Ep 272 - David Lesondak and Finding Fascia: “The Rebel MT” with Allison Denney

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0:01:32.5 Speaker 2: David Lesondak, is a fascia guru, atleast that's how I see him. He is, as his resume boasts, a professional staff member at the University of Pittsburgh Medical Center, a Board Certified Structural Integrator, author of the book, Fascia: What it is and Why it Matters. Architect and editor of the textbook, Fascia, Function and Medical Applications, host of the podcast, BodyTalk with David Lesondak and contributor to the health and education of humans worldwide. At the heart of it all though is a man who loves the structure and function of the human form and loves to talk about it even more.

0:02:17.8 David Lesondak: I could remember the first time that I assisted in an Anatomy Trains three-day weekend. And I'm just like, I have no idea why I'm here. I don't belong here. I'm sitting in the car with Tom Myers and the senior teachers, and I'm just desperate, I'm desperate for something to say. And I'm looking at the license plate in the car in front of us, 'cause we're at a red light and we're in Florida. And I go, "Hey, if you rearrange the letters in Florida, it spells Ida Rolf," it was like, "Oh, okay, all right, maybe this isn't gonna suck." [laughter]

0:02:56.5 S2: One of the first points that David wanted to clarify with me when we sat down to talk was that he is not a message therapist.

0:03:03.6 DL: So well, structural integration is not massage therapy. Massage therapy is not structural integration. As one of your guests has said, one of my favorite people, Rachelle Clauson, "Different things do different things." And I love that. That's like my new favorite phrase. So I started out in 1992 as a Clinical Massage Therapist. That's how I differentiated myself, but I went to community college here in Pittsburgh to study massage therapy. I had the good fortune of having a teacher, Carma Stanton, who had been at this for like 30 years. She was like one of those old school massage therapists. And the class I was in was mostly older adults, I was about 25 at the time, who were looking for a second career or a career change or a part-time job. This would've been 1990, so predominantly everybody in this class was coming at it from a very serious place.

0:04:06.0 DL: And so she taught to that and she developed courses beyond just the introductory one that we all took, to further our own education along this path. It would be disingenuous of me not to talk about the fact that I started out as a massage therapist. And I used the term clinical in front of it because I was trying to differentiate from relaxation, because I always had a mindset of, this is something that can help people live better lives. This is something that can help heal people. I remember going to a wedding and my cousin-in-law was there, who my mother worshiped, he ran a PT department at a prominent hospital and I was so excited to tell him what I was doing, 'cause I wanted to come work for him. And when he was done laughing at me... [laughter] yeah, and I'm not kidding. He's just like, "Oh, run along, run along and play, little boy. You obviously don't have the brains that it takes to do what I do. Hahaha." That was a lot of fun. I'm one of those people you shouldn't say can't do things 'cause that just makes me wanna do them more.

0:05:16.4 DL: But my goal, I worked with Earl Timberlake who was an educator in the Ohio area and we would spend two hours [0:05:23.3] ____ on this, he would do these seminars. But basically he would break the body into regions like, okay, we're gonna focus on the neck and shoulders. So this weekend, we're gonna focus on the lower back and we're gonna spend the two hours, three hours on Friday studying the anatomy. And then over the weekend, we're gonna learn five or six different approaches because different people respond to different things. So this whole idea of getting you better was always front and center in my mindset.

0:05:51.5 S2: I think a lot of us can relate to the feeling that we aren't always respected in the field. David dug in and rose to the challenge.

0:06:00.9 DL: As I said, I continued to study at the community college and then they asked me to start teaching, which was weird. But they were willing to pay me like $12 bucks an hour. And this was 1990... '91, are you kidding? Yeah. And what was nice was these were lower stakes adult evening education courses. They weren't... But it was an intro into even being able to teach this stuff. So it was... I got a lot of people who just... It was something that they did, it was something they did for their partners or their spouses and they actually wanted to learn more about what they were doing. So it wasn't so much the career-oriented types, but it put me... Made me comfortable in that teaching environment. But yeah, I dug in and I just... I built a reputation over an eight-year period of somebody who was able to treat certain conditions, also be deeply relaxing at the same time, and get the job done.

