Ep 249 – Fascia: Use It or Lose It with David Lesondak

A bundle of white wires shaped into a human form.

David Lesondak’s personal need to understand why things work, and why sometimes they don’t, drives his continuing search for the latest scientific knowledge and innovative approaches. In this episode of The ABMP Podcast, Kristin and Darren speak with David about being a fascial fitness trainer, how to bring a fascial awareness to our movement, and how presenting his new book, Fascia, Function, and Medical Applications, to a medical audience was so important.

Author Images: 
David Lesondak, author of Fascia, Function, and Medical Applications.
Darren Buford, editor-in-chief of Massage & Bodywork magazine.
Kristin Coverly, director of professional education at ABMP.
Author Bio: 

David Lesondak, BCSI, ATSI, FST, VMT, FFT, IAHE, is a member of the Allied Health Professional Staff in the Department of Family and Community Medicine at the University of Pittsburgh Medical Center (UPMC). He is a board-certified Structural Integrator, visceral manipulator, fascial fitness trainer, and more.

The success of his first book, Fascia: What it is and Why it Matters, now available in 9 languages, led to contributing a chapter to an orthopedic textbook, which resulted in his being asked to architect and edit the first-ever fascia textbook designed for the medical and health-care field: Fascia, Function, and Medical Applications.

He is host of the podcast BodyTalk with David Lesondak, which has listeners in 36 countries.

Darren Buford is senior director of communications and editor-in-chief for ABMP. He is editor of Massage & Bodywork magazine and has worked for ABMP for 22 years, and been involved in journalism at the association, trade, and consumer levels for 24 years. He has served as board member and president of the Western Publishing Association, as well as board member for Association Media & Publishing. Contact him at editor@abmp.com.

Kristin Coverly, LMT, is a massage therapist, educator, and the director of professional education at ABMP. She loves creating continuing education courses, events, and resources to support massage therapists and bodyworkers as they enhance their lives and practices. Contact her at ce@abmp.com.

Sponsors: 

Anatomy Trains is a global leader in online anatomy education and also provides in-classroom certification programs for structural integration in the US, Canada, Australia, Europe, Japan, and China, as well as fresh-tissue cadaver dissection labs and weekend courses. The work of Anatomy Trains originated with founder Tom Myers, who mapped the human body into 13 myofascial meridians in his original book, currently in its fourth edition and translated into 12 languages. The principles of Anatomy Trains are used by osteopaths, physical therapists, bodyworkers, massage therapists, personal trainers, yoga, Pilates, Gyrotonics, and other body-minded manual therapists and movement professionals. Anatomy Trains inspires these practitioners to work with holistic anatomy in treating system-wide patterns to provide improved client outcomes in terms of structure and function.    

Website: anatomytrains.com    

Email: info@anatomytrains.com          

Facebook: facebook.com/AnatomyTrains                     

Instagram: www.instagram.com/anatomytrainsofficial

YouTube: https://www.youtube.com/channel/UC2g6TOEFrX4b-CigknssKHA  

     

Fascia Research Society (FRS) was established as a membership organization to facilitate, encourage, and support the dialogue and collaboration between clinicians, researchers, and academicians, in order to further our understanding of the properties and functions of fascia.

Every three years, FRS hosts the International Fascia Research Congress (IFRC). 

Beginning in 2007 with the first IFRC, and triennially since, the IFRC has been the premier fascia congress in the world. No other fascia congress brings together the very latest in fascial discovery and the diversity of the leaders in fascia. Registration closes August 31, 2022—don’t miss out!

For more information on FRS, or to register for the 2022 IFRC, please visit us at www.fasciaresearchsociety.org.

Questions about either FRS or IFRC? Email us at info@fasciaresearchsociety.org.

