Fascia, our living wetsuit

Can imagining our fascia as an alive, dynamic, and energetic wetsuit help us understand and treat our bodies better? That’s what Sue Adstrum suggests in her new book The Living Wetsuit.

During the last decade, the fascia research field has literally exploded. Hundreds of fascinating studies have been published and a continuous stream of new insights have been presented to the general public.

You could expect that these new findings fundamentally have transformed how we treat our bodies. Unfortunately, that’s not the case. It seems like fascia is such a complex subject that it is hard to define, communicate, and translate it into daily activities and training programs.

To capture the heart of fascia in a way that almost everyone can understand, Sue Adstrum likens it to a wetsuit. And she asks us to imagine our fascia as a soft and squishy wetsuit surrounding, connecting, and protecting all our bones, organs, nerves, and muscles. 

The Living Wetsuit is also the name she has given to her new book about fascia.

In this interview, she explains how we can use the analogy of the living wetsuit as a way of taking better care of our fascia – our medium of function.

As a senior member of the fascia research community, she is also sharing her thoughts about the current research.

– We’re thinking too much of fascia in terms of collagen fibers, strain transmission, and biotensegrity, she says. But that’s just one part of it. What has been overlooked is the part of fascia that is universal and goes everywhere in the body. And it’s not the collagen fibers. It’s something we could call a gel substance or a fascial substance. 

Peter Appel

 

About Sue: Sue Adstrum, Ph.D., is a researcher with an academic background in anatomy, anthropology, medical history, and public health. Se initially trained as a physiotherapist before training in fascia-related bodywork therapies.

 

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 [The transcript is slightly edited for clarity.]

Peter: Welcome Sue Adstrum! You have a very wide background and I really appreciate that. You have been studying a lot of things from anatomy to anthropology, from medical history and physiotherapy to public health. And because of this, you’re looking at things from a lot of different viewpoints.  And I think we need that.

Sue: I think so too. We don’t need many people who think like that, but I think we really do need some. And I think that the fascia research field is desperately in need of some people who have that sort of trans-disciplinary training.

Peter: And then you have written an amazing book. It’s called The Living Wetsuit. And here you are kind of wrapping things up. So we’re gonna talk about your book.

And, yes, my name is Peter Appel. I’m the founder of a new way of moving that I call Movingness and it is very much related to fascia.

In the book, you ask a very fundamental but also very intriguing question: What is the body? You know, I love these fundamental questions. We take so many things for granted but when we start to look into them, there are so many gems to be found.

So Sue, what is a body?

 

The body is not the body

Sue: It depends on who you are, on your perspective, and on the environment you’re working on.

When I’m in the physiotherapy world, it’s basically a neuro-musculoskeletal body. In the anatomy world and the world of clinical anatomy and anatomy research, it’s a dead and dissected body and the different parts that it is made up of. For the bodyworker in me, it’s a whole, living body. And the whole really comes from the fascia and – something I haven’t talked about much publicly but that really interests me – the structure of the energy system. You know, the body has subtle energy structures as well.

So, yeah, the body is many things to many people. And I think people think there is validity in that. But it becomes really, really useful when we start stitching them together and integrating these different points of view. This makes it possible to end up with an expanded, multifaceted view of what the body is. And I find this really useful. All the little separate views are valuable too. But when you put them together, that’s the place where we can make progress.

And it’s the same with fascia, you know, fascia as a part of the body. There are so many different ways of thinking about fascia and describing what it is. 

Peter: So if I may interrupt you here a little bit… How we think about the body depends on what we’re working with. If you are a psychologist, if you are a bodyworker, or if you are a doctor, or whatever, you look at the body from different perspectives. But we still use the word body in normal language. And we think we are talking about the same thing. So that’s not a good basis for communication.

Sue: No. And that’s very, very important. I think when we are talking with other people about the body, anatomy, and fascia we need to clarify the meaning we’re giving it. So I won’t just talk about the body without saying, well, this is the way I’m seeing it here. And this is the spin I’m giving on it right now. We can’t expect other people or other professions or people in different cultural groups or in different countries or different times in history to think about it in the same way. They don’t. 

Peter: In the book, you use the old Indian metaphor of the elephant and six blind men. Traditionally it was used as an image to illustrate how difficult it is to describe God, but here we are talking about the body and it’s just as useful there. To my mind also came a quote from Tao Te Ching:

Cast clay into a pot. The emptiness inside makes it useful.

