A New Paradigm of Anatomy with John Sharkey

Apr-11-2018

Audio Description

Conversation Highlights

What is a clinical anatomist?
For a long time there was a big gap between the medical field and massage therapy. He made the decision that physiology and anatomy were gong to be the foundations that he was built on.
Alma mater is Dundee University in Scotland. The clinical anatomy department there was within the department of anatomy and human identification so it was a broad speciality.
Clinical anatomy is all about "where". Where is the phrenic nerve? Where is the... and not just where, but what is its path? What structures lie close to it? This informs surgeons as to where the nerves are and in what percentage of population would you find it 1cm lateral or medial etc. Anatomists feed on technicalities, detail, and specificity.
Me: If clinical anatomy is about where and about knowing the names of structures then it is steeped initially in the old paradigm. Yet you are also a champion for the new paradigm. Do you agree with terms old/new paradigm and how would you differentiate them?
His work with Dr. Stephen Levin who was investigating the biotensegrity model.
When studying anatomy, new students are given a textbook like Grey’s, they open it up and will tell them how to carry out a dissection. They will follow the dissection descriptions the same way previous students carried it out the same way students previous to them carried it out and on and on... from that viewpoint dissection always the same.
We also want to get through the skin and get to the structures that matter the most like the nerves, blood vessels, and viscera. This is the focus of parts and the language of parts. John wanted to explore the language of wholes and appreciate the relationships and continuities.
John's work with Dr. Levin's BIG (Biotensegrity Interest Group).
Definition of biotensegrity in his terms.
To give a visual people will often use the Skwish toy made by the Manhattan Toy Company. However we are not made of wooden struts and elastic bands.
Words are hugely important. Human tissue is not supposed to be stretched. It does not stretch.
Once tissues in the pelvis have stretched they will not return to their former state. There are many people who will spend hours stretching- gymnasts for example. How are they achieving this new range of motion? We don’t want to take the origin and insertion further away, so we are changing the tissues that lie between them.
Also doesn’t like the term sliding. Many people use that term. However place one hand on top of the other and move your hands back and forth. Feel the heat which is the consequence of friction. This is not a good way to build a body. In living architecture tissues do not slide, they glide relative to each other. Guimberteau’s videos demonstrate that beautifully.
We talk about stretching in a Newtownian way. If we take the Newtowninan tube- for example the heart or blood vessels- the tube would lengthen and it would expand under pressure and with all the pressure the blood vessels of the brain should also expand and would squeeze the brain out of the ears. And that doesn’t happen because of non-linearlity.
Language has to evolve alongside our models as they evolve.
We’re getting a very antiseptic view of the human body. However let's not throw out the baby with the bathwater. He loves the history of anatomy.
The icosehderon as the building block of biotensegrity. We will never get to see that because the icoshedron is a 3 dimensional version of a 4th dimensional thing.
We have a right eye and a left eye. All the visual information you take in that goes to the brain will cause the brain some problems because the images from the 2 sides do not correct, and the brain fills in gaps. At best we see in 2.5D, but tensegrity icosehedrons happens in 4D. Like a mobius strip- there is no inside or outside but only continuity- that is what living architecture is like.
We need to recognize that what we are dealing with requires soft matter physics. This will give us the mathematical models that will provide us with computer graphics to help us to explain the multidimensional dynamics.
It's amazing to me that we are still working on the idea that the body is a lever based system. In an x-ray we can see there is space between those bones. Why are the bones not crushing each other? People have this notion that there must be a lot of fluid in the knee joint. However if you lick your hand- that’s how much fluid is in the knee joint.So what is keeping the integrity of that joint space?
People like Serge Gracovetsky have demonstrated that to do a deadlift it would have to demonstrate so much intra abdominal pressure that they would explode.
Bone is soft matter- it is all it is is a continuation of the fascia.
Me: You recently co-authored 3rd edition Concise Book of Muscles. What was the approach to building bridges between new and old paradigms in that book?
Change takes time. Origin and insertion type of detail is important for med students. However, the other aspect is introducing a section co-authored with Dr. Stephen Levin to introduce biotensegrity for a new anatomy of the 21st century. In the next 10 to 15 years the 6th and 7th editions will look very different.
Working with cadavers treated with formaldehyde changes the texture and color- everything looks same.
Once you make an incision to skin and allow atmospheric air to touch what is beneath the skin you will begin to see changes taking place. From that viewpoint if someone takes a tissue out of the body and investigates it what you are actually witnessing are emergent properties. You have to see it in situ.
Jean Claude Guimberteau could do what no university would allow. He got permission from patients to place a camera under their skin. For the first time in history we have recorded images of our connective tissue in living tissue. It has blown people away.
This is the type of evidence that demonstrates to people that you cannot stretch tissues. Tissues glide relative to each other. In fact in Dundee we are going to bring in an endoscope and use it on the Thiel cadavers. The cadavers hold on to original colors, fluids move, lungs inflate and deflate. It is as close to being a surgeon as possible. However there is no life in the tissue.
Aliveness changes so much which is why Guimberteau’s films are so important.
Individuality is the norm of human anatomy.
Every bone is a sesamoid bone.
Anatomists have discovered a new muscle in the quadriceps- not sure what we're going to call the quadriceps group now...
In the dissection room students will take out boxes of femurs and pelvises and they will measure them. When they come back they will find none of the measurements are similar in any of the bones. This tells you that there is no one squat that fits all. You have to work with people as individuals.
There is nothing perfect in human anatomy or neurology.
The real motors for movement in shoulder come from lower limbs. So many people who train things in isolation do it for purely for cosmetic reasons. If you think of it in terms of chains and links you have this massive link with no relationship to the entire chain. Now it produces forces out of sync with the entire chain.
Our strengths used to be dictated by needing to climb a tree or over rocks. We didn’t have a fitness center where we could put our legs in a leg press and disassociate these structures and ask them to repeatedly contract. When we do this we are teaching the body new neuromuscular anagrams and losing the connection between the whole body.
People should be informed. Once people understand the ramifications they can make an informed choice.
Children involved in sports and demanding activities will have long term ramifications to their adult form.