0:06:56.9 DL: I ignored that slight that happened and I just kept moving on in my own path. So as I mentioned, I started doing some teaching at the community college. And I just... Unfortunately, even though I was working in a hair salon, the owner of the salon, there were some weeks he was the only person who came back to see me because that was part of our deal, was like, "You know what? I get to see you every week. I see you at this time every week and it's $20 bucks." "But hey, you own the salon. You're giving me a place to work. I'm good with that." But he put no conscriptions on how my practice was to evolve. So, aroma therapy and all those sort of things that I saw in the '90s as being a little trendy, he was fine if I chose to do those things or if I did not choose to do those things.

0:07:47.5 DL: And I suppose I was struck early on that the body had a lot of internal healing capabilities. This whole idea that we slough off and regenerate cells. And like, every seven months, you regenerate your liver, which is the most regenerative organ in the body. And I always thought that was amazing. And I always had this thing in my mind, of, "Well, if that's true, why can't we regenerate those cells in healthier patterns? Why... In terms of disease and illness and chronic problems. So that idea was rattling around in my head early, early, early on. I was starting to develop some repetitive use injuries of my own. I was working in a number of locations, one of them was a chiropractic office and I was given a room that was too small for me. So, I didn't... I had to... The angle that I was using my hands and arms was steeper than optimal to not get some repetitive use injuries and it began to scare me. Because it's like, "Wait a minute, I'm having chronic pains and I'm in my early 30s. This can't be good." And then somebody who did a form of structural integration called Hellerwork came into town and started working at the New Age bookstore. At that point, I had moved from the hair salon to the New Age bookstore.

0:09:07.6 DL: So it really was frying pan into fire for somebody like me. But this Heller-worker, which is a brand of structural integration, came into town, and rather than see her as competition, I wanted to make friends with her. So we immediately set up an exchange. And when it happened, it was this three-part thing of, "Oh my God, this is exactly what I need. Oh my God, what is this? And I think I'm doing this sometime, but I don't know what it is that I'm doing." Because when you're working with the body facially, it has a completely different tactile, kinesthetic feel. And the person on the table has a different kind of energy about them often than in what I had been previously associated with. So when I said, "I think I'm doing this sometimes," I literally meant that, but in a way that, like, "I need to know more about what this is because I don't understand it."

0:10:04.7 DL: So that's where I made the transition from massage therapy to structural integration. It took me two years before I found the school that worked for me. And once I graduated with my little certification in structural integration, one of my instructors really strongly suggested that's what I want to do... That that's what I should do. I shouldn't try to do both because then I run the risk of not being very good at either.

0:10:32.4 S2: But as David was discovering, being strong about who you are in a world that fights you in that process is not always the easiest thing to do.

0:10:41.2 DL: Some of the other practitioners at the New Age bookstore, one in particular made a fuss about me. I still don't know what that was about, but basically I was shown the door even though I was the most successful practitioner there by the numbers. But there was ranking in seniority and pecking order just like everywhere. And so I actually had to open up my own place, that was the option. So it was kind of nice to do this. So I was running my own place, plus having a career change shortly after opening my own place. I found a place and hung up my shingle and created Health Alternatives of Sewickley, which is a little town outside of Pittsburgh, thinking that I could create kind of a nice multidimensional environment where we could have acupuncture or chiropractic and massage and trigger point therapy and all of the things. So it was around that time that I'd been introduced to structural integration. I realized I needed structural integration. And then I went to school for it within two to three years after opening Health Alternatives in 1999. And I went to school at Anatomy Trains Structural Integration, which back then was called KMI, in 2002, graduated in 2003.

0:11:55.2 S2: David's experience landed him on a path he may not have expected, but life isn't always comprised of obvious choices.

