February 25, 2025 • 85 mins
Episode 152 centers on a lively conversation between Kevin and Dr. Kate Oland Galligan as they trace her path from a curious undergrad to a passionate fascia educator and clinician. The duo challenges old perceptions of fascia, recounting stories from early lab experiences where fascia was simply “ripped out,” and contrasting them with new insights on its dynamic, interconnected nature. They reveal how subtle fascial restrictions can cause significant clinical symptoms—linking pelvic imbalances to jaw pain—and explore the emerging field of mind-body connections in fascial therapy.
0:00:00 | Introduction
0:00:55 | Introducing Kate Introducing Fascia
0:17:06 | Fascia Mini Lesson *
0:20:00 | Rip That Fascia Out!
0:37:14 | Get Ready for Annual Debriefing
0:39:00 | The Hip Bone is Connected to the Jaw Bone
1:03:08 | We’re on Substack! *
1:06:13 | Mind-Body Connections
1:21:45 | Staying Connected
* Breaks
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Understanding fascia requires abandoning the traditional anatomical view of separate structures and embracing a model of interconnected, living tissues. (Jean-Claude Guimberteau)
Introducing Kate Introducing Fascia
16 minutes
In this segment, Kevin reconnects with Dr. Kate Oland Galligan, a former student who has since become a passionate fascia educator and clinician. They reminisce about their time studying physiology together, sharing a nostalgic moment about the infamous Krebs cycle. Kate shares her professional journey from graduate school to clinical practice, detailing how she discovered her deep interest in fascia. As she explains, her dual role as both an instructor and practitioner has given her unique insights into why fascia deserves more attention in undergraduate education. Their conversation sets the foundation for an in-depth exploration of fascia’s overlooked importance in both teaching and clinical applications.
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
>>Kevin Patton (00:00:00):
In his recent book, Architecture of Human Living (00:00):
undefined
(00:03):
Fascia, the surgeon and researcher Jean-Claude Guimberteau states, "Understanding fascia requires
abandoning the traditional anatomical view of separate structures and embracing a model of
interconnected living tissues.">>Aileen Park (00:00:25):
(00:25):
Welcome to The A&P Professor. A few minutes to focus on teaching human anatomy and physiology
with a veteran educator and teaching mentor, your host, Kevin Patton.
>>Kevin Patton (00:00:34): In episode 152, Dr. Kate Oland Galligan joins me (00:39):
undefined
for a discussion of the human fascial system.(00:00:56):
Well, in this episode, I am so excited to be here with Dr. Kate Oland Galligan,
(01:02):
who it turns out is a former undergraduate student of mine who in physiology at St. Louis University,
back when I directed that course and taught that course. And at the recent HAPS conference,
we sort of accidentally ran into one another and reconnected and have had some conversations. And
(01:27):
one of those conversations was about fascia because as we'll talk about in a moment,
she's really into fascia in her clinical life as well as her teaching life because guess what?
She's now teaching anatomy and physiology to the undergraduates at St. Louis University. Oh man,
(01:47):
what goes around comes around, right? I did confirm that one of the things that she remembers
that from my course was the Krebs cycle.>>Kate Oland Galligan (00:01:59):
Oh.>>Kevin Patton (00:01:59):
Yeah. See. For those of you that have been with us for a long time in this podcast,
way back in episode 79, I talked about the story that I tell in my class just to kind
(02:11):
of break things up and make a little bit more fun. And now I have a witness to confirm. So,
what were your thoughts when we were doing that silly Krebs cycle thing in class, Kate?
>>Kate Oland Galligan (00:02:24): Oh, it was just so silly, but I remember (02:24):
undefined
taking things so seriously in undergrad and this was a serious class, but here is this guy having
fun with physiology, so it made you more human and I think that made it easier for us to receive
information from you. And clearly that's how I remembered that you taught me 24 years ago.
>>Kevin Patton (00:02:51): Kate, what have you been (02:51):
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doing in those 24 years?>>Kate Oland Galligan (00:02:56):
I've been a little busy. I've done some things. So, I was in your physiology class in undergrad
at the time I was working on my bachelor's in exercise science, and then soon after
that I finished my master's in physical therapy. I started working as a physical therapist and it was
(03:15):
a pretty cool time to be a physical therapist. So, at that time I could start working with my
master's, but then I continued to work on my doctorate and I finished that a couple years
later. So, I worked as a physical therapist since I guess January of 2005 and did a little more
(03:36):
schooling those first couple years. But then life gets busy. I worked, I got married, I had kids,
I got divorced. And then a couple years after that I took a deep dive into the fascia world. I went
to my first myofascial release course in 2020 and found a new passion. And so that's, I guess kind
(04:01):
of catches us up to where we are today.>>Kevin Patton (00:04:04):
I had been thinking about how we teach fascia and the fascial system in the typical undergraduate
A&P course for a while now. And I mentioned this to you, I had been collecting a couple
papers and jotting down some notes. Because I wanted to do an episode about fascia that is
(04:27):
what we're thinking about fascia these days. And that is rapidly evolving as we'll find out during
this conversation and what does that mean for the typical undergraduate A&P course? What is it we
can do with that to help students understand the human body better? And not only that,
I mean this is a foundation preparing for many of the students are going to be going
(04:53):
into clinical applications as you did, Kate. So, what kind of preparation can we give them? What
initial thoughts about fascia can we give them? So, I had been thinking about that,
and as you and I were reconnecting, you brought up the idea of like, "Hey, did you ever think about
doing an episode on fascia?" And I'm like, "Funny, you should mention it. Yeah." And so let's do it.
(05:14):
Let's do it together. And here we are.>>Kate Oland Galligan (00:05:17):
Well, I think my conversation with you started with, "Hey, can we get a chapter
in your anatomy book about fascia?" So, I think I got a little ahead of myself, but yeah.
>>Kevin Patton (00:05:28): Well, yeah, I mean I remember that (05:28):
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that's how that conversation started off. And that's a good question. On the practical side,
our editors are pushing us, and this is true of all textbooks, not just A&P textbooks and
across different publishers and so on. They want us to make our books no bigger than they
(05:51):
are now. And if possible, make them a little bit smaller. Because those A&P books now,
they're I think they cause problems with fascia by having to carry them around and stuff.
>>Kate Oland Galligan (00:06:03): Those printed textbooks get heavy. Yes, (06:03):
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they can contribute to lots of low back pain.>>Kevin Patton (00:06:08):
See, there you go. I literally, well, I think people who know
that I do the Krebs cycle thing.>>Kate Oland Galligan (00:06:16):
Oh.>>Kevin Patton (00:06:16):
Krebs cycle thing, yeah, thank you. They will believe me that every time we start
(06:25):
a new revision on a new edition of our textbooks, I always ask, can we put wheels on them like they
do with luggage? The students won't have to carry them around and they laugh, but I'm being serious.
We need to do something. But I think it's already happening. The solution is digital textbooks.
>>Kate Oland Galligan (00:06:47): Yes. I'm so jealous of my students (06:46):
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that get to carry their textbooks around in their devices. It's so much better ergonomically.
>>Kevin Patton (00:06:56): Right. And they can have it (06:56):
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with them anytime. So, if they find some time to review some stuff that they didn't
anticipate and they're somewhere way far away from their study materials, then well, no,
they aren't way far away. They're just a couple of clicks on their device. And there you go.
>>Kate Oland Galligan (00:07:16): Exactly. I still love a good old-fashioned (07:15):
undefined
book though. I like to flip through the pages. And actually a couple years ago I started teaching A&P
at SLU and it was not even two to three weeks into the semester. And even as a teacher,
my textbook looked the same as back when I was a student. I dripped coffee all over the top of
it at some point in time.>>Kevin Patton (00:07:36):
(07:36):
All right, well, but that shows that you're using it.
>>Kate Oland Galligan (00:07:38): That's right. (07:38):
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>>Kevin Patton (00:07:38): So, we all like to see that, right? (07:39):
undefined
>>Kate Oland Galligan (00:07:42): Yes, yes. (07:41):
undefined
>>Kevin Patton (00:07:43): So, anyway, here we are in our (07:43):
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episode about the fascial system about fascia. And I guess the best place to start is because
this is kind of, well, as we'll see, it's kind of a little bit muddy, is what is fascia? And I've
been using the term fascial system. So, what's fascia and fascial system? I don't know, Kate,
(08:05):
you want to start us off on that?>>Kate Oland Galligan (00:08:07):
Yeah. I love that you refer to it as the fascial system. That's something that took me a while to
wrap my head around it. I've been enthusiastic about fascia for a couple of years now,
and the fact that there could be this whole other system that ... the body,
it just was hard to wrap my head around. But I do believe it's way more complex than we've
(08:30):
given it credit for in the past. I think in the textbook that I use with my students,
I think there's two lines describing fascia. They say something like it's a dense irregular
connective tissue. We describe it, we define it in the chapter on tissues, but actually the past
(08:51):
couple of years we fit my lecture about fascia. We slid that in during the muscle structure lecture
is where we have been presenting this information. And that might be a good place for it too.