Full Transcript: 

0:00:00.4 Kristin Coverly: Fascia Research Society invites ABMP Podcast listeners to attend the Sixth International Fascia Research Congress, September 10th through 14th, 2022 in Montreal. The event includes eight keynote speakers, over 60 parallel session talks and posters, seven full and eight half-day workshops and a two-day fascia focused dissection workshop. The line up of keynote speakers and workshops is already available on the Fascia Research Society website and the full congress schedule will be out June 3rd. Register for the Sixth International Fascia Research Congress today at fasciaresearchsociety.org.

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[music]

0:01:50.6 Darren Buford: I'm Darren Buford.

0:01:51.8 KC: And I'm Kristin Coverly.

0:01:53.1 DB: And welcome to The ABMP Podcast, a podcast where we speak with a massage and bodywork profession. Our guest today is David Lesondak. David is the author of the international best seller Fascia: What it is and Why it Matters, currently in nine languages. His follow-up book as editor, Fascia, Function, and Medical Applications, was nominated for a 2021 British Medical Association Award. In addition to the contributing chapters to numerous other publications, he hosts the Podcast BodyTalk with David Lesondak. Beside that, I would also be remiss after reviewing his background to not also mention, he has some interesting things like being a DJ and involved in the funeral arts, which I'm sure we'll ask about it in just a second. Learn more about David at davidlesondak.com. Hello, David. Hello, Kristin.

0:02:40.4 David Lesondak: Hey, thanks a lot. Thanks for inviting me on. This is great.

0:02:43.6 KC: David, we're so excited to have you here and as Darren said, he really did have to shorten that bio, you have a lot of really fascinating things in your background, one of them is talking about being a fascial fitness trainer, and that was a new category for us, that was a new phrase for us. What does that mean?

0:03:04.6 DL: Okay, well, that's a long story, but for a number of years, I was involved with a group of people in Germany, including Robert Schleip and Divo Muller, PJ O'Clair over here in the States, and they were taking the scientific concepts that we were promulgating in the various Fascia congresses and saying, "How do we specifically apply these principles to Sports and Movement and what would that look like as opposed to bodywork and rehabilitation scenarios?" So I got very involved with that group in Germany over the years. There was a lot of R&D, a lot of trial and error, if I could be quite frank, in terms of finding what worked, what didn't work, what was too much, what wasn't enough, in terms of application, and I believe now, the fascial fitness as a brand or a thing to learn and be certified in is available through the Fascia Training Academy, and I'm blanking on the gentleman's name, who runs that, but yes, I was very involved with that for years, it's four core principles, I don't... I never turned it... It was like when I got my yoga teacher training, I didn't wanna be a yoga teacher, but I wanted to have that knowledge base more solid to inform my day job, and it was the same thing with the facial fitness training, it's like, "Well, where am I gonna go with this?" And I use it a lot, in when I'm giving my patients homework and such.

0:04:33.1 DB: Is that a situation where you would complete the 10 sessions of Rolfing structural integration and then you would work with that same practitioner or you would then move to a different practitioner who is probably specifically trained as that?

0:04:46.5 DL: Well, no, the idea behind fascial fitness was that once or twice a week, you would go to a facial fitness class that incorporates the principles of elastic recoil, incorporates the aspect of sensory awareness, incorporates the aspects of rehydration, preparatory counter movements, softness, you don't wanna be a bull, you wanna be a panther. And then there were also applications to whatever it is that you normally do for your fitness. So let's say I'm a gym rat and I'm gonna do lat pull-downs, I think we all know lat pull-downs. So every say third time I'm in the gym doing my lat pull-downs, I would add a facial component. So I would lighten the load so I could get more of a bouncing action going, get a little recoil going, and then I would actually turn slowly to the left and turn slowly to the right and work in vectors so that I'm training in all the possible angles. And the idea behind fascial fitness is that this is a longer term project. This is something that you're gonna notice results from three, six, nine months, 12 months down the road gradually, and it's gonna give you more resilience, and that was part of it too, is like we realized there's people who were actually doing these classes every day.