Cut doors and windows to make a room, emptiness makes the room useful.

So now we’re going to talk more about fascia. Fascia is kind of what makes the body useful, isn’t it? 

Sue: That’s part of what makes the body useful. It’s a very important part that the Western medical tradition has not paid much attention to in the last 200 years. They were very interested in it before that. But in the last 200 years or so, no, they haven’t been. They’ve been interested in describing the walls of the room. 

 

Getting a grip?

Peter: But we can see it in other modalities like Shiatsu massage, or Thai massage, for example. Or maybe in some yoga forms. They didn’t call it fascia, but there was some kind of understanding of it anyway. Here in Finland, we have something we call Kalevala bone setting, which is also into fascia. So it’s kind of being there under the radar and coming into the Western world through many somatic traditions. So maybe it’s not a coincidence that for example, Robert Schleip, one of the most known fascia researchers, has a background in Rolfing and Feldenkrais. Maybe his background has made it easier for him to enter into the scientific way of studying fascia, or what do you think?

Sue: Yeah, I think that brought his broader experience. Robert himself, just who he is, has a lot to do with it and the way he thinks. He’s not just coming from a mono-disciplinary point of view and he’s not just interested in describing its physical structure anatomically. He’s very focused on what this means functionally. What does this mean clinically? Somebody asked me recently what I thought about fascia and I heard myself say something I’d never really thought before. To me, fascia is the body’s medium of function. It’s that space where things happen. All of the systems and their activities happen in that facial matrix. 

Peter: I remember an article in the Washington Post a couple of years ago about fascia research. One of the main challenges was that it’s everywhere in the body. So how do you isolate it? How do you know what it’s doing?

Sue: Yeah. And different people are interested in different things it’s doing. During a webinar a few weeks ago under the umbrella of the Fascia Research Society, they were proposing a new definition for the facial system. And so they’re starting a conversation about that. But the definition is still like our last definition of the facial system. It’s still very much geared toward people who are interested in its physical capacity to generate and transmit physical strain.

So there is the interest in the collagen and the strain transmission and the biotensegrity and all of that stuff. It’s of interest to manual therapists and bodyworkers. But it’s only one facet. There’s so, so much more to fascia and fascia functioning than that. And so I sent Robert some feedback with some things I think absolutely have to be considered when we’re developing definitions. I got a nice email from Robert about that and I’ll be interested to see where it goes.

 

19 different qualities – and counting

Peter: That’s great! In your book, you are describing 19 different qualities and functions of the fascia.

Sue: Yeah, that came out of my doctoral research. But of course, it’s got many more but those are the ones that came out of the data I collected. And as time goes on and we get to understand more and more, that list will grow a lot longer.

Peter: I’ve especially looked at your definition of the mobility of fascia:

Fascia is normally mobile. It glides smoothly in some places, is anchored in others, and enables movement within and between the body’s numerous parts. Some fasciae are more mobile than others. Unhealthy fascia is often associated with a decline in mobility and abnormal sticking together of body parts.

That’s interesting for me because I’m into movement. So fascia maybe could be the centerpiece here that makes the body function as you said earlier?

Sue: I really do think of it as the medium of function. Yeah, it’s where all of this stuff happens. We’ve got the movement happening in there. However, when it gets dense and sticks together, you lose that movement. And you know, all that physiological and metabolic and immune and all of those other functions, endocrine, they all happen in there.

But at the same time for that to make sense, we’ve got to get away from thinking of fascia primarily in terms of collagen fibers, which has been the most of the emphasis on what fascia is, what people think fascia is, and what it does. Conventionally in the anatomy and surgery professions, medical professions, and to a lesser extent, the bodywork professions, most of the attention has gone to these strong collagen fibers. That’s what fascia is. The categorization of fascia has centered around the prevalence, orientation, and organization of those fibers. But what has been overlooked is that the part of fascia that is universal and goes everywhere is not the collagen fibers. It’s the gel, and it’s that gel substance, I think of it as fascial substance.

In the days and the century, before microscopes were discovered and microscopes came into the world of anatomy and science, there was this wonderful discussion amongst anatomists throughout Europe and Britain – because that’s where most of the anatomy was happening in the 17th and 18th centuries. They talked about it, that’s what they were interested in. They weren’t talking much about the collagen fibers and the cells. They were secondary.

