The Importance of Anatomy to all Healthcare Practitioners
by Caroline Barrow
Originally published in Positive Health issue 96 - Feb 2004
Anatomy from a Baby's Perspective
At what age did you first start to study anatomy? I bet you were about 18 months old. You learned, 'nose, mouth, eyes, arm, leg, toes…' As your studies developed you went further and added knees, elbows, shoulders and 'tummy'… and while you may not have yet learned about different types of joints or the digestive organs themselves, you may have realized that limbs move differently and that food and toilet visits were intimately connected! Naming and understanding what the 'bits' are for is useful to us from a young age; and the depth of our understanding naturally reflects both our level of interest as well as our need for applying it.
Anatomy has developed as a system with complex names, which may put some people off, yet serves to quickly identify exactly what we are talking about. While in general life we may get away with stomach or head to describe aches and pains we are all, no doubt, happier that surgeons know exactly what tissues and structures they may be aiming for and passing through (or bypassing) when they diagnose, or even operate on us. I strongly believe that the more we understand about the body systems we are working on, the better we can support our clients and the more benefits we will reap.
The Subtle and the Tangible
Sometimes in healing and medicine, it seems we are being pulled in two different directions. One is the lure of the tangible physical body from the biochemical and molecular level of cell physiology. On the other hand, for many of us there is an undeniable experience of the energetic and the (not always) subtle shifts in feelings and perceptions that often accompany a
change in 'well-being' and previous 'disease' states. As therapists we work with our intuition and 'follow the listening' (a term used in a visceral manipulation course recently attended!), yet I do believe that we can be even more accurate in our treatments when this approach is melded with a deep understanding of the structures and physiology of the body.
Tips for Studying Anatomy
- Get used to the words: it is often the unfamiliarity with the words that can put students off. Write them down, say them out loud, repeat them, look up their meaning – most things have some reason for their name and knowing the root of the word can help. Things are typically named either for shape, location, function or the discoverer.
- Look things up: if you come across terms you don’t know, look them up! It’s easy to get put off by not knowing one or two terms in a sentence. Also, some things have two (or even more!) names so knowing what they refer to really helps.
- Use pictures: after looking at pictures, perhaps from more than one text, draw them yourself, make models out of plastacine, and then...
- Test yourself: once you think you’ve grasped a concept, test yourself on it. Use questions in text books or other workbooks, fill in the gaps in your knowledge and when you are ready...
- Explain it to others: if you can explain how something works to a willing listener then you probably understand it – if you can’t then you usually identify what it is you are not so clear about.
What Do We Need to Know?
Medics spend 5 years training. They are trained to diagnose and often do so with the back up of current technology – from blood tests or scans to more invasive cameras or biopsies. Despite all this gadgetry, as we all know there are still many things doctors cannot understand, explain or deal with. We are not training to be doctors, nor legally allowed to diagnose. So how much do we need to know?
There is a lot of work going on at the moment to set standards and core curriculum in some of the disciplines (eg homeopathy and acupuncture) and this will spread to others over the next 20 years or so. Massage, aromatherapy or reflexology courses have anatomy and physiology components that vary from 12 to 30 week courses. Other interventions such as Reiki and other types of healing require no anatomical training. While this is not perhaps necessary to practise the discipline, does it become more important if people practice? What if we are practising on people with diseases, or alongside other health professionals? And what about the detail learnt initially but forgotten? Should we recap it? Should we aim to deepen the understanding? It won't surprise you to know that I think we should!
Tips for Integrating Study into Your Practice
- Start a study group: Find out one new interesting thing each time to talk about. (And again if you can explain it clearly you probably understand it!). Ask others about things you are not sure of. Work it!
- One hour a month: set some time aside, be it only an hour a month or so, to read around the subject and go over topics you are hazy on. Remind yourself of the anatomy of an area, think about the problems that can occur, find out a bit more detail. You may need to push yourself a little to do this but it is worth it!
- Clinical Follow up: pick a clinical condition or problem that has arisen in your practice (or from family / friends) and find out more…
- Development: At least once a year plan a visit to a museum, find a CPD (continuing professional development) course that will take your knowledge further, go to a conference, write an article… You don’t have to have done all the work yourself – a lot of work is going on out there! Let it re-inspire, refresh and refocus you.
- Repeat, repeat, repeat: I’ll say it again! Don’t expect yourself to remember everything even though you knew it once! Go over the information again. Reread your notes, read other books, and follow through on topics that inspire and interest you. And then go through it all again.
How Best to Learn?
So what is the best way to go about learning? Different people learn best in different ways, however there are common strands and it seems to me that a combination of approaches is the most valuable:
- Build the framework: just as a house first needs foundations, walls and a roof before windows and doors a new student needs to gradually build up a picture of the overall systems before more detail can be covered. The detail of the interior design and functioning of each 'room' can then be understood in relation to the whole. Often what happens is that once the framework is built we have somewhere to 'hang' the detail. When we can relate a topic to ourselves, others around us or those we work with it becomes more interesting and therefore more memorable.
- Link Structure to Function: names of parts are all very well, but it is the understanding of what the parts do that is the most important, why things may be situated where they are and how this helps them do their job. From this point we can also begin to understand how some of the more unexpected symptoms occur, from referred pain to the point of the patella!
- Look Things Up: no one can be expected to know everything and certainly not to learn it all at once, but with the amount of resources available today it is usually easy to look up words you don't know, go into more detail about topics that interest you or become relevant in your practice.