0:06:08.1 DL: Wasn't such a good thing for the instructors because they were over-training their fascial system and actually engendering a lot of inflammatory states. So when I say there was a lot of R&D, that was part of it. But I still use... I still use some of those ideas to help my clients and patients in my practice. So that's just how I've chosen to incorporate it.

0:06:31.1 KC: I love that, and I also love thinking about fascia in that way, so activities of daily living, things we're already doing, but bringing a fascial awareness to our movement or to our practice, and that's a lot about what you talk about with fascia, just having an awareness of that it exists and its role in the body.

0:06:50.3 DL: Well, exactly, exactly. And paying attention to what you're doing. So you don't wanna be checked out, you don't wanna be checked out watching a video while you're doing your exercise, you wanna be feeling what you're feeling, and there's that tendency also... Again, I'm just talking specifically about weight lifting kind of things here, 'cause that's just the thing I picked, we could apply this... We did this great... We worked out this great sun salutation sequence with many bounces and all these, elastic recoil, very different from the more traditional yoga one. But there's that tendency in weight lifting, like you go really "Boom," and then you kinda sink, you kinda... You give your effort in the last one, and then while you're resting before your next set, you kind of collapse in on yourself and go like... That's not a very fascial principle.

0:07:31.8 DL: We want you to be kind of sitting up right and kind of being like, "Okay, I'm just gonna sit here and feel what I'm feeling and where I'm feeling it," and just go, "Oh, that's interesting." So that was an important component of it too, but even in day-to-day life. So if you have switch plates in your house that aren't the little levers, but the little kick plates as they call them, use your foot. You wanna turn on the light, turn it on with your foot. Little things like that throughout the day. It's great too... If you're in a building with an elevator and there's other people there, you kinda reach out with your foot.

[laughter]

0:08:06.0 DL: And they look at you and you're like, "I'm 60, deal with it."

[laughter]

0:08:13.0 DB: David. When did you catch the fascia bug? We talked a little bit... Obviously, your background is super fascinating and interesting, where did you actually get fascinated and interested to pursue fascia as a career?

0:08:25.8 DL: About the year 2000. About the year 2000, it's actually... It's a three-prong story, so to speak, but I'll try to condense it. I had been working at that point for eight years, and I was a self-described clinical massage therapist, I had done a lot of trigger point studies and other things. And my whole objective was, "Let's treat your pain and get you out of pain," 'cause I know that this can do it and you can stay there, and we can also do it in a way that engenders a deep relaxation, you don't have to be champing at the bit, we don't have to give you more pain to get rid of your pain. So that was kind of been my channel and I had developed a pretty good reputation, but at the same time, there were things that weren't adding up. So I could have one person... I could have three people who all have low back pain and this person after seven visits, they're doing great, this other person took 17, this person never got better. Or pick any other sort of condition that somebody might come to you for, and so that was like, okay, what...

0:09:29.0 DL: This is... Where is the missing link to all this. In the meantime, I started developing some of my own repetitive motion issues, some of my own little chronic aches and pains. And then every once in a while, I would be doing a session and the tone of it would change, 'cause the tactile quality of what I was doing with the body, I always remember a very specific session, I was working in the rhomboid area up underneath the posterior surface, so they were supine, and I was like... It just felt like I was just pulling apart... This would be like 1999, working with the whole shoulder joint and everything, and it was very different from the other kinds of tactile qualities, the other techniques that I used, like PNF or trigger point or effleurage or any of that.