Of course, they couldn’t see the cells, but without microscopes, they could see the collagen fibers, the type one ones, they couldn’t see the other types of collagen. But their focus was on this universal substance. That’s what they were really interested in. They were a lot more philosophically interested than the scientific anatomy profession of these days. It’s just a joy to read about the debate and how it developed back then just 200–300 years ago. They were absolutely fascinated with this stuff called cellular substance. And that’s been totally forgotten. I’m the only person I’ve seen who’s been referencing that stuff.

But that’s basically the heart of fascia. People are saying fascia wraps around every muscle cell, but the Endomysium doesn’t have type one collagen fibers in it. And it doesn’t have much in the way of fibroblasts either. It’s the gel, it’s that ground substance, the facial substance, it’s the facial substance that goes into all the little nooks and crannies. In the places where it needs to be strong, it’s reinforced by the collagen fibers. And in some places, it needs more elasticity. There’s some elastin in there – the fibers and the sheets of the elastin – but the bulk of fascia is a gel that is colorless and transparent and invisible.

So it’s invisible. In a dissected body it breaks apart very easily if it’s not reinforced by collagen fibers. But it’s that fascial substance. These days, Neil Theise is paying attention to it. It’s his work on the interstitium that people are quite interested in, but it’s been there for a long time. People are now getting really interested in it and its gel substance. That’s the medium of function. The collagen fibers in the cells are embedded in it, but they’re not primary. The primary is the gel. And you know, some of it’s got bound water, some of it’s got unbound water, there’s fluids flowing through it. The gel is changing from liquid to a more gel-like state. And I think that’s where we’re going to see a lot, lot, lot more interest in the next few years.

 

A system for communication

Peter: So you’re are talking about the fascia gel and it’s everywhere in the body... Some researchers today talk about how it is communicating, that fascia is a communication system... 

Sue: Yeah, it communicates in several ways. It communicates strength and physical strain. If you are compressing and stretching that physical strain, those physical forces get transmitted through it. That’s the physical communication.

And there’s neurological communication. You’ve got the nerves running through it. Most of the sensory nerve endings in the body are embedded in that gel.

You’ve got cells in there and they’re communicating. I think Helene Langevin came up with it a few years ago, a photograph showing fibroblast cells. They’re not separate and discrete. They have these long finger-like processes, branching processes that synapse. So you have this web of cells of fibroblasts embedded in that gel and they communicate with each other neurologically.

The fluids are involved in the communication and transport of neurotransmitters as well. The neurochemicals. We’ve got all sorts of things in there and they are involved with communication and transmitting information. 

So there’s a lot of information being communicated. But there are other things too. One of my teachers along the way, spoke about fascia being the skin of the spirit. Sort of being the interface between our physical, and non-physical body forms. And James Oschmann has shown that fascia is capable of generating and transmitting information in the form of bio-electro-magnetic energy flows.

But people generally don’t talk about energy that much because it’s a little… It’s not the best thing if you want to establish academic credibility. But we’ve got to start talking about that stuff more too. I applaud Carol Davis, an American Emeritus professor in physical therapy. She’s been very closely involved with John Barnes, the chap who coined the term myofascial release therapy. She’s been working with him for decades. And now that she’s retired, she’s really getting quite outspoken about some of this energy transmission stuff that’s happening in there. The communication of energy.

So, you know, as society evolves, as the technology evolves, we’re going to be learning some things about fascia that are totally new to us in this day. So it’s really fascinating.

 

The diaphragm is mainly fascia

Peter: Personally, I do my daily training and then once a month I go to a physiotherapist who is also a Kalevala bone setter. Without using force, just small manipulations, she’s really releasing the body. Sometimes she also talks about energy. She says that when she sees the color red, then she knows that the energy is flowing.

But practically speaking, this communication system that we call fascia... As a practical example, if you relax your neck or some other part of the body, does that translate to the rest of the fascia throughout the body?

Also, the most common meditation method is to focus on your breathing. And from what I’ve read, the diaphragm is also connected to the facial system.

Sue: The diaphragm is mostly fascia. It’s got muscle cells embedded in it, but actually, it’s mainly fascia. So it makes perfect sense that you focus on the breath. And you allow it to gradually relax and deepen. And then you have a whole-body experience through the fascia. Its relaxing and deepening with the breathing. And it has an effect on the autonomic nervous system. You know, it has effects on the immune system too. It’s not linear, it’s three-dimensional nonlinear stuff that’s happening in there. And breathing, I think is one of the most powerful things we can do. It’s there and very important in pretty much all of the non-Western healing traditions. It’s right at the center there.

