, you get to see different presentations which are instantly mind-expanding.

 

0:12:15.3 NT: No, absolutely. And this brings us to number four, our last point, and probably my favorite when it comes to seeing anatomy in the dissection lab.

 

0:12:23.8 RC: Mine too, actually. [laughter]

 

0:12:26.4 NT: Yeah. No, totally. We talk about this all the time. When we study the body in the lab, we get to see everything, including all the in-between stuff that's missing from our books and apps. We see what the anatomy looks like before the connective tissues are cleared away to reveal their more famous cousins. You know, we take for granted that what we see in a photo, drawing, or 3D graphic on our computer is all there is. But in reality, in order to see all those perfectly separate organs and muscles, nerves and blood vessels, a whole bunch of stuff was removed.

 

0:12:57.0 RC: And why this is so important to massage therapists is because you are always massaging all the things. And if you have never really seen things that the other parts of the body have, how can you know where they live and what they feel like? It's like having a roadmap, but like none of the lakes are in it. Like if you go off roading and you're only using the map, you might actually end up underwater and not even realize what happened. Is that a weird analogy? [chuckle]

 

0:13:25.9 NT: No, I get it. And I like it because it gives you a sense of how sometimes we're unprepared for what we find in our clients' tissues. And we basically have to guess about our blind spots.

 

0:13:36.8 RC: That's a good way to put it. And that's actually a really good way to sum up this last point. Seeing what's missing from the drawings helps remove your blind spots.

 

0:13:46.3 NT: Love it.

 

0:13:46.4 RC: So let's get back to our story. Danielle, she ended up interviewing other teachers and students from previous dissection workshops, and they had some really interesting things to say as well.

 

0:13:58.7 NT: Okay, so one student commented that she felt better equipped to help some of her postpartum clients. She was struck by just how many layers of abdominal muscle can be severed during a cesarean birth, right? She said, now I can visualize what that looks like. It's so different than seeing a picture in a book. Some really profound stuff for a hands-on body worker to experience. And it can affect the trajectory of their career.

 

0:14:23.4 RC: I mean, it really could. One of the medical lab instructors had thoughts on some of the new ways we're looking at the anatomy that I also found particularly interesting. He said, new technologies such as three-dimensional virtual software have made the human body easier to study and some argue rendered cadavers unnecessary. But medical students will still say that seeing, touching and holding real human tissue is far more instructive than pictures or models. And it leads to better, are you ready for this part? More compassionate care. It's an enormously humbling experience. When you hold a heart in your hand, you are never the same again.

 

0:15:02.2 NT: Life-changing without a doubt. All that being said, still, dissection is not the only way to learn anatomy today.

 

0:15:09.7 RC: Which is good because not everyone has the opportunity to come to a lab.

 

0:15:16.0 NT: And not everyone is interested in coming to the lab.

 

0:15:18.6 RC: For sure. The classic methods are still excellent ways to get a solid working anatomy knowledge in your mind. Drawings, illustrations, paintings, still solid.

 

0:15:29.1 NT: Totally. And there are many advantages to them as well, such as accessibility, labels, color coding.

 

0:15:36.2 RC: Exactly. We have all benefited from Netter's color choices for yellow nerves, green lymphatics, red arteries, blue veins, and the little blue bursa bubbles.

 

0:15:46.1 NT: They're so cute. And they're not really blue.

 

0:15:48.6 RC: True, which might be a comment on some of the flaws in our mind maps. Add to that, new innovations from modern technology have helped improve our 3D perceptions. Pinch to zoom, spin, rotate, and remove have really upped the game, helping us to see and memorize the unbelievable amount of detail that exists in our bodies.

 

0:16:09.7 NT: Yeah, and additionally, we can also think about the types of imaging that are used in research and medicine and provide even more views, each revealing a different aspect that may not be visible with the naked eye, yet tells you something about its structure and organization.

 

0:16:24.4 RC: Are you talking about things like x-rays, MRIs? 

 

0:16:29.4 NT: Yeah, yeah. And ultrasound and histology slides. Many of these methods show the body in cross-section, essentially in slices, which I personally find incredibly informative. It's a totally different view that shows how structures and organs fit together as a whole.

