Exploring and Learning from the Gift of Life

Posted on August 24, 2015 by admin

By Patrick Cunningham, LAc, BCST, FMT

I’m grateful to have had the opportunity to teach cadaver dissection classes and workshops with Stephen Cina at the New England School of Acupuncture over the past seven years, first through the Sports Medicine Acupuncture Program and later as a NESA elective course. We use unpreserved specimens that are flash frozen with no exposure to chemical preservatives so the tissue closely reveals the reality of the living body. In our classes, we utilize the specimen to the fullest extent. We examine tendons, ligaments, bones, disks, and menisci in situ and in cross section. We experience the strength of these structures by placing them under stress. I once cut through a sacroiliac joint with a scalpel, it took 20 minutes and I was dripping with sweat when finished. But this joint has a demanding job in the body, so it has to be strong. It’s amazing how well we are put together and how each structure is uniquely designed for its purpose. I’d like to share with you four things that have changed the way I look at the human body.

First

The first is the arterial system and the nature of arterial plaque. I had always imagined plaque to be similar to lard and you do find that, but when they say “hardening of the arteries,” it’s not an abstract concept. Our specimens ranged in age from 50 to 101, and most have had plaque, many to a degree that I find remarkable. Sometimes it forms pebbles embedded in the arterial wall, some small, some quite large and generally rough and lumpy. Sometimes it forms long needle-like shards of calcified plaque that are sharp as a needle and can easily pierce the skin through a glove. When you grasp the outside of an artery that contains this type of plaque and squeeze, you feel and hear it breaking under your fingers, like a muffled version of the sound of walking on thin ice on a winter sidewalk. Some of the thicker shards are strong enough that they are difficult to break with your fingers, and some of the pebbles are as dense as the pebbles in your driveway. We have seen arteries such as the common iliac or femoral artery, so densely filled with plaque that you wonder how any blood got through at all. In some cases, expansion of the artery during systole must have been the only way for blood to move past the obstruction.

One dissection was a woman who lived to the age of 90. I often discuss with the students what we’re going to see, and due to her age, I felt confident that we would see some significant arterial plaque. However, much to my delight, this 90-year old woman had beautiful arteries, they were clean, elastic and completely free of plaque. We removed the heart so students could hold it and feel the strong rubbery consistency of the heart muscle. When I held her heart, I was deeply moved. Time stood still and I could feel her spirit. Then it was time to pass the heart to the next person.

Second

I’d like to talk about the spine. There is such a remarkable difference between a healthy spine with thick disks and a spine in the advanced stages of degeneration where the disks have compressed and dried out. Healthy disks have thick, strong rings of tough annulus fibrosus with a nucleus pulposus that looks like thick creamy yogurt. In a spine with advanced spondylosis, you see the bone spurs that have tried to shore up the spine, while the disks are thin, dry and brittle. Stretching and exercising the spine is so important,

keep your disks supple and hydrated with movement and fluid intake. Sit less and move more.

Third

I’d like to talk about fascia. Through the work of Luigi and Carla Stecco (1) and many others, fascia has been analyzed to a degree never imagined just a few decades ago. During dissection, one can simply marvel at the interconnection and at the endless variation in how fascia responds to movement and muscular contraction. Fascia creates a complex web of connection throughout the body, and provides sensory and proprioceptive input to the nervous system. Fascia allows us to be far stronger than we would be with muscles alone. As many have said before me, traditional anatomy books were made by people who removed the fascia to get at the muscles, never appreciating the interdependent relationship between them.

Some muscles, like the erector spinae, vastus lateralis, and gastrocnemius have strong thick bands that resemble strapping tape. These structures provide great tensile strength and store energy when elongated, only to release it upon shortening. Fascia responds to the stresses it encounters, including elongation, compression and torsion. In one male specimen the suboccipital muscles had numerous thick bands of supporting fascia so strong they were like thin pillars of bone. I wondered if he had been a wrestler as I could imagine him doing neck bridges. In others, the suboccipital muscles are soft and almost mushy. Muscles will atrophy when not put to use. A recent specimen was from a woman inactive at the end of life, her multifidi were about 70% fat.

The infraspinatus muscle is one of my favorites for observing fascia. I always look forward to carefully exposing its surface where you often see circular swirls and curving lines of fascia going out in many different directions, to accommodate complex, multiplanar movements.