The osteopaths who were responsible for the development of craniosacral therapy.… One of them was asked, which is the most important part of the body now that you’re at the end of your career. Where’s the single most important part to treat: The thoracic diaphragm, respiratory diaphragm!

It’s so powerful. Working there affects the whole being and you can sort of reach up through the fascial sheets up into the brain. Other structures as well are all anatomically connected. All of these connections can be dissected out if you want to see a connection. You just go on and show it if it hasn’t been described. It’s just because nobody is sort of trying to show that connection. But nowadays, we’ve got the technology that can show these connections. Before it might just have been physically dissecting a cadaver using our naked eyesight. But with the technology that’s available to us nowadays, some of the stuff that pathologists like Neil Theise are using… They’ve now got the technology to show living fascia and its continuity and the connections right up through it. It’s wonderful!

 

Can fascia store memories?

Peter: Well, another thing that you also mentioned in the book is that the fascia can store some memories. That’s something we also can see in trauma therapy, can’t we?

Sue: I don’t think the science is there showing it yet. Memory and emotion… But okay, it’s 10 years since I did the research for that. But a lot of people claim that it can store memory. And I have absolutely no doubt that it does based on my experience as a clinician. But the science isn’t there, wasn’t there 10 years ago, but I haven’t been able to look recently. So I don’t know if it’s made any progress, but I know a lot of people are now using somatic work to release emotions and I think it’s even possible to sometimes release other types of holding as well.

When I work with a client, this is really interesting. I’ve been working for the last three or four months… I’ve just gone back to being a physio again… They ask me to do this sort of work and, you know, people are releasing memories of childhood trauma. I haven’t had past life recalls in this practice, but I’ve had a lot of it in the past when I worked in my own private practice. Just because something hasn’t been scientifically validated doesn’t mean it’s not true. 

So I have to be careful. I can’t go out saying, it’s stored there, traumatic or somatic memories… But I think there is, there are a lot of indications that there is. A lot of people are saying that there is. According to my experience in my own body and in many clients’ bodies, yes, it is. So it’s just a place where the research hasn’t caught up.

And I don’t really think that quantitative research, you know, the randomized control, the double-blind, randomized control trials, are going to show it. We need to use other methodologies and other theories. Anthropology is one of those places, you can go there. Phenomenology is another one. Sociology. We need to hear people’s stories and people’s stories are validated outside that very narrowly focused world of science. So science is not the gold standard, it’s useful, but it has some remarkable limitations too. We’re limited in how much new knowledge we can gain with science.

And, you know, the fascia research field at the moment, it’s very new. And so it’s very immature and it’s putting a huge amount of emphasis on scientific research and that is normal and to be expected and it’s valuable, but that field won’t start maturing until we bring in other types of research as well. But the movers and shakers in that field are not yet ready to hear that. I’ve been saying that for 15 years.

As an example, I’ve had an abstract accepted for The Vancouver Research, Fascia Research Congress. I guess it was another poster. They wouldn’t want me to speak about that sort of thing because the people who were reviewing the literature were scientists and had very clear ideas about what made good quantitative research. And qualitative research didn’t fit into their understanding. So, you know, a lot of this stuff has been sidelined but that’s changing. As the field matures, we will expand our focus.

 

The richest sense organ in the body

Sue: Here, I’m thinking of [the German philosopher Martin] Heidegger. Have you ever read?

Peter: Yeah, a little bit.

Sue: Yeah, I’ve only read a very little bit of it too. But he’s saying, look, no one way of looking at things is going to tell us the whole truth. Science is wonderful, it makes it possible for us to see certain things about the body structure, about fascia. But at the same time, it’s like wearing blinkers. It shuts us out from seeing all sorts of other stuff as well. So once again, this is where it really helps to integrate different ways of thinking and looking at these things. And that enriches our overall understanding.

Peter: We need to be careful so we don’t make science into the New Catholic Church of the Middle Ages.

Sue: Oh, no. Exactly. It’s a little bit like, you know, the dead and dissected body form. It’s very, very valuable and it’s contributed and contributing some really useful information. There’s nothing inherently bad about it. It’s pretty much all good, but it’s much more useful when we add these other facets to it. Then we get a much more mature understanding.