(00:09:04): Because the muscles are (09:04):
undefined
heavily influenced by fascia, and the fascia is heavily influenced by the muscles and the motion
and the trauma that it can occur to our muscles over the years. But I think I'm getting ahead of
myself. Physiologically that fascia is comprised of collagen, which will give it its support,
(09:27):
give the body support, give the body shape and stability. It's comprised of elastin, which can
give it that dynamic flexibility. And then we have the ground substance. And the ground substance
will provide the cushion and that surrounds each cell in the body, which can help determine its
(09:47):
physiological functional capacity. So, that ground substance, that's important that surrounds every
cell and it's in each of our cells. And I've read some literature that talks about how there's even
fascia going down into the cell as a part of the cytoskeleton, not just giving our full body some
(10:10):
structure, but also helping to provide some structure at the cellular level as well. It's
pretty interesting stuff.>>Kevin Patton (00:10:18):
Yeah, that's one of the things that really intrigues me is that connection. And I think
that's where, I mean it seems to me being sort of an outsider looking into the world of fascia,
(10:32):
that seems to be like an area where we're really expanding our understanding and that is all that
connection. As a matter of fact, in my textbook, I use a similar definition that you just recalled
from the textbook you're using. But I want to read it because a couple of things in there. There's
a few sentences long, but maybe three or four sentences long. But I want to read it because a
(10:56):
couple of different things in there that I think I want to at some point in this episode bring up
and discuss.(00:11:05):
And that's one of them, that connection. So, what my book states right now in the 11th edition of
A&P, "Fascia is always some sort of fibrous connective tissue and almost always features
(11:20):
many collagenous fibers that are interwoven in an irregular arrangement. In some areas of the body,
for example, under the skin fascia is mostly adipose tissue. In other areas, such as around
some of the muscles, it is dense, irregular, fibrous tissue. Often some of the fibers of
fascia extend into the tissue of nearby organs, thus strongly binding to them. For convenience,
(11:47):
anatomists often distinguish between superficial fascia, which is just under the skin and deep
fascia, which extends well into the body and surrounds muscles, blood vessels and
other organs."(00:12:01):
And of course, fascia comes up in many other areas. And circling back to that mention you
made of, we need a chapter, a textbook chapter on fascia. What I've been doing in our book,
(12:12):
and maybe a chapter is a good solution and maybe we can get to that point. We have
to figure out what other stuff to take out to make that fit. But something we've been doing,
we're working on actually the 12th Edition, the 11th edition is out there now, but we've
been trying to integrate it and that is working pretty well because fascia really does come up in
(12:37):
a million different places.(00:12:38):
As a matter of fact, I ran one of those articles I saved, it was from a clinical anatomy journal,
and they had a special issue on fascia, and I'll have a link to that in the show notes. But one of
the papers in that special issue was about, it was by Rebecca Pratt. I wrote down her name, so I'd
(12:57):
remember that to give her credit for this idea, she wrote an article called Educational Avenues
for Promoting Dialogue on Fascia and a lot of what she was doing in that article ... And I highly
recommend it'll give us a lot of good ideas. She even had some demos that you can do in a class
to really give students a good understanding of fascia. And I'll mention those in a second. But
(13:21):
she goes through the different areas, say this can come up in many different areas of the course.
(00:13:26): So, Kate, you were talking about, well, (13:26):
undefined
in the textbook it comes up in the discussion of tissues. But the way you folks tell your story at
St. Louis U, it works better for the students and their understanding when you talk about it in the
discussion of muscles. And so she goes through all those different ways that can come up. And so what
(13:48):
we're trying to do in our book is find some of those places where it's appropriate to mention
fascia again and say, remember fascia and how it connects. Well, here it is, connecting again.
(00:14:02): And I just want to mention too, that a previous (14:01):
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episode I mentioned, I think it was called, and I should have this written down somewhere,
but I'll have a link to it in the show notes, but it was something like 10 things we often forget to
tell students about cells. And that was one of the things I mentioned is that cytoskeleton connects
to the extracellular matrix and that extracellular matrix is part of the fascia and connects to all
(14:27):
those other things that we consider to be fascia and part of the fascial system. So,
I tell my students that I'm overstepping a little bit, I'm exaggerating a little bit, but one way to
think of the body as not as separate parts that are all stuck together, let's think of it as one
giant part and it just has different regions.>>Kate Oland Galligan (00:14:48):
(14:48):
I love that you bring that up. Because that was something when I went to fascia class the first
time to just stop dividing the body into these micro-diagnostic little pieces. But to look at
it as one fluid organism and that fascia is what connects it all. Now you talk about where can
(15:10):
we mention this in class? Well, my students are probably sick to death of hearing about fascia.
Because I bring it up all the time and I am always making that clinical connection to them.
(00:15:23): So, I'm a fascia enthusiast and they hear a (15:23):
undefined
lot about fascia and I'm hopeful that I teach for the Department of Clinical Health Sciences. So,
my goal in this is to give them more perspective about not just fascia, but how it relates to every
system and then what a fascia therapist could do for either their future patients or for
(15:48):
themselves. Because I do believe that every person could benefit from some fascia work, but we can
get into that a little bit more when we talk more about the clinical aspect of fascia treatment. But
I talk about fascia almost every week, because it relates to every system in our body.
>>Kevin Patton (00:16:03): I'm thinking. And now that you can take (16:03):
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or leave this bit of unasked for advice, but if I were you, I would consider having your students,
whenever you mentioned the term fascia, to yell out, "Yes, fascia, we love it." And then-
>>Kate Oland Galligan (00:16:22): A little whoop, a little cheer or something. (16:22):
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>>Kevin Patton (00:16:24): Yeah. And then that'll keep (16:24):
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them listening for the word.>>Kate Oland Galligan (00:16:30):
That'll carry on your tradition. You know what, I think I'm going to have to do that.
>>Kevin Patton (00:16:35): All right, well if you do let (16:34):
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me know. I want to hear that that goofiness is living on beyond my teaching career.
>>Kate Oland Galligan (00:16:48): Oh, the goofiness resides in my classroom (16:46):
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whether I like it or not.>>Kevin Patton (00:16:52):
Well, that's good. That means a lot of learning is going on. These students are engaged. So, cool.
>>Kate Oland Galligan (00:16:59): I hope so. That's the goal. (16:58):
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>>Kevin Patton (00:17:00): Let's take our first brain break. (17:00):
undefined
(00:17:07): Hey, you may already know this, (17:05):
undefined
but I have another website called lionden.com, and that's a website I built in the way olden
days before our college had its own website or were even thinking about having a website. But I
knew that I wanted to jump into it and have some resources available for my students to help them
(17:29):
learn A&P, not only resources that I put together for them, but links to other resources. And it
could be edited on the fly in real time so that they could have the latest information that helped
them with my course as it existed at that very moment. And that website's still around. I still
(17:51):
have outlines that my students used to help guide their learning. These are, oh, excuse the phrase,
skeleton outlines. They're very sketchy and they don't include the things we were doing
in the lab course, only the things we were doing in the so-called lecture part of the course.
(00:18:10): And so there are big (18:10):
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chunks of things missing, obviously because we were focusing on them in the lab. But you
might find them helpful. You might want to point your students to one or more of them,
or you may want to adapt them to make some skeleton outlines that the students can
use to kind of act as a framework for what they need to be learning in your course. So, they're
(18:32):
there if you want them. And there's lots of other resources at lionden.com too, such as some of my
old slides. Many of them are animated. Word lists and lab lists and just all kinds of stuff. So,
you can go exploring around there. But the reason I'm bringing it up now is that there is something
there called a mini-lesson. These were sort of adjunct outlines where they outline things
(18:58):
that weren't in the textbook, and so therefore they're just slightly more detailed than they
would be for the material that covers stuff that they could also read about in their textbook.