0:10:24.3 DL: And I started doing more and more of that 'cause people really liked it, and then sometimes they'd be like, "Could you do that thing you did again last time" and it wouldn't be as good the second time, which was a little frustrating for everybody. [chuckle] It was like, 'cause that was really great last time because... Well, they got that piece last time, there was another piece related to that piece. And then I met somebody who did fascia bodywork, she was a Hellerworker, she came to work at location in the same town, 9 miles west of Pittsburgh proper that I was in, and I thought well, I should find out what she's doing and make friends with her. And it was just like, boom, it's like, "Oh my God, this is what I need for my problem. I think I need to go learn this, and I think sometimes I'm doing this, but I don't know what I'm doing, so I better learn something about it." So it was just all those things happening at once. And once I went there, I'm like, "Okay, this is what... This is what I wanted to be doing all along." It just was obvious to me.

0:11:26.5 KC: And for those listeners who aren't familiar with Hellerwork, can you tell us a little bit about that David.

0:11:31.9 DL: So you mentioned earlier, Rolfing structural integration. Okay, so just as there are different brands of things, there are different types of pilates, different types of yoga, different types of massage approaches, some of them have little circle Rs after them or circle Cs. Structural integration is a blanket term, like tissue paper or hamburger, but there are different brands underneath that, so Rolfing is like a Big Mac, Hellerwork has us lead you 11 sessions, they don't do 10, they have more of a dialogue involved, a little psycho-emotional approach. I went to Anatomy Trains where a Royale with cheese, and we have 12 sessions, but it's all hamburger.

0:12:17.5 KC: Oh, I'm sorry, I'm laughing out loud at the Royale with cheese.

0:12:20.5 DL: No you can laugh.

[laughter]

0:12:21.9 KC: That's great. I love it. Thank you, that was really helpful. I'm sure for someone who's like, "Wait a minute, what is that modality?" And there are modalities sometimes that aren't as well known. So I love that you did that. I was curious, I thought maybe the funeral director was gonna sneak its way into the awareness of fascia story, I wasn't sure.

[laughter]

0:12:39.8 DL: I was not a funeral director, that you have to go to school and get a fancy piece of paper for that. And the place I worked for is like, you wanna get it fine, but you still gotta work full time. And I'm like, "No, that doesn't work for me." 'Cause that's a...

[laughter]

0:12:50.8 KC: Yeah.

0:12:55.3 DL: I was looking for a job that I could get to by bus that paid better than minimum wage. And there was a eight location funeral home chain in the South Florida area, that was looking for an embalming crew intern. So all of the bodies were processed in a central location and they were looking for somebody to kinda show up, wear a suit, pick them up in the car, bring them in, take them to the airport, 'cause sometimes it got flown to other places for burial. Take the medical examiners, take them to the funeral home for the viewing, help dress them. I learned how to do a mean head of hair. There's almost nothing you can't do with an extreme comb over. But I never actually learned any of the embalming techniques or any of that because that was next level in terms of schooling and certification and all that. And that definitely wasn't a career I wanted to do. But I'll tell you, the first time that I went into a cadaver lab, and I was kinda nervous, and I walked in and I saw the bodies and I had the smells and I'm like, "Oh, hey, yeah, I know, I'm good, I'm cool." So [chuckle] I never thought that, that experience would come back around in a positive way over a decade later. So that was an okay thing.

0:14:10.1 KC: Alright, David, I'm gonna tap into your fascia expert knowledge right now, because a lot of times I know therapists are like, "I understand that fascia is an important part of the body, that it's one of our tissues that we need to learn and understand about. But why does it matter? Why is it so important?" So let's talk about why does fascia matter?

0:14:30.5 DL: Okay, so it's two parts. Fascia responds to supply and demand and use it or lose it is a biological reality. Okay. So let's unpack those two statements. Supply and demand. The more I do something, the more my body is gonna respond slowly over time to reorganize the collagen matrix to support that thing that I'm doing. So let's say for reasons I decide, I wanna hop on one foot four hours a day. Over a period of one to three to four months, the structure, the collagen structure on the leg I'm hopping on is going to change to support that repetitive habit. Likewise, the leg that I've got, the knee bent so it's not hitting the ground at all, is going to reorganize around that constant mechanical input. The cells that build collagen respond to mechanical input, pressure and vibration. So that's gonna do a slow remodeling so that I can continue to hop on one foot every day for four hours a day and do so relatively well supported.