Peter: Yeah, that’s for sure. And then we get a wider view. There’s another thing I’d like to ask you. Recent research by, I think it was, Robert Schleip looked into the sense properties of the fascia and suggested that the fascia is the richest sense organ in the body. It’s richer than the skin and it’s richer than our eyes. This is of special interest to me because when we’re practicing Movingnes, we are connecting with the feeling body. So is there anything you’d like to say about the feeling body?

Sue: What we feel is information and we transmit it through the fascia and through the nerves that are embedded in the fascia. A lot of it is sensed through the sensory organs in the fascia, the ones that are myelinated and also the unmyelinated autonomic nerve endings, the free nerve endings. They are just giving us so much information. And I think Professor Siegfried Mense from Germany made some important contributions to advancing our understanding of the link between the pain receptors in the thoracolumbar fascia and low back pain. He has demonstrated in experiments with rat tissue that most of the perception of back pain is in the fascia, which is really interesting because physios and doctors and surgeons are focused on the joints and on the discs and what’s happening in them. And if nerves are getting compressed… So they have been been able to do things like mobilization, manipulation, injections and surgery, but they haven’t been able to consider things like roughing and moving and myofacial release and acupuncture and all of these things.

So, yeah, when we add that sensory component, it makes a lot of difference.

Peter: From touch research… These tactile C-fibers that give us pleasure… From what I remember we have most of them on the back because we are used to scratching each other’s backs.

Sue: I haven’t heard that before. That’s new to me.

Peter: So like cats and dogs we like being scratched. Could you imagine going to a cafe and then asking the waiter to scratch your back because you really need a scratch? I think it would be very natural for our species to return to these very ancient ways of treating each other.

Sue: Yeah, very much. You sent me links to some reports about how lack of movement is adversely impacting people’s health. And you know, there are a lot of studies about this. Sitting too long and so on. But loneliness, all of these things are linked to a lack of touch, and none of them are really talked about. You need to buy a standing desk, you need to go to the gym, you need to go and do all of this stuff to fix these problems, but nobody’s saying, hey, get your back scratched!

And they should be and, and you know, do that, do that gentle movement, that um intuitive movement that I think is part of, you know, that’s looked to me to be like the heart of your Movingness. It’s like movement, touch, loving touch, listening touch, compassionate touch, all of these things really matter. We need to bring these modalities into the public health system, the publicly funded health systems need to be doing these things, not just the injections and the surgeries, we need to be able to prescribe more of this.

But then, I mean, these things are quite complicated. There’s a lot of complex interactions going on in the body. There are a lot of complex ones and it’s not easy for the human mind to keep hold of complex things. And that’s why I wrote that book.

 

The living wetsuit

Peter: And then you came up with something like this, right? [Showing a black wetsuit.]

Sue: Yeah, I used to have a pink one.

 Peter: This is my son‘s wetsuit. I found it in the basement. He used it when he was a teenager. But how do you think the image of a wetsuit can help us get a grip on fascia? How can it help us take care of it in our daily lives? 

Sue: I didn’t actually think, oh, this is a good idea. I just heard myself using it! I heard myself talking about the soft tissue as being like a wetsuit when I was teaching some massage students. I’ve had a few roles in the massage therapy education system in this country, and I just found myself using it with the students – and they got it! I’ve also used it with my clients from young children to old people. And when I speak about the skeleton wearing a wetsuit, they got it! 

We can make the wetsuit fabric as complex and complicated as we like. But for most people, the moment you talk about anatomy…. You know, those long Latin words for the different parts of the body… Their eyes glaze over. After five seconds, they’ve glazed. They’ve tuned out. It’s too complicated to understand. And they think: “I’m just going to hand all this stuff over to my doctor or my physio or whatever. They can take care of it for me.”

I’m not going to say that’s all a bad thing. Lots of people benefit from that, but I also think it’s really important, especially in this day and age, that people have more agency. That they have more control over the decisions that are made about their health and wellness. And for that to happen, they’ve got to understand the body in a way that makes sense to them. So I think talking about a skeleton wearing a wetsuit explains the wholeness of the body. They can buy into it! It gives them the possibility to understand that their hurt shoulder might be related to something that’s going on in their pelvis, or their foot, or their neck, or whatever. And they very quickly learn to understand that getting the wet suit to fit better, getting it to function better, is going to have a huge effect on their health.