Fourth

Let me briefly mention the organs. The stomach wall is much thinner than I had imagined it. It’s thin and stretchy and the mucosal layer internally is also much less formidable that I expected. I’m more careful now not to stuff my stomach with excess food. The Chinese have a saying “eat until 80% full.” It’s good advice. The intestinal walls are much thinner than the stomach, thin enough that you can easily see through them to the waste within. When you see the intestines in all their blue-collar glory, fasting and cleansing seems like a smart idea. Abdominal fat stores toxins to a greater extent than fat in other parts of the body. People who had chemotherapy shortly before death often have greenish abdominal fat with a toxic chemical smell, while fat on the rest of the body appears normal. The greater omentum also seems to reflect overall health. It too absorbs chemical toxins, and in smokers is gray, dry and shriveled, when it should be moist, yellow and bright. In smokers you can smell the cigarette smoke as you expose the greater omentum, almost as if someone in the room were smoking. There is a vast difference in the appearance of healthy and unhealthy organs. Healthy organs are brightly colored, there is a vibrancy and integrity to the tissue. They look beautiful.

Changed My View

I lead a healthy lifestyle, but doing dissection has changed how I look at myself and how I look at others. We all have an inner reality, but we focus on the outer. At this moment, your bones, muscles, organs, (3) nerves, and arteries all have a reality that is partially hidden from you. We’ve all heard stories or had patients who suddenly experienced chest pain, went to the doctor only to find that their coronary arteries were 90% blocked. Maybe they were feeling fine up to that moment. The body does a remarkable job of coping with the constraints and stresses of life and lifestyle, until it can’t.

I’ve always been a people watcher and as a structure and movement specialist I look at how people stand, sit and move. Now there’s an added dimension, I picture what people look like on the inside. I visualize spinal degeneration, picture the pitting of osteoarthritis and the joint destruction of rheumatoid arthritis. I have seen metastatic colon cancer that colonized the entire abdomen, and the blackened lungs of smokers who died of lung cancer. I picture the many different kinds of fat in the body, how different it looks in different areas, and how much it varies between body types. I feel and imagine the fascia, resilient and protective in active athletes and less than it could be in sedentary individuals.

We begin and end every class with a ceremony of gratitude for the individual who donated his or her body to further the education of others. Maybe they did it years before death, maybe shortly before. These people took the time to think of others not only in their lives, but afterwards. If I can see into the body it is because of these generous individuals, and I am forever grateful.

Reference

1. “Fascial Manipulation: Practical Part,” Luigi & Carla Stecco, Piccin, 2009.

Patrick Cunningham is chair of the manual therapy department at the New England School of Acupuncture. He specializes in orthopedic and myofascial acupuncture, zhenggu technique, craniosacral and visceral therapy, chronic pelvic pain, and manual lymphatic therapy. He can be reached at livinganatomy@gmail.com.

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(Editors note: I have known Patrick for many years and have been the grateful recipient of many hands-on sessions with him. I was also privileged to attend one of his dissections and am still absorbing lessons from that amazing day. Those of you in the Boston area have an amazing resource in him. This article was originally published in Acupuncture Today.)

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(apologies for the formatting; for some reason, this one has been a disaster.)

2014 YLT, 11th Weekend Summary

Posted on February 10, 2015 by admin

Working with the Prana Vayus:

This is the eleventh entry in a series of twelve posts summarizing the basic material covered in the year long training which began in January of 2104 and will come to a completion on February 15th. Previous posts can be found on this blog page. A lot has been covered over the past year. If any questions arise, please feel free to contact me.

We are now working with the subtle energies, so some quietness and reflection is needed, even in dynamic postures. Meditation is primary in all poses, and the heart is the place to start. We are cultivating subtle streams of perception in both the fluid body and the etheric or spatial body, so some patience and persistence is required. Developing the skill of resting in stillness will allow the more subtle energies to reveal themselves.