 

0:16:46.5 RC: And don't forget about seeing images taken with electron microscopes. I learned so much from those images. They capture the three-dimensional reality of tissues and structures hyper-magnified.

 

0:16:57.5 NT: Like that image of the honeycomb structure of the endomysium completely emptied of muscle fibers.

 

0:17:02.7 RC: I literally can't get enough looking at that image. Okay, so we've given our listeners all these cool ways to see human anatomy. So really, Nicole, in your honest opinion, which way would you say is best? 

 

0:17:15.4 NT: Well, of course, it totally depends on what you need to know.

 

0:17:17.0 RC: Aha, I knew you were gonna say that. [laughter]

 

0:17:18.9 NT: Well, to identify many pathologies we rely heavily on what we can see through imaging technologies. Without them, it would be challenging to identify bone fractures, tumors and other pathogens. These methods help save lives. We're lucky to have them.

 

0:17:33.7 RC: Fair point. But what advice would you give to our listener, the professional massage therapist or body worker? Where do you think they should go to learn and see anatomy? 

 

0:17:45.9 NT: Well, great question. And I'd have to say all of the above, wouldn't you? 

 

0:17:50.2 RC: [chuckle] Well, you know I would. For me, the more ways I can learn to see the body, whether drawings of the parts or seeing the body in cross-section, looking at slides or sculptures, or plastinates at Body Worlds, like the ones I helped create with the Fascial Net Plastination Project.

 

0:18:05.7 NT: Oh, right. Plastinates are another incredible way to see the body close up and in 3D outside of the dissection lab.

 

0:18:13.8 RC: Totally. All of these different ways of seeing, though, together gets me closer to understanding the real living anatomy of my clients, which no one ever sees in its entirety.

 

0:18:25.9 NT: Because our bodies aren't see-through.

 

0:18:27.4 RC: Exactly.

 

0:18:28.0 NT: So before we tell you how this story ends for Danielle in the New York Times article, we hope you're getting the idea of why Rachelle and I are so passionate about what we do.

 

0:18:39.8 RC: There's so much to share with you, so much to see and understand. We really think learning anatomy deserves a return to the artistry of its historical origins. One that makes us fall in love with our anatomy, helps us understand how connected we are to nature, and that the beauty in the world around us is inside of us too.

 

0:18:58.5 NT: I love it. Creating meaningful, fun, dynamic experiences is at the heart of AnatomySCAPES for us.

 

0:19:05.4 RC: At the end of this month, Allison Denney from Rebel Massage is joining us to teach the hands-on application in the Matrix workshop with us. I think she's actually bringing a whole truckload of her body butter for us to use too. Lots of surprises in store. Listeners, if you want to join us for this amazing event, please connect with us on our website and see if there's still space available, anatomyscapes.com/matrix. That's like landscape, but for anatomy, anatomyscapes.com/matrix. We'd love to have you join us.

 

0:19:36.9 NT: Yes, we'd love to have you. And now for the ending. Danielle says in her article that the days in the dissection lab went smoothly for her, but afterwards she felt shaken. When she arrived at the airport that night, she didn't see travelers, she saw walking cadavers.

 

0:19:51.6 RC: I get it. Being in the lab can be intense, which is why we spend so much time with our students preparing them for the experience, both for taking them into and out of the dissection lab with great intention and support.

 

0:20:05.8 NT: It's so important. Danielle ends her story by saying as time passed, she's come to appreciate the intricacy and interconnectedness of every muscle, tendon and bone. And that being in the cadaver lab gave her a new appreciation of her own body's ability to move. And then when she got home, she went for a run.

 

0:20:24.1 RC: [chuckle] One of my favorite things to do after a lab experience is to go to a really good modern ballet performance. It brings tears to my eyes every time I see the beauty of the human body in motion. We are amazingly made.

 

0:20:37.1 RC: If you'd like to share your thoughts with us about this episode, you can find links to all the fun stuff we referenced in this podcast, along with how to get in touch with us at AnatomySCAPES at abmp.com/anatomy. That's all for now. Tune in next time for part two in the Your Practice in 3D series as we focus on feeling anatomy, understanding the textural qualities of the tissues we touch. I'm Rachelle Clauson.

 

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0:21:04.5 NT: And I'm Nicole Trombley. Thank you for listening.