Yes, it’s useful for them to understand what the thyroid gland is doing. But the anterior cruciate ligament can be explained to them as well. It’s like putting them together. Their health professionals can tell them about the little parts that particularly relate, but in conjunction with how it affects the whole body. And so when people start thinking “Well, actually, I can understand this wetsuit idea. It makes sense to me.” Then they can be more involved in the choices about their health care. They can consider using some other types of health care that may be safer, less expensive, more effective, less harmful to their bodies and to the environment. And you know, more aligned to their cultural beliefs and values. For example, something they can do when the world is locked down and they have to stay at home with COVID, something they can do when they’re 300 miles away from a particular medical specialist. It gives them things they can do to help themselves while they’re waiting to see a specialist, or while they’re on a waiting list for surgery, or even afterwards.

So the really specialized, complicated anatomies are for the experts. But we also need to have a way of explaining the body or ways of explaining the body that makes sense to ordinary people and also to the less academic health professionals. Yeah, I know a lot of massage therapists here and I have to really simplify my writing to make it accessible to them. My academic training tended to make me too academic in my writing and so I have to dumb it down. I have to make it simpler, and I find that very hard, but chatGPT is my friend now. I can put a block of my academic writing into ChatGPT and say, hey, write this so it’s suitable for a grade eight American reader. And you know, I wish I’d known about that when I wrote my book.

 

An empowering image

Peter: Yeah, but let’s return to the image of the wetsuit. I mean, it gives you the opportunity to check yourself. How is my wetsuit doing today? [Showing] A little bit stiff there? I can feel that. OK, I need to do some moments there. It’s a bit tight there. It’s a bit twisted there, it doesn’t feel comfortable there.

Sue: You know, when I lift my shoulder, it pulls into my neck. And that’s all the anatomy a lot of people need. So this is just a way of thinking about the body structure that makes sense to them. So I’ve chosen to describe the fabric as predominantly made up of fascia.

Peter: And it empowers you, right!? You can do it yourself. You can check it for yourself. You don’t need a machine that costs millions to check it. You can just feel it. It’s awesome.

Sue: The information that comes out of those MRI scans, the machines that cost millions, is of limited use because it’s just looking for these little parts that may or may not appear to be intact or damaged. But it’s not looking at the effect of that on the whole body, on that person’s well-being, on their health. And once again, it’s not a criticism of the machines that cost millions of dollars. They’re useful. They give us really good information, but we need also to use our other resources.

Peter: We cannot carry people through life. We want to grow up, we want to take care of our own bodies and we have the most advanced system, our nervous system, to really pinpoint ourselves. Wherever we go in the body, we can feel what’s going on there.

Sue: I would question whether our nervous system is the most advanced system. It’s the common belief that it is. I suspect the facial system might be right up there alongside it.

Peter: I’m not dividing things here. We have a lot of boxes, right? We have the nervous system, we have skin, we have the senses, we have the fascia. As I see it, the new research is kind of removing the boxes,

Sue: We can see more now than in the early days. I mean, most undergraduate anatomy textbooks talk about 10 or 12 body systems. [Shows Gray’s anatomy] Oh yeah, that was my graduation present to myself.… You know, when you look through it, it’s got something like 44 systems mentioned in the index. It just depends on how you look, what you’re looking for, and how you’re describing it. There are many, many ways and in the future, as our understanding develops, we’re going to be talking about a lot more systems than we are now. But it's too much for the average, undergraduate student, too much for the average clinician, too much for the average member of the public to understand. Those are all specialty fields.

But for ordinary people… We’re living in a world where most countries and their health systems are overwhelmed. Especially post COVID. But it’s not just all down to COVID. Looking at the British National Health Service. I think that’s one of the most visible ones at the moment. The health systems are just not able to cope even when they have an increased percentage of gross domestic product GDP pumped into them, which most of them have. It’s still not enough to keep up with demand, and what people want and require from them. So we’ve got to change the way we think of getting older.

Peter: The population pyramid is upside down, we have more old people than young people. So we need to start to take better care of ourselves. There was one researcher or writer who said that we are dying slower and slower. We are prolonging the death process because our health is going down even though the average lifespan is growing.