Vayu means air or wind and the term Prana vayus refers to the five fundamental organizing movements of the energetic body. We will be working from the tensegrity/fluid body/pressure cavities perspective to make these movements both tangible and integrated. For anyone living in their body with sensitivity and intelligence, three major pressure cavities can be experienced, the cranial vault, the thoracic region, and the abdominal/pelvic region. Relative to the outside world, the head and abdominal cavities have positive or higher pressure and the thoracic cavity has a lower pressure. To present this in a more dramatic way, if you puncture the head or belly, stuff squirts out, but if you puncture the chest, it collapses inward, as in a collapsed lung. The basic point here is that this pressure gradient of the body is constantly moving energy toward the heart, i.e., pressure draws energy from higher to lower to create an internal equilibrium that is a major player in all of the fluid movements of the body.

This equilibrium can cover a whole spectrum from very dynamic, vital and healthy, to highly restricted and pathological. Our process in yoga physiology is to maximize the dynamic relationships for optimum health. And, it also turns out that in doing so we cultivate a deep inner presence in the heart center that is a place of infinite stillness and wholeness. Tada drashtuh svarupe avasthanam. We have to make it stable, of course, through practice and surrender, abhyasa and vairagyam.

We’ll begin with our Hoberman spheres and begin to feel the energies of the two directions: opening the sphere, expanding out from a center, which we can call the yang or centrifugal energy; and closing the sphere, condensing from the perimeter into the center, the yin or centripetal energy. When they are in balance, we can find a dynamically stable state of the sphere at any where along the spectrum from open to closed.

When we come to the body and the Prana vayus, we first come the first, also known as the prana vayu, which governs the process of taking energies into the body/mind. (I’ll use a capital P when refering to the general term including all five, and a small p when referring to the intake. The prana vayu ,or prana, is an expanding field that creates space and invites energy to move into the body. This expansion is centered in the mid chest at the heart and balances the negative pressure usually felt in the chest which causes the outer world to press in upon the chest. If you hadn’t noticed, as people reach middle age and older, the chest has more often than not sunk in a bit from this pressure. Gravity and the aging belly energy also play a part in this sinking. By consciously finding, feeling, creating an expanding field from the heart, the chest opens, the heart lifts, and we are ready to be present to whatever the world offers us in the moment. If your connective tissues have fallen into a collapse of any level, it may take a while to reconfigure them. The intercostals and other chest muscles, as well as the diaphragm and mediastinum are involved. The prana vayu is usually associated with respiration, but on a sublte level governs everything you take in, from emotions to ideas, sensations and images.

As we are open systems, we have to balance taking in with moving out. The second vayu, apana, governs elimination, or what we let go of, at all levels. Apana is a squeezing or condensing energy, complimenting the expanding of the prana vayu. Expand to take in, squeeze to move out. Very simple. Most commentators focus on the downward flow, as solid and liquid wastes are eliminated predominantly out through the pelvic floor, but the apana is more complex than that. Sweating takes place throughout the body. Exhalation of the breath takes place through the nostrils or mouth. Regurgitation, a hopefully infrequent form of expelling unwanted material, moves out the mouth.

Ultimately apana is a radiallly condensing energy. However, it also has an unusual role in that the downwards aspect is also what governs the action of the legs and tail, real or imaginary. So we might say the the abdominal/pelvic cavity also can be expanded to include legs and tail. As we saw with the prana vayu, aging often takes a toll on the connective tissue structures of the body. The apana is a squeezing energy, but the belly has a positive or outgoing pressure. Aging often leads to this positive pressure creating the pot or beer belly, giving many middle agers the look of being slightly pregnant. With this state, the ‘sqeeziness’ is also much weaker, creating all sorts of problems from poor elimination and digestion, to lower back problems. From the perspective of Ayurveda, the medical wisdom of the Vedic tradition, poor elimination is the beginning of the disease process.

The samana vayu, classically associated with digestion, governs absorption. It is the decider or mediator between what comes in and what goes out. When healthy, we retain the ‘good stuff’ and eliminate the ‘bad stuff’. From the perspective of the pressure cavities, samana sits between the expanding center of prana in the chest and the squeezing center of apana in the pelvis. When healthy, the expanding nature of the abdomen is carefully directed away from the abdominal wall and aligned with the spinal axis. Some of the energy lifts up through the diaphragm and into the heart, supporting the prana vayu; some of it extends downward to grow legs and tail, supporting the apana vayu. This action can be felt as a natural, mild uddiyana bandha. Here Krishnamacharya is demonstrating a slightly stronger version as part of pranayama practice.