- Exposure: get as much exposure to the subject matter as possible. Take advantage of the multitude of resources available on the internet. While there is a varied level of detail available and it may seem time consuming to sift through, the speed of access is unprecedented compared to years gone by. Visit public places such as museums and science centres who now devote exhibition space to interactive explanations of the human body.
- Find your Favourite Topic: learning comes most easily from inspiration. When you find an area that is really interesting to you then follow it through. I often press students to choose a favourite joint, an area of physiology that amazes them, or a pathological process that is somehow relevant and let this fuel their study to lead them into a greater understanding of the area.
- Collaborate: it can be easy to become a bit isolated in this work but if you have fellow students, friends, others doing the same kind of work it can be really supportive to meet up and discuss approaches, help each other study, ask lots of questions and help each other find the answers.
- Use your Clinical Experience: This is also where our work with clients comes alive: if clients present with particular issues think about them. Look up any pathologies you haven't come across before. Actually having a person to talk to who is experiencing something can be an invaluable route to remembering. If something in their body isn't working and they can describe what problems this causes then it will help your understanding.
- Repeat it, Repeat it, Repeat it! Use it or lose it. Feel the fear and do it anyway. Throw enough spaghetti at the wall and some of it just may stick. (Tom Peters, The Pursuit of WOW). Just do it… Use whatever quirky phrase or saying works for you, inspires you or reminds you to keep going. Learn the language of the physical body and sooner or later you will find yourself talking fluently and creatively to your clients and colleagues and instinctively adding an extra dimension to your
The Benefits of Anatomy
I have always believed it is in everybody's interest for alternative practitioners to be in on the secrets about the body that science has discovered and to understand the way the body works. This contributes to our practices in a number of ways:
Understanding the body, in as many ways as possible, leads to a truly holistic approach (we cannot call it holistic if we miss out big chunks). We do not, for example, need to know all the names of every structure, but when we understand some of the intricacies about how we have been put together and how structure serves function we can extend this into our treatments when appropriate. Appreciation of nutrition, lifestyle impacts, physiological processes, conventional approaches to conditions etc. broadens our awareness.
- Dialogue with Practitoners: Being able to talk the same language, or at least learn some of the words, enables us to dialogue more eloquently and effectively with other health care professionals as well as our clients. This is important for referrals – especially as it is becoming increasingly common for complementary practitioners to work within surgeries and group practices.
- Dialogue with Clients: Also, the greater availability of information about physiology, anatomy and pathology means the general public often has at least a sufficient baseline understanding from which to understand and ask questions about both diagnosis and treatment. It is helpful for us to explain what we are doing and, if necessary, contrast our work with other approaches.
- Precision: In bodywork, for example, the more detailed our understanding of the structures and processes occurring under our hands, the more precise we can be with what we are doing. We may get a greater understanding of the links to other parts and be more accurate in our ability to pinpoint the problem – and therefore a solution.
- Intuition: This links directly with the point above – we can use our intuition to explore precisely what is happening when we have a detailed knowledge of the territory. A good treatment is often a combination of well practised techniques, an empathy and understanding from the practitioner, sometimes mixed with an intuitive sense of something that the patient needs or wants. This intuitive sense does not need science, it cannot be proven or even measured at this point in time, beyond an experience or change in the client. Yet while the honing of intuition needs neither science or technology the application of it within a strongly understood framework of anatomy and physiology can guide you to exactly the right place. People working intuitively with cells in the immune system have, for example, been able to describe cell structures with incredible accuracy.
- Accountability: Complementary and alternative medicine is undergoing much greater scrutiny than ever before. Governments, the medical profession, bodies speaking for CAM and the majority of practitioners themselves are keen to validate the instances where patients can truly benefit from alternative approaches. There has been a call for more research and more regulation within many therapies and different bodies are working to respond to this. Patients are turning to these approaches for a number of varied reasons. Some are 'pushed' through dissatisfaction of orthodox medicine and rejection of high tech interventions and toxicity of drugs; others are 'pulled', finding some aspect of an alternative approach attractive or useful for particular conditions, especially when dealing with an emotional or spiritual dimension that is not addressed in orthodox frameworks. Whatever the reason it is important that the practitioners they turn to are professional and accountable for their work.
- Referral: In any profession it is important to know when you can help and when you cannot. The more we understand about pathology for instance the more we will know when it is appropriate to refer patients whose symptoms exceed our abilities and experience, and perhaps to know who to refer them to. We will also know when what we offer may be of assistance to a patient.
- Development of new techniques: New approaches to healing which rely on scientific or anatomical understanding are also constantly being developed. The examples of osteopathy, manual lymphatic drainage, sports massage and visceral manipulation come to mind, to name just a few.
- Fascination: Is it not just simply fascinating? The more I work with and learn about the body, the more I am amazed and humbled by the magical the processes that continually go on, generally keeping us healthy but also adapting to illness or distress when needed. A colleague has as her work screensaver: 'I may not look like I'm doing much but on a cellular level I'm really very busy'!.
About Caroline Barrow
Caroline Barrow BSc is a Shiatsu and Cranio-sacral practitioner. She is also the founder of the College of Body Science which specialises in running a variety of courses for complementary health practitioners to study anatomy (for real!), physiology, pathology and aspects of biomedical science. The vision is for high quality, on-going teaching, support and exchange to be available and suitable for practitioners at different stages of understanding,
enabling a truly holistic approach to health. She can be contacted on Tel: 0845 108 1088; firstname.lastname@example.org www.collegeofbodyscience.com