Sue: It’s in the last two or three years that cost the country the most money. That’s when people are the heaviest consumers of the health system. And of the country’s health budgets, the majority is being spent on people in the last 12 to 24 months of their life. And that’s wrong. You know, I could, I could go on into some pretty politically dodgy territory on that one, but I won’t. It’s like we’re keeping people alive. We’re keeping them alive but we’re not keeping them well. But we could do better.

Peter: Yeah, we could. There could be so much more joy for people to feel alive in their own bodies. And feel that they need to take care of their own lives. They could be more independent. They could play with their grandchildren. They could have a lot of fun.

 

There’s so much we can do!

Sue: I don’t know what it’s like in Finland, but in New Zealand, we’ve got a real problem with people with osteoarthritis. So many of them are getting to a place where they need to have their hip joints replaced. The way the health system is presently treating it is that they go to their primary physician, the general practitioner, they get prescribed painkillers and they get prescribed anti-inflammatory medication as well. Full stop. And when it gets bad enough they go on to the waiting list to see a surgeon. And then they stay on a very miserable and painful waiting list, waiting for surgery that they may or may not get because it’s very expensive and so many people are requiring it. If you’re wealthy, you can jump the queues and go privately. But we’ve got people 4, 5, 6 years on a waiting list for surgery and their lives are just miserable. They can’t work, they can’t do all sorts of stuff.

And there’s so much we can do…

I listened to an interview recently and they were saying, look, we’ve got to come in with physiotherapists talking about strengthening exercises. We’ve got to get dieticians talking about weight loss and we’ve got to get occupational therapists teaching people how to live with their condition. None of those are considering the fascia! But when we bring the in fascia, you know… We could also be teaching about hydration, supplements to support fascial health, anti-inflammatory nutrition, bodywork, movements, and stretching and strengthening exercises further down the track. It would just give us so much that people can do.

I do a lot of that stuff myself. When I was 17 years old, an orthopedic surgeon told me I would need to have one of my hips replaced when I was 40. I’m not quite double 40 but I’m well on the way. And I still have my own hips and yeah, I’ve been able to work out, hey, that the pain and stiffness. It’s not in the joint, it’s in the soft tissue. And so I’ve worked with my own soft tissue, my own wetsuit and I’m still going strong there.

So if we made that public knowledge….  Thinking about the wet suit… It would make it possible for us to say, hey, look, we can be doing these things!

 

What are the warning signals?

Peter: So over time, the fascia easily gets stiff and then from stiffness, it can also go into what you call tight spots. So can you give some advice here? What should we look for in the body? When should we react? What should be the alarm signals we should pay attention to? Is stiffness generally an alarm signal?

Sue: I think we should pay attention to our habits too… You know, we clean our teeth every day. We should also be looking after our fascia every day, right from a young age. And you know, the moving is really, really important there. But I also don’t think we’re putting nearly enough emphasis on hydration and anti-inflammatory nutrition. They are so important. And moving, you know, posture, movement. 

Peter: But if you sense your body… If you allow your body to be felt… I mean, pain is such a broad concept… What kind of signals would be beneficial for us to follow and feel?

Sue: I think I would put pain under just being uncomfortable, your body doesn’t feel comfortable to wear anymore. The wetsuit isn’t comfortable. Your body’s not happy. 

Peter: And you need to pay serious attention to that and not just overrule it.

Sue: Right. People need to become more aware that you have to work with your body. This is where I think the living wetsuit analogy comes in really well. You can talk about it shrinking, you can talk about it twisting, you can talk about it getting stiff. You can talk about it affecting pain, affecting how things work, and affecting how the body can move.

They don’t need to know that it’s this particular sheet of fascia. Or if you’ve got a densification of the fascial substance. Or if you’ve got an adhesion between two layers of membrane. They don’t need to know all of that when they go and see the health practitioner – even though it sometimes might be useful to explain it.

But for an ordinary person, it’s just the wetsuit not fitting the skeleton properly. It doesn’t feel comfortable. Things aren’t working as well as they should, as well as you would like them to be. So when you start to feel not comfortable, when you start to feel stiff, that’s a signal that you need to take seriously. It’s not just my age, it’s a signal from my body. You need to do something. And you don’t cover it up with painkillers and anti-inflammatory drugs. You need to move!

Peter: Wonderful! I think that’s a great place to stop, Sue. Thank you so much for this conversation. It was so lovely to talk to you. Thank you!

Sue: Thank you for reaching out. I really enjoyed having this conversation with you too. Thank you!