0:15:42.6 DL: So let's translate that into somebody who's been in an accident and has had their foot in a boot for three months. And everything's fine, but they're not fine. And people are looking at the side that the boot is on. They're not looking at the other side that was having to do the heavy lifting while they were in the boot. Or somebody who has a change of jobs and maybe is doing a very different physical job than the one they used to. So our body is designed to continually to grow and adapt and mold itself to the activities we do on a regular basis. And so that's number one.

0:16:17.7 DL: And number two, use it or lose it is a biological principle. If I don't get up and move enough, my collagen network is gonna become highly disorganized. So you can think about it as a garden that's never gets weeded. Okay. So without regular mechanical stimulation, whatever it is, even just going out and going for a walk for 40 minutes a day, the cells that build the collagen aren't getting enough mechanical information to know the right way to maintain the architecture that your body wants. So the big thing about fascia is, if you think about it in terms of the body having an architecture, it is the mortar, but it's the living biodynamic mortar in between the bricks of the bones and covering the muscles and the organs and so on and so forth. And that's why it matters. And we can change it. We can change it. We can engender a change and keep it going in the direction of restoration rather than deterioration.

0:17:18.4 DB: Let's take a short break to hear a word from our sponsors.

0:17:21.5 KC: Anatomy Trains is delighted to invite you to our in-person fascial dissection workshop, May 30th through June 3rd, 2022. We're excited to be back in the lab with Anatomy Trains author Tom Myers and Master Dissector Todd Garcia in Todd's Laboratory of Anatomical Enlightenment in Boulder, Colorado. Join students from around the world and from all types of manual movement and fitness professions to explore the real human form, not the images you get from books. Visit anatomytrains.com for details.

0:18:00.4 DB: Now let's get back to the podcast.

0:18:01.8 DB: Now, is that change that you're helping to implement permanent or is that something that it's a continuous process?

0:18:10.0 DL: It can be permanent, permanent being a relative state. So ideally, whenever I have somebody new that I see for the first time, I tell them that my job is to put myself out of a job. So I want you to come in because you want to, not because you have to. So if I'm doing my work correctly, if I'm engaging... And I work at a hospital, so I'll use the word patient, it just comes out that way. If I'm engaging with my patient correctly, making sure that I'm helping to build their proprioceptive awareness, not just, "Oh, hey, I feel better." And there's nothing wrong with feeling better, don't take that personally, anybody. And I give them simple things.

0:18:57.0 DL: So I usually give people a one physical homework, which could be a very simple stretch that has a traction or more fascial component to it to help maintain whatever good result we got in that session was. And then I usually give them an awareness homework, a little bit of Zen homework. So it's like, "Okay, that thing that you're feeling, you're not feeling it now. I'm not great." So the next time you feel it, take a moment and just make a note of what you're doing or how you're doing it. Here's a good one. So, for people who tend to lock out their knees, hyperextend their knees, there are bit of Zen homework. Maybe just throughout the day, ask yourself, "Where are my knees?" Oh.

0:19:37.7 DL: Just think it very simple, just where are my knees. And you begin to get... Indoctrinate that person, guide that person into having a deeper relationship with their own body, which for me is the secret sauce, because then that carries them on when we're done. So it may be that in weekly visits, some of it is biweekly visits over a period of three to five months, we've reached most of the goals. Now, there are people who, and this is not a value that I was taught in school but it's when I learned in the field, who may have a more chronic condition that is less or their body itself is more... In a more deteriorated state, and then ideally what I'd like to see. So I've worked on 74-year olds who... I've worked on people who are 44 years old who were more deteriorated than some of the 74-year olds. So age doesn't matter. It can, but it doesn't.

