a community of practitioners
OK, I did a lot more this summer than this, but there is one thing I want to tell you about. Why should you care what I did? Apparently you read my blog because I have something important to say. This one is real important, at least I think so.
Many of you longtime readers know of my dissatisfaction with many existing theories of explanation for myofascial release. If it had stayed grounded in the simple model of 20-30 years ago, a model of ground substance, elastin, and collagen, things probably would not have gotten so contentious. But people just had to take myofascial release and fascia into areas of energy medicine and calling it the most important tissue in the body (paraphrasing inserted, but I think you get my point). This only got folks like Paul Ingraham, a Canadian journalist and former massage therapist, irritated enough to write about it. (See here and http://saveyourself.ca/articles/does-fascia-matter.php for some pretty brilliant writing) I used to hate Paul’s writing; thought it was just angry fluff from a “non-believer”. The sort of stuff I had to put up with when I was “debating” other non-believers on SomaSimple.com (more on this later). Things have changed for me over the past few years. My allegiances have changed in that I have no longer have allegiances. No, maybe I do, my allegiance is to not continuing to perpetuate non-truths. When one is unaware that what they are saying or practicing is not valid, I call it a non-issue, no foul, even though ignorance is no excuse. But when information comes to the forefront showing what you once believed to be false or simply bad science, continuing along this path is wrong.
My vacation, you may ask, right? Getting there. We are talking about a process here, not an event…
I started on SomaSimple.com around 2005, on a mission to protect my beliefs and my teacher from the non-believers. SomaSimple had/has a lot of them. My plan did not work very well. When confronted with folks who knew a lot more about pain and pain science than myself, I was made into mincemeat. Repeating lines or “science” that I had been fed was quickly seen for what it was, garbage, and I was told so, in not too polite terms. After bobbing and weaving, I succumbed to defeat and sat on the sidelines for quite a while. But, I lurked (that good old-fashioned pastime that the internet allows). During my lurking I read, and BOY is there a lot to read on SomaSimple. (Just post ten times and be a member for a month and you have access to all of it. Tell them I sent you…don’t expect that to be received well. You’ll thicken your skin there, trust me.) None of it would have been interesting to me in the past, because none of it supported what I was doing. But I read and continue to read to this day. During the time I was being spanked on SomaSimple, there was one person who continued to converse with me, offline, with great patience. Diane Jacobs, another Canadian, this time a physiotherapist (what is it about Canadian therapists?) is a proponent of what she terms DermoNeuroModulation, or DNM.
I took a seminar from Diane this past weekend on DNM. It was quite nice to meet her in person, as well as a number of therapists from around the world who I’ve “known” online for a number of years. What I learned was that if one stood back and watched Diane treat as well as watch a typical myofascial release therapist treat, they may not seem too much difference. Sure, we all have subtle or not so subtle differences in the way we treat, but the basics LOOK the same. And, the results may seem quite similar. But, it is what comes between the two that is what is dramatically different. I’m not going to bore you (yet) with the details, because I am still learning and integrating. Suffice it to say that one can explain the changes we achieve from simply looking no deeper than the cutaneous nerves and how we interact with them.
Diane does not present a list of techniques to conform to, but presents a mindset to adapt to. I feel that one of the reasons the fascial community has struggled so long to explain pain from the fascial standpoint, one that is reproducible and testable, one that is supported by accepted science, is that it is so far removed from reality that there isn’t an explanation. There are those who are taught and continue to repeat that proof doesn’t matter, “I am making changes! That’s all that matters!” (sound familiar?) And, what should it matter if you are helping people? It does matter if you know that what you are telling patients is untrue (lying) and if you look deeper into the models of explanation, it WILL lead you to more effective means of treatment.
My profession, physical therapy, has long been moving toward an evidence-based model of practice. Don’t confuse this with a science-based model. Massage is moving in similar directions. Take, for instance, the POEM project (Project for Open Education in Massage), which intends to move massage into a more science-based model. All good stuff. But there are dinosaurs in every profession who are so enthralled by the flash of a modality that they are not able to look at themselves fully (I was a very guilty offender).
So, what I did on my summer vacation was to allow my eyes to be opened. How will that effect my practice and my Foundations in Myofascial Release Seminars? Not sure yet…Already I’ve treated a few folks with results that I had not been able to achieve before this past weekend. I know I do and teach very good work. If nothing else, the model of explanation that I use will change. As for flushing the words “myofascial release” out of my vernacular, I’m not so sure. There is a name recognition value that I find appealing and I don’t know if I wish to discard this. Time will tell. Stick around, this should be an interesting ride!
Walt Fritz, PT