(00:19:09): So, one of the mini-lessons that I have (19:08):
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there is on the fascial system, so you may want to take a look at it. Now, what you would do is just
go to lionden.com and I think it's fairly easy to navigate, but then again, I built it so it would
be easy, right? In my mind. But you may not find it so. And if you run into problems with that,
(19:31):
let me know so I can make them a little bit smoother for your average user. But anyway,
at the very top of every page there's a navigation ribbon. And so you just select learning A&P and go
down to the choice that says learning outlines. And then in that sub-menu right at the very top
is something called list of outlines. So, click on the list of outlines and you'll easily be able to
(19:55):
find the one on the fascial system.(00:20:01):
Fascia, oh my gosh. Yay, fascia. Let's not do that during this episode. That'll get-
>>Kate Oland Galligan (00:20:08): It will get real [inaudible 00:20:08]- (20:07):
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>>Kevin Patton (00:20:08): Yeah, that'll get annoying. (20:09):
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>>Kate Oland Galligan (00:20:10): Like a drinking game, take a shot every time we (20:10):
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say fascia. We won't get through the episode.>>Kevin Patton (00:20:14):
Those of you that are listening, keep that in mind as an option. You can do the drinking game part.
Wow. Now you might not remember anything we talked about, so I don't know if that's such a good idea,
but it's an option. All right, so oh my gosh, there's so many things to talk about fascia.
>>Kate Oland Galligan (00:20:35): I had a little bit of an idea, because (20:34):
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you mentioned a minute ago that we're getting all this new clinical application about fascia,
and I have my little spiel that I give clients because I educate my students and then I have
my own fascia private practice too. So, I have a little spiel. Are you ready for it?
(20:55):
Do you want me to give you my->>Kevin Patton (00:20:56):
Sure.>>Kate Oland Galligan (00:20:58):
... little fascia spiel? Okay. So, I do feel very passionate about trying to educate so many
people about clinical aspect of fascia. And I think people initially are a little hesitant.
Why is this girl so excited about something I've never heard of? And she's telling me it's one of
the most abundant tissues in my body. Why haven't I heard about this? Well, when I first attended
(21:20):
classes, which I just want to real quick give a nod to John Barnes, I go to the John Barnes School
of Myofascial Release.(00:21:28):
So, a lot of the ideas and concepts that I bring up, this is all information I've learned from him
and his instructors. So, I just want to make sure to give a nod to the people who educated
(21:41):
me because I know that they're the ones who planted this seed of enthusiasm for me. But
what John talks about and what I identified with in that very first class is a cadaver with fascia.
We learned about the body initially for hundreds of years through dissection of cadavers. And in a
(22:03):
cadaver that fascia, you don't see its function at all. It's dehydrated tissue. And I have a
clear memory of being in gross anatomy and Jeff Watson coming in, he taught gross anatomy to me
and my classmates just, oh, we got to get that fascia out of the way and just kind of grabbing
(22:23):
it and just pulling.(00:22:24):
He had to use a lot of force to try to rip that fascia out. And there were times when trying to
get the fascia out of the way, trying to use the scalpel was just not cutting it. It's very thick,
very fibrous, strong tissue. But again, I think from that perspective,
(22:44):
we saw how it holds everything together, holds it in place, and how that might allow things to slide
and glide a little bit better. And that was the basic understanding I had until recently. And I
guess it's been maybe I'm guessing 30 to 40 years ago when in the medical world and the scientific
(23:04):
world, we started to be able to study living tissue with in vivo technology, in vivo cameras.
This isn't horribly new information. As I was glancing through the papers prepping for today,
making sure I had information straight in my head, I was kind of taken aback by the fact that some of
(23:26):
this information that I am using in my clinical practice comes from studies that were done in the
sixties and the seventies.(00:23:34):
So, this is some information we've had for a while and we're just now really able to
take that information and apply it in a way that pertains to clients. And again,
I'll get to the clinical aspect again in a second. I'm sorry. I went off on a tangent
(23:49):
about fascia and how we learned about it. In one of my classes, we saw this pretty awesome video,
and I think you can find it on YouTube. It's called Strolling Under the Skin. Strolling
like you're going to take a stroll or a walk. Strolling Under the Skin. It's about a 25-minute
video that really you get to see a lot of living fascia and how it moves in the body. They talk
(24:15):
about how they were discovering how fascia worked and the fractals and it's really fascinating.
(00:24:21): So, if it calls to you to take a peek, I don't (24:20):
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know that you have to watch the entire thing, but just I think getting a glimpse of, I think I share
a two-minute clip of the video with my students in my lecture just to see how the fascia works in the
human body, I think is fascinating. You can see how it breaks apart and comes back together again.
(24:41):
Which I don't know, Kevin, I don't know of any other tissue in the human body that does that.
>>Kevin Patton (00:24:47): Only in science fiction. (24:47):
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>>Kate Oland Galligan (00:24:49): Right? Yeah. It's kind of like watching (24:49):
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science fiction for the nerdy type, I guess. So, this is information we've had for about,
I don't know, 40, 50 years. And now that we get to understand it and know that it doesn't just
hold things in place, but it helps communicate between the different systems of the body as
(25:13):
well. I tell my clients it's a head to toe 3D web of connective tissue and literally it's a
3D web. And when you get a restriction in your fascia, a one-inch restriction can put up to
2,000 pounds of pressure on the surrounding tissues. So, that can cause problems.
>>Kevin Patton (00:25:35): Wow. (25:35):
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>>Kate Oland Galligan (00:25:35): Right? (25:35):
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>>Kevin Patton (00:25:35): That is crazy. That is something, yeah. (25:35):
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>>Kate Oland Galligan (00:25:39): Ouch, right? And that's actually, (25:39):
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that's information out of a paper that was published in 1961 in Kyoto. So, we've known
that for a while that fascia can wreak havoc. And sometimes where that restriction is that's going
to be where you get your symptoms. But if you recall, I mentioned it's a 3D web now when you're
trying to picture that, one of the analogies I use with my clients is think about a hand knit sweater
(26:07):
of each stitch in its place. And when that gets snagged, the snag is of course where you notice
the changes in the stitching, but it changes the tensile property of the entire sweater.
(00:26:23): And so often when you (26:22):
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have a restriction in your fascia, the symptoms may not be right where that restriction is. So,
one of our sayings is honor the symptoms, but look elsewhere for the cause. So, again,
this is where I had to change my mindset of what this is where they're hurting, but that could be
(26:45):
coming from a totally different location. So, we have to think about the human as one entity,
not all these little subdivided joints or parts or systems of one entity that all works together.
>>Kevin Patton (00:27:00): I don't want to put you on the spot, (27:00):
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but can you think of an example of some symptom happening in a specific area of the body where the
cause could be pretty far away from it?>>Kate Oland Galligan (00:27:13):
Absolutely. So, I have a story about a client, and I'll share that in just a second. But then
something that's very common that tends to shock people is, one of my favorite locations of the
(27:25):
body to work on, one of my favorite areas to work on is the cranium, the head, the neck,
helping people with migraines, headaches, or TMJ. And when people call me, I usually try to have a
conversation with clients before they come in, just because fascia work is a little different
than traditional physical therapy. So, I want them to know what they're getting into. But when we're
(27:49):
talking about their TMJ symptoms, I always like to prepare them that there is a direct correlation
between TMJ dysfunction and pelvic imbalances.>>Kevin Patton (00:28:04):
Wow.>>Kate Oland Galligan (00:28:04):
Right? So->>Kevin Patton (00:28:05):
Wow. Yeah. Okay. You got to tell me how that works.
>>Kate Oland Galligan (00:28:13): Well, I'm a little biased. I believe (28:10):
undefined
that everything starts with the pelvis, and most of us don't have a completely 100% balanced equal
pelvis. But if your pelvis is off, if you have an upslip and one hip is riding higher
than the other, well that's going to just cause problems above or below that chain. Now actually,
(28:38):
and this is something I've heard, this is not something I've researched, but I've heard that if
you can watch one of those videos of embryological development where they speed it up, so you get to
see what happens over time, that if you watch the pelvis developing and the jaw developing,
it's almost as if they mirror each other. So, there's some sort of connection and whether it's
(29:05):
just if your pelvis is imbalanced and that throws everything off, and then the jaw that's kind of
got that hook mechanism. If one side isn't working as balanced to the other side, that's going to
cause strain and pain. So, I think it comes from the pelvis and what's level, what's riding high,
(29:26):
and how that affects things up chain.>>Kevin Patton (00:29:30):
Yeah. Wow.>>Kate Oland Galligan (00:29:31):
Yeah, so that's a theory. It's something that there's definitely a correlation that's been
proven and why that is I think we still need to look into that little bit.