The vyana vayu circulates the energies throughout the body. First felt as the fluid flow of the blood, vyana also governs the nerve currents circulating information throughout the body and the flow of Prana through the subtle energy channels known as nadis. There are fourteen principal nadis, of which three are most commonly known. Ida is the lunar or cooling nadi associated with the feminine and parasympathetic nervous systems. Pingala, the solar or masculine nadi, works with the sympathetic nervous system. Susumna, the center channel, works with the central nervous system. There are some parallels with the meridian system in Chinese medicine.

The vyana vayu has both expanding and condensing energies and also governs movement. The grace and elegance of the limbs in movement is an indication of healthy vyana.

The udana vayu is a fascinating one. An upward moving energy, udana governs growth and development at all levels of reality. At conception it facilitates embryological development and triggers the urge in the baby to move out of the womb and into the world by extending out through the crown chakra. This same energy takes the soul out of the body through the crown chakra at death. During your life, udana is a sustaining field of intelligence that integrates the other four pranas in an on-going urge to grow physically, emotionally and spiritually. When udana gets stuck, it feels as if our whole life is ‘stuck’. Coming back to the heart center and resting there is always a way to get ‘unstuck’.

In any poses you choose, find these energies. In dynamic postures such as standing poses and back bends, to much muscular energy is a sign of blockage in all the vayus. Start with opening the prana vayu and follow it through the others. In more restorative of meditative poses, find the udana vayu as a field of integration and stillness, where the whole body mind is awake and relaxed simultaneously.

2014 YLT 10th weekend summary

Posted on January 8, 2015 by admin

This weekend we focused on using energy lines in new ways. So far, we have been using lines and circles/spheres of energy to create simultaneous balance and extension (moving out of tension) in the postures. The Hoberman Sphere has been our metaphor for breathing as expanding and condensing, and sustaining an internal, 3-dimensional spaciousness. The circle is the feminine side of sacred geometry, and to this we have added the masculine, the straight line, as an axis through the sphere to give is another polarity, such as head and tail, or heaven and earth. From these we have created the basic shape of an organism centered in the cosmos. The gyroscope gives us the sense of dynamic stability the is at the essence of all life.

For the next level, we will begin to explore some new energy shapes based on what are known in math as the conic sections. These are defined by the different angles one can slice through a cone. We have played with the circle so the next to come is the ellipse. Like the circle, the ellipse is a closed shape, but where as the circle has a single center to define its perimeter, the ellipse has two centers, known as focal points. We use the elliptical shape to explore 2 chakras at a time , one at each focal point. For example, when lying in savasana, or any supported position, we can imagine the heart chakra at one focus and the navel center, or the sacral center as the second. Any two chakras will work, but if you use the alternating ones, (1-3, 2-4, 3-5, etc) the chkra between can also emerge as the center of the two focal points. The earth’s path around the sun, as well as that of the other planets, is ellipsoidal, so this is a very cosmic, macro-phase pattern to align with.

When we come to the parabolic and hyperbolic curves, we enter a new phase in our integration as these are open curves, coming from outside the body, passing through us, and then moving on again. From the conic perspective, the parabolic curve is parallel to the edge of the cone, where as the hyperbola is parallel to the perpendicular axis of the cone. Hyperbolas also come in pairs, but one half is enough for our somatic play. Parabolic curves are more focused, and such are used in mirrors and auto headlights. Hyperbolas are more open, that is the ‘arms’ can spread wider.

Try standing in a nice simple, grounded tadasana, find your heart center, and from there open the arms, pointing slight up and forward. If you have some anatomical sensitivity, align the shoulder girdles, arm bones, ribs and heart center into a parabolic shape and let the bones, muscles, connective tissues, blood vessels etc feel suspended and supported by the energy flowing through you. Widen to find some hyperbolic lines.

This can also be done lying down, with arms up and out to ceiling, or even with the legs, like a parabolic or hyperbolic anemone. In any pose, invite these in to light up aspects of your interior, or to bring into focus cells, organs or any structure that invites you.

Homework for the final sessions: Review, Read Hsin Hsin Ming, continue with Gita and Sutras as you feel inspired. Keep practicing.