0:12:03.8 DL: There's what you wanna do and there's what life throws at you to work with to do those things. And sometimes you need to go with the flow and sometimes you need to realize, "No, I have to go in this direction, even if it's not the easiest direction." And something that I had already inculcated in myself many years prior to this is, when I have a dilemma, when I have a choice between two difficult choices, here's the question: Which direction am I gonna learn more? And that answer tells me the direction that I need to go in. It's not always the easy choice of the two, and often both are difficult, but that's always been a guiding light for me. And I realized that I was morphing my practice from massage therapy, results-oriented massage therapy, clinical massage therapy, whatever... However you wanna frame it, into this structural integration format, because I really was interested in chronic pain, dysfunction, injuries, helping people heal and rehab from these things. And this model gave me a foundation that allowed me to get more consistent results.

0:13:25.8 S2: So David was living in Pittsburgh and traveling to Helena, Montana to learn under the tutelage of Tom Myers, and in the midst of it all, he fell in love with fascia.

0:13:36.7 DL: Yeah, that was... To me, that was the bigger thing. That was the bigger deal underlying all the bells and whistles and bows and things of Anatomy Trains, which is a wonderful bells and whistles and bows, was, "Oh, there's the bigger thing here, which is this fascia piece. I wanna learn as much about this as I possibly can, because why does working this way work so well?" I just was so... And Tom, as you know, can speak very well to the anatomy and physiology, but can also speak pretty well to the science. And I met Robert Schleip through there and things like that, so I just became completely fascinated with really trying to understand this so I could express it better.

0:14:21.1 S2: So in the early 2000s, David settles back into Pittsburgh and becomes heavily involved with the world of fascia when things were just beginning to take off for all of those involved.

0:14:32.6 DL: My education was pretty intimidating because I was really good with the stuff I was good at, and I knew enough to know that there was more that I needed to know. So I'm talking about like on the cusp of going to Anatomy Trains for structural integration. So there, I was confronted with how much I didn't know I didn't know. So that was a lot. And we had a very high bar in that class. There was like, somewhere between two dozen and 30 people. There were three or four PTs, a couple of chiropractors. There was a guy who did field ops medicine in the Navy SEAL Program. I mean, there was some heavy hitting people in this class, and I was kind of somewhere in the middle. They were accepting volunteers to be teacher aids, so I threw my hat in the ring, and they didn't throw it back out, which I was grateful for, [laughter] because I knew the only way I was gonna get to know this is, I needed to just immerse... I needed further applications.

0:15:37.8 DL: There was an Anatomy Trains dissection in 2005, I think, was the first one. It was part of Todd Garcia's Tour of the Human Body, was a six-day long dissection course, and I thought, "Well, if I'm assisting and I wanna teach this stuff, I need to know it as intimately as I can." So I threw my hat into that ring and went to the first dissection course, where for two days in the musculoskeletal part, we tried to tease out Anatomy Train models, but the rest of it was Todd's program. Of course, now everybody knows Anatomy Trains has their own dissection program. So I kind of felt like I came into all this on the ground floor when they were still figuring out what kind of tile to put in the lobby, and, "What style of furniture are we gonna use in the waiting area?" So it was... The opportunities were just ripe and there, and I just ran for every one that came at me.

0:16:33.1 S2: It may seem obvious to look back and see who was going where back then, but in the moment, David was not totally sure. As uncertainty leads to insecurity, impostor syndrome was something he confronted early on.

0:16:47.5 DL: If you're not feeling impostor syndrome, you're probably not trying hard enough, and I really... That sounds really cute and clever, but I honestly mean that. I can remember the first time that I assisted in an Anatomy Trains three-day weekend, and I'm just like, "I have no idea why I'm here. I don't belong here." I'm sitting in the car with Tom Myers and the senior teachers, and I'm just desperate, I'm desperate for something to say. And I'm looking at the license plate in the car in front of us, 'cause we're at a red light and we're in Florida, and I go, "Hey, you know, if you rearrange the letters in Florida, it spells Ida Rolf?"