>>Kevin Patton (00:29:42): Sure. (29:42):
undefined
>>Kate Oland Galligan (00:29:43): Yeah. (29:43):
undefined
>>Kevin Patton (00:29:43): Well, isn't that kind of the (29:43):
undefined
state of fascia in general anyway, is that we're now in a stage of learning? For me,
that's one of the more exciting aspects.>>Kate Oland Galligan (00:29:55):
I think I got->>Kevin Patton (00:29:55):
[inaudible 00:29:56] about fascia is like, wow, we didn't know that. Now we know this,
and here's three things we need to know.>>Kate Oland Galligan (00:30:03):
(30:03):
Yeah, absolutely. I am really excited to get into this work at this time. There've been teaching
classes through John Barnes school for I think 20 to 30 years now. But at first it was kind of
seen as taboo and this new way of thinking. And anytime there's a new way of thinking,
I think people are skeptical. So, it's becoming more and more accepted. I don't have to deal with
(30:27):
some of the scandals or whatever that were happening at the beginning of this practice,
but as I was reading through the articles, so many of them say, well, we need to have more research
in this area. We need to have more research in this area. As a clinician, I went to class,
I bought into it, and I started practicing right away and seeing really great improvements with my
(30:49):
clients. I believe in it. And so many of us that are doing this work are clinicians.
(00:30:56): So, trying to figure out a way to bridge (30:55):
undefined
that gap between clinicians and scientists or turning some of these clinicians into a little
bit more of the research scientists and doing more clinical trials, I think we'll learn a lot. So,
we have a lot of theories and we're getting some success with people feeling better and how that
works or we need to do more work on that. Well, so I mentioned, you asked me to talk about stories or
(31:23):
examples of where you can have a restriction in one area, but symptoms in another. And I wanted
to share a story. This is one of the classes I went to, I think it was the fascial pelvis class
I went to, and the instructor was sharing a story about one of his clients who came in, I can't
remember how many years. She'd been having pain for years, debilitating pain, couldn't work.
(00:31:44): She was having this pain, and I'm talking (31:44):
undefined
to fellow A&P professors or anatomy enthusiasts. So, I can just say her pain was in her mastoid
process, kind of an odd place to have debilitating pain, but it was just she couldn't think. When you
have pain, it makes it hard to think and function and it's exhausting. So, anyways, she shows up in
(32:08):
his office and it is skeptical. She's seen all the people to try to help her. And so he says, "Okay,
you know what? Let's try this." And he puts her on the table and he has her laying on her side. And
again, that cranium-pelvis connection, he started working on her quadratus lumborum and her pelvis,
and she immediately kind of freaked out, "Oh my gosh, what's going on?" He said. She said, "Oh,
(32:32):
I can feel that." It's hurting in her painful area, in that mastoid area.
>>Kevin Patton (00:32:37): Wow, okay. (32:37):
undefined
>>Kate Oland Galligan (00:32:38): Yeah. And he said, "Oh, should I stop?" (32:39):
undefined
She's like, "No." She said, "All the people who worked with her before, they immediately go
to that painful area and work on that area to no avail." And it didn't change her pain, didn't make
it better, didn't make it worse. So, she was okay with the fact that this work was making it worse,
because she recognized there was some sort of connection. With fascia work, sometimes you're
(33:02):
going to get a little bit increase in pain, and that's therapy, any PT. Sometimes there's a little
increase in pain before you get better. Well, so ultimately jump ahead a couple more years.
That patient in particular, she got better and she became a licensed massage therapist, and
she started attending myofascial release classes and she's now a myofascial release therapist.
>>Kevin Patton (00:33:24): Oh my gosh. Wow. (33:24):
undefined
>>Kate Oland Galligan (00:33:26): Right? (33:26):
undefined
>>Kevin Patton (00:33:26): All right. Yeah, (33:26):
undefined
I've heard of stories and I love these stories when people get some relief through some
clinical procedure or clinical approach and it intrigues them so much that becomes their
life's work. It's so heartening to see that sort of thing happen. But that is, I mean,
(33:49):
that's an amazing situation where, I mean, who would think unless you know this kind of approach,
but I mean not knowing that kind of approach, it would never occur to me to start looking elsewhere
for pain related to the mastoid process. I would think it's got to be in the head and neck area.
(00:34:10): It's got to be there and only there. (34:10):
undefined
And if it's anywhere else, it's just coincidental. It's not really related. But then we see, yeah, it
is related. And it does seem, I mean, when things like that, when there are successes like that,
it seems it's unbelievable. I mean, it's literally unbelievable. Do you run into
(34:34):
that much with patients where they're like, what in the world is going on here? Why are
you looking at some other part of my body to treat rather than where I said it hurts?
>>Kate Oland Galligan (00:34:50): It happens all the time. It happens all the time. (34:50):
undefined
So, when clients come in, I usually tell them that little fun fact. Our thought process or theory
is to honor your symptoms, but look elsewhere for the cause. So, when people come in, I usually say,
you're having pain in your neck, and that's where I'm going to start today. Because people want to
feel better where they hurt, right?>>Kevin Patton (00:35:11):
(35:10):
Sure.>>Kate Oland Galligan (00:35:11):
But also, I want to give you the heads-up, I might be looking other places and maybe next time you
come in, we're going to really work on balancing your pelvis even though it's your shoulder that's
hurting. But just, gosh, I guess I have a client I've seen, I think now three or four visits,
and she came in, her primary complaint was in her SI joint, and I think on her second visit
(35:35):
I really dug in into a scar that was in the right lower quadrant and her SIJ pain was on the right.
And I can't remember if it was a hysterectomy scar or a C-section scar. It might've been both,
but that scar tissue on that right side, when I really worked on it, she came in that very next
visit saying I cannot ... she was amazed at how much better she felt. She couldn't believe it.
(00:36:02): Her pain was on the (36:01):
undefined
posterior side. I worked on the anterior side, but she got so much relief. And those scars,
I think scar tissue for the most part is just overgrowth of fascia. Those fibers, collagen and
elastin fibers could grow together to hold us back together. And that's important. We need to heal,
(36:24):
but if we allow them to grow unchecked, they can cause a problem, especially in that pelvic region.
There's so many sensitive structures in there that can be really affected by scar tissue. And
that's an area of the body too, where I think people are amazed with how treating that area
physically can provide relief. I think anything in the pelvic region, in the abdominal region,
(36:48):
we automatically jump to medical issues. Is it my gallbladder, is it my kidney? Is it my ovary? When
it could be a dysfunction in fascia.>>Kevin Patton (00:37:03):
As always, I have some questions. Let's get to those after another quick break to reset our
(37:09):
thought processes.(00:37:14):
When the episode that you're listening to is first released I will already be working on the
next episode, and that one is, yeah, you guessed it, our annual debriefing episode where I debrief
the previous year in the podcast, we kind of look over what we did, what worked, what didn't work so
(37:35):
great, what we might be thinking of doing for the coming year. And then remember last year and the
year before that and the year before that, I gave some predictions what I think is going to happen
in the world of A&P teaching. So, we're going to revisit those predictions and see how well I did
with those predictions. And not only that, we're going to make predictions for next year, for the
(37:58):
coming year. And I bet you have some thoughts about what things are going to be like over
the coming year or maybe some questions or some anxieties or maybe some excitement about what's
going to be happening over the next year.(00:38:13):
And I'd love for you to share them not only with me, but with everybody who listens to this
podcast. So, why don't you go ahead and send me a brief audio file that just says, "Hey, this is me
(38:27):
and I think here's something that might be happening, or here's this other thing that I might
be happening." Maybe have one thing, maybe have two or three things that you want to share with
us. So, please do that so that we can hear your voice along with mine and along with some others.
Hopefully we'll have several people. Last year I think we had two or three people that shared
(38:49):
their thoughts. So, go ahead and send that in or call the podcast hotline, and you'll get that at
the end of the episode.(00:38:57):
I am back with Dr. Kate Oland Galligan, and we're talking about the human fascial system. So,
a couple questions occur to me as outline what's going on there with that patient you
(39:13):
just mentioned. You tell me if I'm thinking along the right lines, or maybe this is one
of those areas where we still don't know what's happening, at least in detail, but
it seems to me like if you have a scar and like you say, they can overgrow, so when you're doing
your therapy with that scar, I'm in my mind's eye, I'm imagining the fascia loosening up.
(00:39:40): And we know that fascia can change and actually (39:40):
undefined
change pretty rapidly, change its nature like you were saying before, connect and reconnect,
disconnect and so on. But also it can become more fluid, less fluid, more stiff, less stiff.