0:20:38.4 DL: But their regenerative capacity may be a bit less or they have a very physically demanding job. So I think any kind of professional athlete or a professional physical performer, they may need more frequent tuneups because of what they're putting their body through. But most people, if you can guide them through it correctly, focus it on addressing their specific needs while you are looking at the overall structure and how everything's relating to everything else, you can achieve a pretty self-sustaining effect over a three-to-five-month period. And then literally I'll say come back in three months for a checkup. They come in for a checkup. If everything's fine I'll say come back in six months. And by then they know and they can go and they can get their deep tissue massage, or they're chiropractic, or the other things, and they'll get more out of those things because I've done the weeding.

0:21:31.2 DB: So David, I'm curious. You mentioned in your description there of working with patients at a hospital, that to me rings differently than thinking about doing a series with people out of your practice. How is that different? Can you tell me a little bit about working in a hospital.

0:21:49.6 DL: Well, my practice is in the hospital. I'm affiliated... I'm an allied health member, as they call it in the Department of Family and Community Medicine at the University of Pittsburgh Medical Center, Shadyside campus. That's a lot.

0:22:03.0 KC: Shoutout.

0:22:04.4 DL: So I work in the Integrative Medicine Center. So I'm a Senior Structural Integrator there. We have someone else we just hired about six months ago who's awesome. We have three acupuncturist, two chiropractors, several people who do EMDR, psychologists. We do a fair amount of research and we have an overall medical director who is an MD and also a psychiatrist who kind of writes her... Over everything. And there's maybe 80 or 90 of these kind of departments affiliated with medical universities or university hospitals. Gainesville, Florida is another one. Around University of Maryland, around the country, we do yoga they do yoga, University of Maryland that is. And it's an incredible opportunity. We also have some massage therapists in our department as well. And so when they opened the door to that, I jumped in back in 2008 right about the time the recession happened, great time for a career change.

0:23:03.3 DL: But I always wanted to be working in the medical environment, because I believed and I had seen things that I felt were like, "Okay, this is... This is medicine because this is making the person healthier in the long term." So the integrative medicine movement along with... You can call it mind-body medicine if you like, it used to be called alternative, it's called complementary for a while, they finally settle on integrative because we wanna work with the Western approach as well 'cause they're not all bad. They don't do everything. We don't do everything. But working together, we can do more. So the only way really that it's different, Darren, is that I go into... I go into a different kind of office. I have a decent sized treatment room with the skylight, which is really nice. I can dress how I wanna dress. We reopened...

0:23:53.6 DL: There's another way it was different. So after closing down for two months in March and April of 2020, we reopened in May, so I was working straight through the pandemic because we are predominantly 80% in outpatient pain management clinic. We just needed to get the T's cross and I's dotted to represent as that, but that's the majority of what we do and the kinds of people that we serve. And I'll tell you the other way it's different was when they had this opportunity I thought, "Wow, I am gonna see some really interesting and really different kinds of patient profiles here." They're gonna throw things at me that I would never maybe get in a private practice. So I saw so many... So much potential application for structural integration in other areas of pain management and rehab medicine so I thought what a great chance to jump in and see what's possible.

0:24:49.0 DB: David this might be a good time to transition and talk about your newest book that came out in 2021, Fascia Function and Medical Applications. This book is a compilation of pieces on the topic of fascia, I believe. How did you become involved with this and why is presenting fascia to this particular medical audience important?

0:25:09.2 DL: So it's a two-part question, Darren. [laughter] I usually have two ideas about everything so now I got four. [laughter] Alright, so let's talk about the book first. I had been asked, due to the popularity of fascia, what it is and why it matters, to contribute a chapter on fascia and fascial dysfunction in a book on physical therapy, Metabolic Therapies in Orthopedics. And the publisher noticed that chapter. It got some good notices, so they contacted me and said, "Could you get us a textbook on this stuff?" And I thought, "Well that's something I've never done before and a publisher is asking me to create a book. I better say yes." Okay, when somebody asked you to do something you've never done before, but it's up your alley, say yes. It's not gonna be easy. You're gonna have to figure some things out, but to me, that's always an exciting place to be. Let's do something I've never done before.