[laughter]

0:17:30.5 DL: You know, it was like, "Oh, okay. Alright, maybe this isn't gonna suck." You know? [laughter] It's just... Yeah. So, you know, you do one and you start filling in the gaps where you feel less secure in your own knowledge. You watch what other people are doing, you watch how the other assistants are doing, so you see different people and their style applied to teaching the same principles, and that's huge. That's a big, big help. And I think every time you take a big step, you're gonna feel some degree of impostor syndrome. I got involved on the working group stage and also the steering and executive committee for the International Consortium on Manual Therapies, which is a group of massage therapists, structural integrators, chiropractors, physical therapists, and osteopaths. And yeah, I felt over my head, and that was two years ago. But if you don't go into those situations, you never... You're gonna stay at that level that maybe gets the job done, but that you're not comfortable with, that you're not gonna be evolving as quickly as you should. I think impostor syndrome shows you that you're evolving right on schedule. And it's okay to wade into those waters and find out, "You know what? This isn't for me."

0:18:54.0 S2: Learning what his strengths are as they were noticed by those around him brought David to be able to take some of his next steps.

0:19:00.7 DL: One of the teachers that I co-taught with on Anatomy Trains was Carrie Gaynor. And she said to me one time, she's like, "You're really good at telling stories." And I'm thinking, "I am? 'cause there's... I admire storytellers, but my bar is up here. And I'm thinking about the authors in the books you see behind me and different scriptwriters, showrunners and things, those to me are my gods in that realm. I'm not a storyteller. I'm not doing that work." And she's like, "No, you really are." And so I was like, "Oh wait a minute. Okay. I'm gonna take that in. I'm gonna listen to that feedback. So what if instead of being worried about teaching anatomy or physiology or the nervous system, or the thing, what's the story? How do I make the tibialis anterior a main character?" [chuckle]

0:19:54.3 DL: What's their personality? What's their role in the superficial front line? What's the overall plot of the superficial front line? And so I started doing this very story-driven approach, which made me relax with myself in terms of getting the facts right, because then I had a framework that worked for me, where memorizing, becoming facile with those things was easier.

0:20:18.7 S2: David became very good at recognizing the opportunities that may not have come easy, but he didn't give up. Dr. Robert Schleip and perhaps a little karma offered up the perfect scenario.

0:20:29.8 DL: I had met him, he did a workshop that he was one of three major presenters in Texas. I sat down and talked to him for a while about one of his research projects. Did a little video interview with him, and he was putting together this fascia summer school in 2010. And from this I learned, and I would pass this on to anybody listening. If somebody wants to do you a favor, let them. Okay, whatever it is, let them. Take that favor, because you may not get another chance. So for us, it was the middle of the recession. I'm sure a lot of your older listeners will remember this, but basically, my wife had her own business, I was running my own practice, I had just started as an independent contractor at the University Of Pittsburg Medical Center. Financially, it was a very uncertain time, and Robert really wanted me to go to this conference, this week-long conference in Germany, and that was a big ticket ask under those circumstances.

0:21:33.8 DL: And I was really humming and hawing about it and not making this up. I had this one patient at the hospital who was really interested in all this stuff, she actually was... She wrote grants, she wrote grants for medical research. So she wanted to know everything about what we were doing and how it worked and all the parts and pieces, and I told her about this conference. She went on to the conference website and signed me up without my knowledge.

0:22:04.1 S2: Oh my gosh.

0:22:05.6 DL: Oh, by the way, her name, Karma.

0:22:08.4 S2: Oh, no way.

0:22:09.9 DL: Oh yeah, way. Yeah. Her parents were two hippy professor types.

0:22:12.4 S2: Oh my gosh.

0:22:15.7 DL: But anyway, but then she came back and she said, I did this thing, I hope you're not upset with me, but you need to go do this thing. This was like October... This was like September. Robert said be sure you sign up by the end of October, the conference was in April of the next year, and she said, "Here's the bad news, you're number 13 on the waiting list." And I went, "Oh, that's not good." So I wrote to Dr. Schleip this very contrite letter, "I'm so sorry." And he wrote back. "Aren't you, this talented video guy?"