Would I be at least thinking along the right lines to think that if you have that scar,
(40:04):
it could be that something either in that scar or connected to that scar is kind of
stuck and it's too stiff and it needs to be loosened up? Or am I just making that up?
>>Kate Oland Galligan (00:40:16): No, you're spot on. So, let's talk (40:16):
undefined
about that. Let's talk about what happens when your fascia becomes restricted. So,
I might have a long-winded answer to your question. I hope you don't mind.
>>Kevin Patton (00:40:28): Oh, that's okay. (40:28):
undefined
>>Kate Oland Galligan (00:40:30): That's what you're going through, right? (40:30):
undefined
>>Kevin Patton (00:40:31): We love long-winded answers (40:31):
undefined
to questions, so go ahead.
undefined
(00:03):
Fascia, the surgeon and researcher Jean-Claude Guimberteau states, "Understanding fascia requires
abandoning the traditional anatomical view of separate structures and embracing a model of
interconnected living tissues.">>Aileen Park (00:00:25):
(00:25):
Welcome to The A&P Professor. A few minutes to focus on teaching human anatomy and physiology
with a veteran educator and teaching mentor, your host, Kevin Patton.
>>Kevin Patton (00:00:34): In episode 152, Dr. Kate Oland Galligan joins me (00:39):
undefined
for a discussion of the human fascial system.(00:00:56):
Well, in this episode, I am so excited to be here with Dr. Kate Oland Galligan,
(01:02):
who it turns out is a former undergraduate student of mine who in physiology at St. Louis University,
back when I directed that course and taught that course. And at the recent HAPS conference,
we sort of accidentally ran into one another and reconnected and have had some conversations. And
(01:27):
one of those conversations was about fascia because as we'll talk about in a moment,
she's really into fascia in her clinical life as well as her teaching life because guess what?
She's now teaching anatomy and physiology to the undergraduates at St. Louis University. Oh man,
(01:47):
what goes around comes around, right? I did confirm that one of the things that she remembers
that from my course was the Krebs cycle.>>Kate Oland Galligan (00:01:59):
Oh.>>Kevin Patton (00:01:59):
Yeah. See. For those of you that have been with us for a long time in this podcast,
way back in episode 79, I talked about the story that I tell in my class just to kind
(02:11):
of break things up and make a little bit more fun. And now I have a witness to confirm. So,
what were your thoughts when we were doing that silly Krebs cycle thing in class, Kate?
>>Kate Oland Galligan (00:02:24): Oh, it was just so silly, but I remember (02:24):
undefined
taking things so seriously in undergrad and this was a serious class, but here is this guy having
fun with physiology, so it made you more human and I think that made it easier for us to receive
information from you. And clearly that's how I remembered that you taught me 24 years ago.
>>Kevin Patton (00:02:51): Kate, what have you been (02:51):
undefined
doing in those 24 years?>>Kate Oland Galligan (00:02:56):
I've been a little busy. I've done some things. So, I was in your physiology class in undergrad
at the time I was working on my bachelor's in exercise science, and then soon after
that I finished my master's in physical therapy. I started working as a physical therapist and it was
(03:15):
a pretty cool time to be a physical therapist. So, at that time I could start working with my
master's, but then I continued to work on my doctorate and I finished that a couple years
later. So, I worked as a physical therapist since I guess January of 2005 and did a little more
(03:36):
schooling those first couple years. But then life gets busy. I worked, I got married, I had kids,
I got divorced. And then a couple years after that I took a deep dive into the fascia world. I went
to my first myofascial release course in 2020 and found a new passion. And so that's, I guess kind
(04:01):
of catches us up to where we are today.>>Kevin Patton (00:04:04):
I had been thinking about how we teach fascia and the fascial system in the typical undergraduate
A&P course for a while now. And I mentioned this to you, I had been collecting a couple
papers and jotting down some notes. Because I wanted to do an episode about fascia that is
(04:27):
what we're thinking about fascia these days. And that is rapidly evolving as we'll find out during
this conversation and what does that mean for the typical undergraduate A&P course? What is it we
can do with that to help students understand the human body better? And not only that,
I mean this is a foundation preparing for many of the students are going to be going
(04:53):
into clinical applications as you did, Kate. So, what kind of preparation can we give them? What
initial thoughts about fascia can we give them? So, I had been thinking about that,
and as you and I were reconnecting, you brought up the idea of like, "Hey, did you ever think about
doing an episode on fascia?" And I'm like, "Funny, you should mention it. Yeah." And so let's do it.
(05:14):
Let's do it together. And here we are.>>Kate Oland Galligan (00:05:17):
Well, I think my conversation with you started with, "Hey, can we get a chapter
in your anatomy book about fascia?" So, I think I got a little ahead of myself, but yeah.
>>Kevin Patton (00:05:28): Well, yeah, I mean I remember that (05:28):
undefined
that's how that conversation started off. And that's a good question. On the practical side,
our editors are pushing us, and this is true of all textbooks, not just A&P textbooks and
across different publishers and so on. They want us to make our books no bigger than they
(05:51):
are now. And if possible, make them a little bit smaller. Because those A&P books now,
they're I think they cause problems with fascia by having to carry them around and stuff.
>>Kate Oland Galligan (00:06:03): Those printed textbooks get heavy. Yes, (06:03):
undefined
they can contribute to lots of low back pain.>>Kevin Patton (00:06:08):
See, there you go. I literally, well, I think people who know
that I do the Krebs cycle thing.>>Kate Oland Galligan (00:06:16):
Oh.>>Kevin Patton (00:06:16):
Krebs cycle thing, yeah, thank you. They will believe me that every time we start
(06:25):
a new revision on a new edition of our textbooks, I always ask, can we put wheels on them like they
do with luggage? The students won't have to carry them around and they laugh, but I'm being serious.
We need to do something. But I think it's already happening. The solution is digital textbooks.
>>Kate Oland Galligan (00:06:47): Yes. I'm so jealous of my students (06:46):
undefined
that get to carry their textbooks around in their devices. It's so much better ergonomically.
>>Kevin Patton (00:06:56): Right. And they can have it (06:56):
undefined
with them anytime. So, if they find some time to review some stuff that they didn't
anticipate and they're somewhere way far away from their study materials, then well, no,
they aren't way far away. They're just a couple of clicks on their device. And there you go.
>>Kate Oland Galligan (00:07:16): Exactly. I still love a good old-fashioned (07:15):
undefined
book though. I like to flip through the pages. And actually a couple years ago I started teaching A&P
at SLU and it was not even two to three weeks into the semester. And even as a teacher,
my textbook looked the same as back when I was a student. I dripped coffee all over the top of
it at some point in time.>>Kevin Patton (00:07:36):
(07:36):
All right, well, but that shows that you're using it.
>>Kate Oland Galligan (00:07:38): That's right. (07:38):
undefined
>>Kevin Patton (00:07:38): So, we all like to see that, right? (07:39):
undefined
>>Kate Oland Galligan (00:07:42): Yes, yes. (07:41):
undefined
>>Kevin Patton (00:07:43): So, anyway, here we are in our (07:43):
undefined
episode about the fascial system about fascia. And I guess the best place to start is because
this is kind of, well, as we'll see, it's kind of a little bit muddy, is what is fascia? And I've
been using the term fascial system. So, what's fascia and fascial system? I don't know, Kate,
(08:05):
you want to start us off on that?>>Kate Oland Galligan (00:08:07):
Yeah. I love that you refer to it as the fascial system. That's something that took me a while to
wrap my head around it. I've been enthusiastic about fascia for a couple of years now,
and the fact that there could be this whole other system that ... the body,
it just was hard to wrap my head around. But I do believe it's way more complex than we've
(08:30):
given it credit for in the past. I think in the textbook that I use with my students,
I think there's two lines describing fascia. They say something like it's a dense irregular
connective tissue. We describe it, we define it in the chapter on tissues, but actually the past
(08:51):
couple of years we fit my lecture about fascia. We slid that in during the muscle structure lecture
is where we have been presenting this information. And that might be a good place for it too.