0:26:06.1 DL: And I thought, "Well, I can't write this on my own, but certainly I know all the right people who contribute to something like this." And they wanted something specific for the medical and healthcare reader. Now, the first book works fine in that, but this is a little more specific. This is a little more academic-oriented writing, because we wanted to create something that any MD could read, and even if they didn't agree with it, could at least say, "Well, okay, I don't know that I agree with this, but this person knows what they're talking about. They're well cited, they're well researched, they're well reasoned." So I got Carla Stecker to write the Anatomy chapter. I asked Antonio Stecker to write the physiology chapter. I asked Robert Schleip to write the Nervous System chapter.

0:26:49.8 DL: So it was really great to kinda go to the best people I could think of in each of these situations and say, "Could you give me 5000 or so words on this topic and kinda just ride herd over the whole project?" And my friend Angela Achy, I'm like, "Could you co edit this with me?" Because I wanted that MD person that I'm not to be able to read through it? And go, "Okay, that works that. That's a little we need to make... We need to tighten that up. That's not quite working here." So that was important as well. And this was really kind of not as unusual in outgrowth as you might think because in 2013, I managed to give a talk at the first integrative medicine conference and I threw my hat in the ring when they were doing a confab. And they gave me like the 8:30 AM last morning sloughed off.

[laughter]

0:27:44.5 KC: Revolve in the next slot, David. [laughter]

0:27:47.5 DL: Yeah, but it was a slot. It was a slot and about, I don't know, 14, 16 people showed up, but they were the right 14 or 16 people. And that's the thing too. Yeah, we all wanna have a couple of 100 people, but if the right dozen people show up, that's just as good as a couple of 100 people. And what I realized is that nobody, even in the integrative medicine world, was talking about this stuff. And every opportunity I had at the hospital to give a talk on a weekend or go into the the medical library and do sitting one on one, I was using those opportunities for five years. I've met every month with an integrative medicine interest group at the hospital where people would show up from different departments, different modalities, and we'd all just together get together and kibitz, learn from each other. So I was comfortable in that environment and I realized that even the people that should know more about this stuff weren't getting it. So maybe that was my job here to help them get it some more.

0:28:46.4 DL: And I'm very happy with how the book turned out. It came out in the tail end of 2020, horrible time to have something new come out. But even at that, it's pretty... I think it's accessible and it's organized in a sequential way. So if you go from start to finish, you're gonna get a cumulative base of knowledge through this that it fits together as a whole and I think that's always been the challenge when you're writing about fascia. When you're putting together a book or a program about it, it can be so many things in so many places simultaneously, and it has so many different, if not functions, potential ways it can influence the body. How do you structure it in a way that creates a gestalt for the reader. So that by the time they get to the end of the journey, they can kinda put it together in the body the way it really is in their brain with the knowledge that they have?

0:29:45.6 DB: I'm seeing... I love the idea that you've helped put this book together for as a communication device between these two communities, and you're already working in that community, so which is fascinating. Has the reception and the understanding about fascia outside of our internal bodywork communities continued to grow?

0:30:06.8 DL: It absolutely has. And it's continuing to... It's a slow process. And I think that's the frustrating thing. There's part of me that's like, "Okay, I've been doing this for over 20 years now and you're just getting it." But if you read The History of Science, which I do, the history of medicine, these kinds of sea changes are slow to take hold because you have to find a way around a lot of preconceived ideas. So my first book actually was the outgrowth of an article that I wrote. I was being pressured very nicely by my mentor at the hospital, who was an osteopath and an MD to write. And when I was at that first conference in 2013, somebody approached me from a journal and said, "I really liked your lecture. Could you write that up as an article?" And I was like, "Well, I happen to have it right here."