[laughter]

0:22:46.4 DL: And I thought, Well, maybe 'cause, like I said, I made things. So when we went into the cadaver lab with Tom Myers, I asked can I bring my video camera? Great, can I turn it into a little mini-documentary? Great. Any time my brain saw something it wanted to make, I would find a way to try to make it. So I said, "Yeah, I can be." So Robert came back to me about a week later and said, "Look, I can knock a couple hundred bucks off your tuition, but it ensures that you will get in if you'll be willing to videotape the proceedings." So I lugged all my equipment to Germany and my tripods and everything. And again, jumping in over my head, and then I had to get all of the rockstars to sign releases and waivers to video tape them. I took on the duties of editing the footage so that it was comprehensible to the person watching it, which meant putting the slides in in the right places, which meant I had to sit there over and over and over again, because I needed to understand it well enough in order to edit it properly, and that became a regular gig for me for about six or seven years. So that was the deep science dive.

0:24:00.3 S2: David was present, he showed up for his clients for his education and for moments that offered him opportunities. He has since then written a book, which is about to be released in its second edition, how did he even begin this process? David saw a need.

0:24:17.7 DL: So I was accumulating a pretty sizable knowledge base between all of the things that I was doing, particularly video taping all these conferences and editing them and making them available for study, and I was lecturing every chance I could get in the UPMC system, which is a multi-hospital group. So any time I had the opportunity, I was up there, I was doing that thing. My mentor at the hospital, who ran the Department of Family and Community Medicine was an MD and an osteopath, and he was like, "Son, you really need to be writing. You need to be writing this stuff." So he was pushing me in that direction. You may have picked this up already, I am a pathological communicator in all mediums.

0:25:03.2 DL: I had been writing all my life, I enjoy it, and I was aware of a need. So there it was, at the time, there was Anatomy Trains, there was Fascia: The Tensional Network of the Human Body. There was Carla Stecker's book, which had just come out, there were some pretty weighty books out there, and I would be talking to doctors and other professionals in the UPMC system, and I would show them these books and they were like, "Why is everybody obsessed with Dupuytren syndrome? They were looking at these books and they could see that these were pretty high level books, but they still weren't getting it.

0:25:40.8 DL: And at the same time, I'm doing lectures, I'm talking to my patients, I'm talking to other professionals in my department, and I had a knack for talking about this stuff and making it accessible. So I'm like, okay, so the people in medicine aren't quite getting it from the heavy hitters, and they're... On the rank and file level, there's still a lot of confusion, there seems to be a place for what I think of as a pop science book, this professional pop science book. And I always love going all the way back to Carl Sagan in Cosmos. I love those kinds of science books, James Nestor's Breath being a very popular one that I'm sure a lot of your listeners have heard about. That's the next goal. But that's like, "Okay, there needs to be a book like that for fascia. Somewhere between breath and cosmos. And I think I can write that."

0:26:33.8 S2: Having thought about fascia and how to write about it and how to talk about it, I asked David if he had an elevator speech he could offer up.

0:26:42.4 DL: Wow, so my first thought when you say that is... What's nice is I find that I don't need one anymore. It's like it's starting to reach a point where people are actively seeking this approach out and coming to me, saying, "Oh, I read about this and you seem like the guy." But yeah, I learned my elevator pitch from a three-year-old I was treating.

[laughter]

0:27:02.1 S2: Oh, really?

0:27:04.8 DL: Yeah, I did. I did. And he was very... I was lucky to get five to 10 minutes and a half hour actually doing anything useful. But he had a palpable line of tension, and his mother... He had special needs. His mother was wonderful, his brother was really cool. And I was one of a number of people working with this kid. But one of his issues was he was not very verbal given his age. So his mother was out of the room to go use the bathroom, and it was just me and him alone. And I was working on his foot, 'cause his plantar fascia was in the stuck pattern. And I just gave it away. I was working on his plantar fascia, because it was part of his tensional pattern, and he had pulled a blanket over himself.