(00:09:04): Because the muscles are (09:04):
undefined
heavily influenced by fascia, and the fascia is heavily influenced by the muscles and the motion
and the trauma that it can occur to our muscles over the years. But I think I'm getting ahead of
myself. Physiologically that fascia is comprised of collagen, which will give it its support,
(09:27):
give the body support, give the body shape and stability. It's comprised of elastin, which can
give it that dynamic flexibility. And then we have the ground substance. And the ground substance
will provide the cushion and that surrounds each cell in the body, which can help determine its
(09:47):
physiological functional capacity. So, that ground substance, that's important that surrounds every
cell and it's in each of our cells. And I've read some literature that talks about how there's even
fascia going down into the cell as a part of the cytoskeleton, not just giving our full body some
(10:10):
structure, but also helping to provide some structure at the cellular level as well. It's
pretty interesting stuff.>>Kevin Patton (00:10:18):
Yeah, that's one of the things that really intrigues me is that connection. And I think
that's where, I mean it seems to me being sort of an outsider looking into the world of fascia,
(10:32):
that seems to be like an area where we're really expanding our understanding and that is all that
connection. As a matter of fact, in my textbook, I use a similar definition that you just recalled
from the textbook you're using. But I want to read it because a couple of things in there. There's
a few sentences long, but maybe three or four sentences long. But I want to read it because a
(10:56):
couple of different things in there that I think I want to at some point in this episode bring up
and discuss.(00:11:05):
And that's one of them, that connection. So, what my book states right now in the 11th edition of
A&P, "Fascia is always some sort of fibrous connective tissue and almost always features
(11:20):
many collagenous fibers that are interwoven in an irregular arrangement. In some areas of the body,
for example, under the skin fascia is mostly adipose tissue. In other areas, such as around
some of the muscles, it is dense, irregular, fibrous tissue. Often some of the fibers of
fascia extend into the tissue of nearby organs, thus strongly binding to them. For convenience,
(11:47):
anatomists often distinguish between superficial fascia, which is just under the skin and deep
fascia, which extends well into the body and surrounds muscles, blood vessels and
other organs."(00:12:01):
And of course, fascia comes up in many other areas. And circling back to that mention you
made of, we need a chapter, a textbook chapter on fascia. What I've been doing in our book,
(12:12):
and maybe a chapter is a good solution and maybe we can get to that point. We have
to figure out what other stuff to take out to make that fit. But something we've been doing,
we're working on actually the 12th Edition, the 11th edition is out there now, but we've
been trying to integrate it and that is working pretty well because fascia really does come up in
(12:37):
a million different places.(00:12:38):
As a matter of fact, I ran one of those articles I saved, it was from a clinical anatomy journal,
and they had a special issue on fascia, and I'll have a link to that in the show notes. But one of
the papers in that special issue was about, it was by Rebecca Pratt. I wrote down her name, so I'd
(12:57):
remember that to give her credit for this idea, she wrote an article called Educational Avenues
for Promoting Dialogue on Fascia and a lot of what she was doing in that article ... And I highly
recommend it'll give us a lot of good ideas. She even had some demos that you can do in a class
to really give students a good understanding of fascia. And I'll mention those in a second. But
(13:21):
she goes through the different areas, say this can come up in many different areas of the course.
(00:13:26): So, Kate, you were talking about, well, (13:26):
undefined
in the textbook it comes up in the discussion of tissues. But the way you folks tell your story at
St. Louis U, it works better for the students and their understanding when you talk about it in the
discussion of muscles. And so she goes through all those different ways that can come up. And so what
(13:48):
we're trying to do in our book is find some of those places where it's appropriate to mention
fascia again and say, remember fascia and how it connects. Well, here it is, connecting again.
(00:14:02): And I just want to mention too, that a previous (14:01):
undefined
episode I mentioned, I think it was called, and I should have this written down somewhere,
but I'll have a link to it in the show notes, but it was something like 10 things we often forget to
tell students about cells. And that was one of the things I mentioned is that cytoskeleton connects
to the extracellular matrix and that extracellular matrix is part of the fascia and connects to all
(14:27):
those other things that we consider to be fascia and part of the fascial system. So,
I tell my students that I'm overstepping a little bit, I'm exaggerating a little bit, but one way to
think of the body as not as separate parts that are all stuck together, let's think of it as one
giant part and it just has different regions.>>Kate Oland Galligan (00:14:48):
(14:48):
I love that you bring that up. Because that was something when I went to fascia class the first
time to just stop dividing the body into these micro-diagnostic little pieces. But to look at
it as one fluid organism and that fascia is what connects it all. Now you talk about where can
(15:10):
we mention this in class? Well, my students are probably sick to death of hearing about fascia.
Because I bring it up all the time and I am always making that clinical connection to them.
(00:15:23): So, I'm a fascia enthusiast and they hear a (15:23):
undefined
lot about fascia and I'm hopeful that I teach for the Department of Clinical Health Sciences. So,
my goal in this is to give them more perspective about not just fascia, but how it relates to every
system and then what a fascia therapist could do for either their future patients or for
(15:48):
themselves. Because I do believe that every person could benefit from some fascia work, but we can
get into that a little bit more when we talk more about the clinical aspect of fascia treatment. But
I talk about fascia almost every week, because it relates to every system in our body.
>>Kevin Patton (00:16:03): I'm thinking. And now that you can take (16:03):
undefined
or leave this bit of unasked for advice, but if I were you, I would consider having your students,
whenever you mentioned the term fascia, to yell out, "Yes, fascia, we love it." And then-
>>Kate Oland Galligan (00:16:22): A little whoop, a little cheer or something. (16:22):
undefined
>>Kevin Patton (00:16:24): Yeah. And then that'll keep (16:24):
undefined
them listening for the word.>>Kate Oland Galligan (00:16:30):
That'll carry on your tradition. You know what, I think I'm going to have to do that.
>>Kevin Patton (00:16:35): All right, well if you do let (16:34):
undefined
me know. I want to hear that that goofiness is living on beyond my teaching career.
>>Kate Oland Galligan (00:16:48): Oh, the goofiness resides in my classroom (16:46):
undefined
whether I like it or not.>>Kevin Patton (00:16:52):
Well, that's good. That means a lot of learning is going on. These students are engaged. So, cool.
>>Kate Oland Galligan (00:16:59): I hope so. That's the goal. (16:58):
undefined
>>Kevin Patton (00:17:00): Let's take our first brain break. (17:00):
undefined
(00:17:07): Hey, you may already know this, (17:05):
undefined
but I have another website called lionden.com, and that's a website I built in the way olden
days before our college had its own website or were even thinking about having a website. But I
knew that I wanted to jump into it and have some resources available for my students to help them
(17:29):
learn A&P, not only resources that I put together for them, but links to other resources. And it
could be edited on the fly in real time so that they could have the latest information that helped
them with my course as it existed at that very moment. And that website's still around. I still
(17:51):
have outlines that my students used to help guide their learning. These are, oh, excuse the phrase,
skeleton outlines. They're very sketchy and they don't include the things we were doing
in the lab course, only the things we were doing in the so-called lecture part of the course.
(00:18:10): And so there are big (18:10):
undefined
chunks of things missing, obviously because we were focusing on them in the lab. But you
might find them helpful. You might want to point your students to one or more of them,
or you may want to adapt them to make some skeleton outlines that the students can
use to kind of act as a framework for what they need to be learning in your course. So, they're
(18:32):
there if you want them. And there's lots of other resources at lionden.com too, such as some of my
old slides. Many of them are animated. Word lists and lab lists and just all kinds of stuff. So,
you can go exploring around there. But the reason I'm bringing it up now is that there is something
there called a mini-lesson. These were sort of adjunct outlines where they outline things
(18:58):
that weren't in the textbook, and so therefore they're just slightly more detailed than they
would be for the material that covers stuff that they could also read about in their textbook.
(00:19:09): So, one of the mini-lessons that I have (19:08):
undefined
there is on the fascial system, so you may want to take a look at it. Now, what you would do is just
go to lionden.com and I think it's fairly easy to navigate, but then again, I built it so it would
be easy, right? In my mind. But you may not find it so. And if you run into problems with that,
(19:31):
let me know so I can make them a little bit smoother for your average user. But anyway,
at the very top of every page there's a navigation ribbon. And so you just select learning A&P and go
down to the choice that says learning outlines. And then in that sub-menu right at the very top
is something called list of outlines. So, click on the list of outlines and you'll easily be able to
(19:55):
find the one on the fascial system.(00:20:01):
Fascia, oh my gosh. Yay, fascia. Let's not do that during this episode. That'll get-
>>Kate Oland Galligan (00:20:08): It will get real [inaudible 00:20:08]- (20:07):
undefined
>>Kevin Patton (00:20:08): Yeah, that'll get annoying. (20:09):
undefined
>>Kate Oland Galligan (00:20:10): Like a drinking game, take a shot every time we (20:10):
undefined
say fascia. We won't get through the episode.>>Kevin Patton (00:20:14):
Those of you that are listening, keep that in mind as an option. You can do the drinking game part.
