The first thing that happens in the human dissection lab is that the bodies are unveiled (there were 8) and you walk around the room and chose which one you would like to work on. You pick not only the body, but also the group of people you want to work with. Marc and I (stunned and already overwhelmed) had met a guy named Brian who was there for his fourth time. Marc thought it best that we stick close to him. When the bodies were unveiled the one we were closest to was an elderly lady that had obviously been sitting slumped in a wheelchair or in an upright bed for a long time. Her head and torso were twisted to the left and compressed down. Her hips were rotated oddly and in death she was stuck in that position. There were other bodies that looked more muscular or had the signs of surgery scars or other ailments that could be revealed during the week making them potentially more interesting. Our little Claudia had none of that, she was just a bit twisted.
Not knowing a whole lot about the process, I figured we would find that Claudia’s muscles were “stuck” in that position, her skeleton even. By looking at her I just assumed we would never be able to straighten her out until we got all of the ligaments and tendons dissected away. Instead, once we dissected off her skin her whole body just relaxed into an almost natural straight line. There was still a slight rotation of her rib cage and her neck was stuck to the left most of the week but in general removing the skin made her body relax. This got me thinking about movement and elder care and all kinds of stuff.
First, the idea that her body relaxed after just the removal of the skin leads me to believe that the first layer of connective tissue (fascia) was where most of her “stuckness” was coming from. Being in the same position day after day had fit the tissue into that pattern but what I thought would resound deeply into her body was fairly surface level. I asked our group guru (Brian) if Claudia was just moved regularly and maybe had light massage done could she have been straighter in life? And his answer was “we don’t know, but probably”. (The answer is ALWAYS “we don’t know for sure, but….). I pondered this most of the week and how it could translate with working with the elderly.
We did find some interesting muscle patterns in Claudia that were a result of the way she had been sitting. Her masseter on the right side was almost 3 times bigger than the one on her left. With her head tilted to the left, the right side masseter was the one fighting gravity. It was overdeveloped from working every day to keep Claudia’s head from letting go completely and just falling forward. Her right side IT band was also bigger than her left side, again because that right side was fighting the pull of gravity to keep her body as upright as possible so it wouldn’t tumble forward. The reticulum on her left ankle was also very prominent but she barely had one on her right. I assumed this was because her left leg was propped on the foot of the wheelchair and was a “pushing” force to stabilize her body. Her left leg most likely didn’t sit on the foot rest and never pushed against anything so a solid reticulum didn’t form. I did expect to find some differences with some of the deeper muscles but when we got to her psoas and QL they were pretty much even on both sides. And there was no difference in muscle size in any of the muscles on her backside.
As an industry, we stress that the only things for healthy living are eating right and exercise. Vigorous exercise for 30 minutes or more 5-6 days a week and you will be fit as a fiddle for the rest of your life. Movement does not equal exercise, because exercise means you are getting your heart rate up and challenging your systems. But what Claudia made me understand is that MOVEMENT is just as important. Moving your arms and legs through a range of motion, rotating at the waist back and forth, bending forward and backward, rotating your ankles and wrists – all are beneficial in keeping the fascia from binding up, keeping the areas sufficiently lubricated and keeping you from getting stiff and sore on the surface level with the skin. These are all things that can be done while sitting in a bed or a wheelchair (with help) and they are not difficult for a second party to assist with. Most elderly people in a nursing home do get some sort of occupational therapy or physical therapy but is what they get enough? Probably not. But if just moving can benefit people so much, and moving is fairly simple how do we get that done?
I did not walk away from our week of dissection with many ideas on how to put what we learned into practice. Mostly, we just focused on the anatomy and what we were seeing and being told. The amount of information given to us was so overwhelming that just processing it took a lot of time and brain power. But the idea of movement as a fundamental building block to any program was a take away that I could immediately put into practice.
When is say movement I mean something different than training. It isn’t weight lifting and it isn’t cardio. I simply mean moving, getting the blood flowing, working the joints in different ranges of motion. Once I separated the idea of movement from the idea of training I started to see how that is just the approach that needs to be taken for so many of our “special population” clients. Start there. Start with movement. Throw in a “feel good” massage once a month. Do more exercising depending on your level of fitness. And then, move some more. Just move. Move. MOVE!!!