[laughter]

0:31:03.7 DL: "I wanna make a few tweaks to it. Can I get it to you in a couple of weeks?" And I thought, "Oh my God, I just got my first published paper. Oh, my God." And it sat in peer review for nine months because they were not using it. They said, "Could you reformulate it as a scientific hypothesis paper?" And I was so burned out at that point. Plus, I was starting to work on the book and I kinda said, the book has to take precedence but here's what happened. He gave it to three people and one person said, "Wow, this is great. You need to publish this. Everybody else needs to know this." One guy said, "I'm not even reading it based on the title." alright. So there's one third of his readership, another third of his readership. And then the other guy they sent it to or a woman I don't know, said, "This reads like a written down medical lecture." And I thought, "Well, that's fair because it's a medical lecture that I wrote."

0:31:46.7 KC: Yeah, you got it.

[laughter]

0:31:49.9 DL: So you kinda found me out there. So I'd say things are improving. And the best thing that works is results and curiosity. I think if you're getting good, consistent results, people are going to notice and that's gonna eventually feed on itself. And I find myself... I talked about interns coming in and hanging out with me for a half hour. Next thing I know, I'm getting referral from a doctor's office. I don't even know this doctor, ah. But that person who sat in with me for a half hour for an afternoon is working in that office now. And they said, "This is the guy you got to go see."

0:32:32.0 DL: And the other thing is to be curious and to be open to what other people are doing. So I think what tends to happen when we feel like we have a highly specialized knowledge that can really make a difference that we're really excited about, we kind of get, a full head steam about making sure that we tell everybody about how awesome this is. And that isn't always the right approach, particularly if you wanna move into a more medical stream because you're gonna be overturning some long-cherished beliefs and myths. But those people don't necessarily look at those as beliefs and myths. But if you go back and read the history of medicine and read the history of science it happens all the time. These turnovers happen and they take decades, in some cases centuries, to change.

0:33:23.5 DL: And if you show interest in what the other person... Whether it's a surgeon or a chiropractor or whatever, "How are you doing what you're doing?" "Okay, well, that's really... Do you ever have any people that you just don't what to do with?" "Yeah, you know, sometimes I do." "Why don't you send those people to me, maybe I can help these people."

0:33:38.6 DL: If you can be a problem solver as opposed to a, "Let me tell you about the part you missed. Let me tell you about the thing I'm bringing that don't have that's gonna be like the best thing ever." You're actually gonna do better. And believe me, I am guilty of that too. [chuckle] I've been at this for three decades. I've made every mistake, some even twice. So the more open you are to being helpful to others, the more that that pool widens, and that's always been the... When I'm writing whatever I'm writing, or the second edition of my first book is getting ready to come out in three months, it's like, how can I make this more understandable, more of service, and get more people interested, engaged, give them good science, but also spark their imagination?

0:34:26.9 DB: This has been a fascinating conversation today. I wanna thank our guest, David Lesondak. For more information about David visit davidlesondak.com. Thanks, David, and thanks, Kristin.

0:34:37.5 DL: Thank you so much, I've had a great time and look forward to the next time.

0:34:43.1 KC: We are looking forward to the next time already too. Thank you so much, David.

[music]

0:34:53.5 KC: Members are loving ABMP Five-Minute Muscles and ABMP Pocket Pathology, two quick reference web apps included with ABMP membership. ABMP Five-Minute Muscles delivers muscle-specific palpation and technique videos plus origins, insertions, and actions for the 83 muscles most commonly addressed by body workers. ABMP pocket pathology, created in conjunction with Ruth Werner, puts key information for nearly 200 common pathologies at your fingertips and provides the knowledge you need to help you make informed treatment decisions. Start learning today. ABMP members log in at abmp.com and look for the links in the featured benefits section of your member home page. Not a member? Learn about these exciting member benefits at abmp.com/more.

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