Wow. Now you might not remember anything we talked about, so I don't know if that's such a good idea,
but it's an option. All right, so oh my gosh, there's so many things to talk about fascia.
>>Kate Oland Galligan (00:20:35): I had a little bit of an idea, because (20:34):
undefined
you mentioned a minute ago that we're getting all this new clinical application about fascia,
and I have my little spiel that I give clients because I educate my students and then I have
my own fascia private practice too. So, I have a little spiel. Are you ready for it?
(20:55):
Do you want me to give you my->>Kevin Patton (00:20:56):
Sure.>>Kate Oland Galligan (00:20:58):
... little fascia spiel? Okay. So, I do feel very passionate about trying to educate so many
people about clinical aspect of fascia. And I think people initially are a little hesitant.
Why is this girl so excited about something I've never heard of? And she's telling me it's one of
the most abundant tissues in my body. Why haven't I heard about this? Well, when I first attended
(21:20):
classes, which I just want to real quick give a nod to John Barnes, I go to the John Barnes School
of Myofascial Release.(00:21:28):
So, a lot of the ideas and concepts that I bring up, this is all information I've learned from him
and his instructors. So, I just want to make sure to give a nod to the people who educated
(21:41):
me because I know that they're the ones who planted this seed of enthusiasm for me. But
what John talks about and what I identified with in that very first class is a cadaver with fascia.
We learned about the body initially for hundreds of years through dissection of cadavers. And in a
(22:03):
cadaver that fascia, you don't see its function at all. It's dehydrated tissue. And I have a
clear memory of being in gross anatomy and Jeff Watson coming in, he taught gross anatomy to me
and my classmates just, oh, we got to get that fascia out of the way and just kind of grabbing
(22:23):
it and just pulling.(00:22:24):
He had to use a lot of force to try to rip that fascia out. And there were times when trying to
get the fascia out of the way, trying to use the scalpel was just not cutting it. It's very thick,
very fibrous, strong tissue. But again, I think from that perspective,
(22:44):
we saw how it holds everything together, holds it in place, and how that might allow things to slide
and glide a little bit better. And that was the basic understanding I had until recently. And I
guess it's been maybe I'm guessing 30 to 40 years ago when in the medical world and the scientific
(23:04):
world, we started to be able to study living tissue with in vivo technology, in vivo cameras.
This isn't horribly new information. As I was glancing through the papers prepping for today,
making sure I had information straight in my head, I was kind of taken aback by the fact that some of
(23:26):
this information that I am using in my clinical practice comes from studies that were done in the
sixties and the seventies.(00:23:34):
So, this is some information we've had for a while and we're just now really able to
take that information and apply it in a way that pertains to clients. And again,
I'll get to the clinical aspect again in a second. I'm sorry. I went off on a tangent
(23:49):
about fascia and how we learned about it. In one of my classes, we saw this pretty awesome video,
and I think you can find it on YouTube. It's called Strolling Under the Skin. Strolling
like you're going to take a stroll or a walk. Strolling Under the Skin. It's about a 25-minute
video that really you get to see a lot of living fascia and how it moves in the body. They talk
(24:15):
about how they were discovering how fascia worked and the fractals and it's really fascinating.
(00:24:21): So, if it calls to you to take a peek, I don't (24:20):
undefined
know that you have to watch the entire thing, but just I think getting a glimpse of, I think I share
a two-minute clip of the video with my students in my lecture just to see how the fascia works in the
human body, I think is fascinating. You can see how it breaks apart and comes back together again.
(24:41):
Which I don't know, Kevin, I don't know of any other tissue in the human body that does that.
>>Kevin Patton (00:24:47): Only in science fiction. (24:47):
undefined
>>Kate Oland Galligan (00:24:49): Right? Yeah. It's kind of like watching (24:49):
undefined
science fiction for the nerdy type, I guess. So, this is information we've had for about,
I don't know, 40, 50 years. And now that we get to understand it and know that it doesn't just
hold things in place, but it helps communicate between the different systems of the body as
(25:13):
well. I tell my clients it's a head to toe 3D web of connective tissue and literally it's a
3D web. And when you get a restriction in your fascia, a one-inch restriction can put up to
2,000 pounds of pressure on the surrounding tissues. So, that can cause problems.
>>Kevin Patton (00:25:35): Wow. (25:35):
undefined
>>Kate Oland Galligan (00:25:35): Right? (25:35):
undefined
>>Kevin Patton (00:25:35): That is crazy. That is something, yeah. (25:35):
undefined
>>Kate Oland Galligan (00:25:39): Ouch, right? And that's actually, (25:39):
undefined
that's information out of a paper that was published in 1961 in Kyoto. So, we've known
that for a while that fascia can wreak havoc. And sometimes where that restriction is that's going
to be where you get your symptoms. But if you recall, I mentioned it's a 3D web now when you're
trying to picture that, one of the analogies I use with my clients is think about a hand knit sweater
(26:07):
of each stitch in its place. And when that gets snagged, the snag is of course where you notice
the changes in the stitching, but it changes the tensile property of the entire sweater.
(00:26:23): And so often when you (26:22):
undefined
have a restriction in your fascia, the symptoms may not be right where that restriction is. So,
one of our sayings is honor the symptoms, but look elsewhere for the cause. So, again,
this is where I had to change my mindset of what this is where they're hurting, but that could be
(26:45):
coming from a totally different location. So, we have to think about the human as one entity,
not all these little subdivided joints or parts or systems of one entity that all works together.
>>Kevin Patton (00:27:00): I don't want to put you on the spot, (27:00):
undefined
but can you think of an example of some symptom happening in a specific area of the body where the
cause could be pretty far away from it?>>Kate Oland Galligan (00:27:13):
Absolutely. So, I have a story about a client, and I'll share that in just a second. But then
something that's very common that tends to shock people is, one of my favorite locations of the
(27:25):
body to work on, one of my favorite areas to work on is the cranium, the head, the neck,
helping people with migraines, headaches, or TMJ. And when people call me, I usually try to have a
conversation with clients before they come in, just because fascia work is a little different
than traditional physical therapy. So, I want them to know what they're getting into. But when we're
(27:49):
talking about their TMJ symptoms, I always like to prepare them that there is a direct correlation
between TMJ dysfunction and pelvic imbalances.>>Kevin Patton (00:28:04):
Wow.>>Kate Oland Galligan (00:28:04):
Right? So->>Kevin Patton (00:28:05):
Wow. Yeah. Okay. You got to tell me how that works.
>>Kate Oland Galligan (00:28:13): Well, I'm a little biased. I believe (28:10):
undefined
that everything starts with the pelvis, and most of us don't have a completely 100% balanced equal
pelvis. But if your pelvis is off, if you have an upslip and one hip is riding higher
than the other, well that's going to just cause problems above or below that chain. Now actually,
(28:38):
and this is something I've heard, this is not something I've researched, but I've heard that if
you can watch one of those videos of embryological development where they speed it up, so you get to
see what happens over time, that if you watch the pelvis developing and the jaw developing,
it's almost as if they mirror each other. So, there's some sort of connection and whether it's
(29:05):
just if your pelvis is imbalanced and that throws everything off, and then the jaw that's kind of
got that hook mechanism. If one side isn't working as balanced to the other side, that's going to
cause strain and pain. So, I think it comes from the pelvis and what's level, what's riding high,
(29:26):
and how that affects things up chain.>>Kevin Patton (00:29:30):
Yeah. Wow.>>Kate Oland Galligan (00:29:31):
Yeah, so that's a theory. It's something that there's definitely a correlation that's been
proven and why that is I think we still need to look into that little bit.
>>Kevin Patton (00:29:42): Sure. (29:42):
undefined
>>Kate Oland Galligan (00:29:43): Yeah. (29:43):
undefined
>>Kevin Patton (00:29:43): Well, isn't that kind of the (29:43):
undefined
state of fascia in general anyway, is that we're now in a stage of learning? For me,
that's one of the more exciting aspects.>>Kate Oland Galligan (00:29:55):
I think I got->>Kevin Patton (00:29:55):
[inaudible 00:29:56] about fascia is like, wow, we didn't know that. Now we know this,
and here's three things we need to know.>>Kate Oland Galligan (00:30:03):
(30:03):
Yeah, absolutely. I am really excited to get into this work at this time. There've been teaching
classes through John Barnes school for I think 20 to 30 years now. But at first it was kind of
seen as taboo and this new way of thinking. And anytime there's a new way of thinking,
I think people are skeptical. So, it's becoming more and more accepted. I don't have to deal with
(30:27):
some of the scandals or whatever that were happening at the beginning of this practice,
but as I was reading through the articles, so many of them say, well, we need to have more research
in this area. We need to have more research in this area. As a clinician, I went to class,
I bought into it, and I started practicing right away and seeing really great improvements with my
(30:49):
clients. I believe in it. And so many of us that are doing this work are clinicians.