0:27:54.6 DL: I let him pull a blanket over himself, but his foot's sticking out. I can get my hand on his foot, so I'll work with what I got. And he pulls the blanket up and he looks at me and he says, "Stuck." And I went, "Yeah, stuck." And then I made motions and I went, "Unstuck. Stuck." Pointing at his foot. "Unstuck." And we made that connection in that moment, that he understood what I was doing and he understood that I understood what his problem was. And that became the elevator pitch. Well, first of all, what do you do? I help, is the first two words you should say when somebody asks what you do. Oh, I'm a this therapist, I'm a that therapist, I'm a the other thing. I help people with is a wonderful opening, 'cause then what it is you do becomes secondary; you've got their attention. But my elevator pitch is, "I help people who are stuck." Because there's... When your body breaks and it needs to be fixed orthopedically or with surgery or a joint replacement, and then there's when it's worn out, and that's not good either, but there's that middle place which is stuck, and that's the realm of the fascia.

0:29:05.8 S2: This was one of my favorite stories, and it would be great if we all had a story like this to help us form such clear definitions about what we do. It made me curious though to hear if David had equal amounts of clarity about his favorite and least favorite parts about what we do.

0:29:22.3 DL: Helping people discover things about their bodies, about themselves, or about what they know about those things that they didn't know before.

0:29:34.9 S2: Least favorite?

0:29:36.6 DL: When what I do isn't effective. Yeah, I always wanna have... I try to keep a list of go-to people, but yeah, my least favorite is when what I do doesn't work. 'Cause nobody wants that.

0:29:51.9 S2: David is probably the first to acknowledge that continuing to try to fix all the things and learn all the things is a good goal, but it's not always possible.

0:30:02.2 DL: Yeah, and sometimes what I have isn't what you need, or it's not... And I don't have any problems using the F-word, fix. "It's not fixable using my methods, but here's somebody who might help you get the next piece." And that's another really important thing too for therapists to realize is that it's a continuum. And the person may come in this way and you may reach the end of the line of what you can do for them; that doesn't mean that there isn't further for them to go. And it's fine to release them into the wild and say, "Here's somebody who might help you get that next piece that you need." Or realize that maybe there's somebody who's better at that piece than you are and send them to that person for that piece. 'Cause they'll still remember you as the person who helped them get what they need.

0:30:48.5 S2: There are many of us who want to continue down that continuum. David not only has some sound advice about how to get there, he also has a book that I would highly recommend as a phenomenal point of reference.

0:31:01.7 DL: What's good about the book too is it's designed to give you a good working knowledge, but also gives you all the pointers of where you might wanna go to do deeper dives. So you gotta have both those things. If you wanna learn more about structural integration, I recommend the International Association of Structural Integrators, IASI is their acronym. It's The, T-H-E IASI dot org, I believe. You can put that in the shownotes. But that will tell you the basics, what the schools are, what the webinars are. Anatomy Trains has a lot of good online introductory programs. And if you wanna learn more about fascial anatomy, there are many great books out there. There's also AnatomySCAPES, which is a company run by a dear friend of mine, and I love what they're doing. So you probably got the idea that I always was a bit of a science nerd, and I love books with pictures of the Hubble telescope. These are like pictures of the Hubble telescope inside the body. And they have that same kind of magic and wonder and awe. And every time I spend time with the good people at AnatomySCAPES, I leave a little smarter. And I love that. I have a little more clarity in what I think I know.

0:32:17.9 S2: But if David could go back in time, of course I wanted to know what advice he would offer up to himself as a newbie in the field.

0:32:26.0 DL: It's going to take longer than you think. So be patient.

0:32:30.3 S2: It seems to me that he heard his own advice. David Lesondak is not only immersed in the world of fascia and its role in who we are and what we do, he is also a gifted speaker, writer and educator. His journey is one that inspires the science nerd in all of us, and I hope he never stops doing what he does.

[music]

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