(00:30:56): So, trying to figure out a way to bridge (30:55):
undefined
that gap between clinicians and scientists or turning some of these clinicians into a little
bit more of the research scientists and doing more clinical trials, I think we'll learn a lot. So,
we have a lot of theories and we're getting some success with people feeling better and how that
works or we need to do more work on that. Well, so I mentioned, you asked me to talk about stories or
(31:23):
examples of where you can have a restriction in one area, but symptoms in another. And I wanted
to share a story. This is one of the classes I went to, I think it was the fascial pelvis class
I went to, and the instructor was sharing a story about one of his clients who came in, I can't
remember how many years. She'd been having pain for years, debilitating pain, couldn't work.
(00:31:44): She was having this pain, and I'm talking (31:44):
undefined
to fellow A&P professors or anatomy enthusiasts. So, I can just say her pain was in her mastoid
process, kind of an odd place to have debilitating pain, but it was just she couldn't think. When you
have pain, it makes it hard to think and function and it's exhausting. So, anyways, she shows up in
(32:08):
his office and it is skeptical. She's seen all the people to try to help her. And so he says, "Okay,
you know what? Let's try this." And he puts her on the table and he has her laying on her side. And
again, that cranium-pelvis connection, he started working on her quadratus lumborum and her pelvis,
and she immediately kind of freaked out, "Oh my gosh, what's going on?" He said. She said, "Oh,
(32:32):
I can feel that." It's hurting in her painful area, in that mastoid area.
>>Kevin Patton (00:32:37): Wow, okay. (32:37):
undefined
>>Kate Oland Galligan (00:32:38): Yeah. And he said, "Oh, should I stop?" (32:39):
undefined
She's like, "No." She said, "All the people who worked with her before, they immediately go
to that painful area and work on that area to no avail." And it didn't change her pain, didn't make
it better, didn't make it worse. So, she was okay with the fact that this work was making it worse,
because she recognized there was some sort of connection. With fascia work, sometimes you're
(33:02):
going to get a little bit increase in pain, and that's therapy, any PT. Sometimes there's a little
increase in pain before you get better. Well, so ultimately jump ahead a couple more years.
That patient in particular, she got better and she became a licensed massage therapist, and
she started attending myofascial release classes and she's now a myofascial release therapist.
>>Kevin Patton (00:33:24): Oh my gosh. Wow. (33:24):
undefined
>>Kate Oland Galligan (00:33:26): Right? (33:26):
undefined
>>Kevin Patton (00:33:26): All right. Yeah, (33:26):
undefined
I've heard of stories and I love these stories when people get some relief through some
clinical procedure or clinical approach and it intrigues them so much that becomes their
life's work. It's so heartening to see that sort of thing happen. But that is, I mean,
(33:49):
that's an amazing situation where, I mean, who would think unless you know this kind of approach,
but I mean not knowing that kind of approach, it would never occur to me to start looking elsewhere
for pain related to the mastoid process. I would think it's got to be in the head and neck area.
(00:34:10): It's got to be there and only there. (34:10):
undefined
And if it's anywhere else, it's just coincidental. It's not really related. But then we see, yeah, it
is related. And it does seem, I mean, when things like that, when there are successes like that,
it seems it's unbelievable. I mean, it's literally unbelievable. Do you run into
(34:34):
that much with patients where they're like, what in the world is going on here? Why are
you looking at some other part of my body to treat rather than where I said it hurts?
>>Kate Oland Galligan (00:34:50): It happens all the time. It happens all the time. (34:50):
undefined
So, when clients come in, I usually tell them that little fun fact. Our thought process or theory
is to honor your symptoms, but look elsewhere for the cause. So, when people come in, I usually say,
you're having pain in your neck, and that's where I'm going to start today. Because people want to
feel better where they hurt, right?>>Kevin Patton (00:35:11):
(35:10):
Sure.>>Kate Oland Galligan (00:35:11):
But also, I want to give you the heads-up, I might be looking other places and maybe next time you
come in, we're going to really work on balancing your pelvis even though it's your shoulder that's
hurting. But just, gosh, I guess I have a client I've seen, I think now three or four visits,
and she came in, her primary complaint was in her SI joint, and I think on her second visit
(35:35):
I really dug in into a scar that was in the right lower quadrant and her SIJ pain was on the right.
And I can't remember if it was a hysterectomy scar or a C-section scar. It might've been both,
but that scar tissue on that right side, when I really worked on it, she came in that very next
visit saying I cannot ... she was amazed at how much better she felt. She couldn't believe it.
(00:36:02): Her pain was on the (36:01):
undefined
posterior side. I worked on the anterior side, but she got so much relief. And those scars,
I think scar tissue for the most part is just overgrowth of fascia. Those fibers, collagen and
elastin fibers could grow together to hold us back together. And that's important. We need to heal,
(36:24):
but if we allow them to grow unchecked, they can cause a problem, especially in that pelvic region.
There's so many sensitive structures in there that can be really affected by scar tissue. And
that's an area of the body too, where I think people are amazed with how treating that area
physically can provide relief. I think anything in the pelvic region, in the abdominal region,
(36:48):
we automatically jump to medical issues. Is it my gallbladder, is it my kidney? Is it my ovary? When
it could be a dysfunction in fascia.>>Kevin Patton (00:37:03):
As always, I have some questions. Let's get to those after another quick break to reset our
(37:09):
thought processes.(00:37:14):
When the episode that you're listening to is first released I will already be working on the
next episode, and that one is, yeah, you guessed it, our annual debriefing episode where I debrief
the previous year in the podcast, we kind of look over what we did, what worked, what didn't work so
(37:35):
great, what we might be thinking of doing for the coming year. And then remember last year and the
year before that and the year before that, I gave some predictions what I think is going to happen
in the world of A&P teaching. So, we're going to revisit those predictions and see how well I did
with those predictions. And not only that, we're going to make predictions for next year, for the
(37:58):
coming year. And I bet you have some thoughts about what things are going to be like over
the coming year or maybe some questions or some anxieties or maybe some excitement about what's
going to be happening over the next year.(00:38:13):
And I'd love for you to share them not only with me, but with everybody who listens to this
podcast. So, why don't you go ahead and send me a brief audio file that just says, "Hey, this is me
(38:27):
and I think here's something that might be happening, or here's this other thing that I might
be happening." Maybe have one thing, maybe have two or three things that you want to share with
us. So, please do that so that we can hear your voice along with mine and along with some others.
Hopefully we'll have several people. Last year I think we had two or three people that shared
(38:49):
their thoughts. So, go ahead and send that in or call the podcast hotline, and you'll get that at
the end of the episode.(00:38:57):
I am back with Dr. Kate Oland Galligan, and we're talking about the human fascial system. So,
a couple questions occur to me as outline what's going on there with that patient you
(39:13):
just mentioned. You tell me if I'm thinking along the right lines, or maybe this is one
of those areas where we still don't know what's happening, at least in detail, but
it seems to me like if you have a scar and like you say, they can overgrow, so when you're doing
your therapy with that scar, I'm in my mind's eye, I'm imagining the fascia loosening up.
(00:39:40): And we know that fascia can change and actually (39:40):
undefined
change pretty rapidly, change its nature like you were saying before, connect and reconnect,
disconnect and so on. But also it can become more fluid, less fluid, more stiff, less stiff.
Would I be at least thinking along the right lines to think that if you have that scar,
(40:04):
it could be that something either in that scar or connected to that scar is kind of
stuck and it's too stiff and it needs to be loosened up? Or am I just making that up?
>>Kate Oland Galligan (00:40:16): No, you're spot on. So, let's talk (40:16):
undefined
about that. Let's talk about what happens when your fascia becomes restricted. So,
I might have a long-winded answer to your question. I hope you don't mind.
>>Kevin Patton (00:40:28): Oh, that's okay. (40:28):
undefined
>>Kate Oland Galligan (00:40:30): That's what you're going through, right? (40:30):
undefined
>>Kevin Patton (00:40:31): We love long-winded answers (40:31):
undefined
to questions, so go ahead.
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