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Interview with Dr. Jean Claude Guimberteau

Interview with Dr. Jean Claude Guimberteau

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Published by Terra Rosa
eMagazine for Massage and Bodywork Therapies
eMagazine for Massage and Bodywork Therapies

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Published by: Terra Rosa on Apr 03, 2011
Copyright:Attribution Non-commercial


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Terra Rosa e-magazine, No. 7 (March 2011)
Dr. Jean-Claude Guimberteau is a hand surgeon and theauthor of the famous film
Strolling Under the Skin
. The filmshows for the first time the most fascinating images of livingfascia. Using a special camera, Dr. Guimberteau showed thatthere is a unique architectural system in human and that thetissue continuity is global. He believes that sharing thesediscoveries will incite people to get into this scientific worldexploring living matter organization. His work become wellknown in bodywork when his film was shown in The FirstFascia Congress in Boston in 2007. He then realised a sequel
Skin Excursion
at the 2
Fascia Congress in Amsterdam2009, and his 3
Muscle Attitudes
at the 7
Interdisci-plinary World Congress on Low Back & Pelvic Pain in LA 2010. Now, we have a privilege to interview him for TerraRosa e-mag.
Dr. Guimberteau, your work has provided bril-liant images of living connective tissues that wehaven't seen before, and inspired many of man-ual therapists who are closely working with theskin and manipulating connective tissues.What led you to the discovery and study of thearchitecture of the connective tissue. Can yougive us a background?
I was seeking a technical procedure to reconstructflexor tendons, when I came upon the sliding systemthat I termed the MVCAS (Multimicrovacuolar Colla-genic Absorbing System). I first used a microscope tounderstand how it was working.This tissue, which neatly ensures the efficacy of glidingstructures and their independence, is composed of anetwork of collagen fibrils whose distribution seems tobe totally disorganized and apparently illogical at a firstsight. This impressed me because my Cartesian mindcould not come to terms with the idea of chaos and effi-ciency co-exists perfectly. This was the starting pointfor an intellectual voyage that took me far from thebeaten track and off into the largely unknown world of fractals and chaos.
* Note: Fractal is a geometric pattern that is repeated at every scale. If you zoom in on a fractal pattern it will looksimilar or exactly like the original shape. This property iscalled self-similarity.Chaos in mathematics is "the irregular, unpredictable be-havior of deterministic, non-linear dynamical systems" which is used to describe objects that are apparently disor-dered, however there is an underlying order in apparentlyrandom pattern.
How do you start making film of live connectivetissues? Why this is not done previously?
First we start taking pictures during surgical tendonreconstructive procedures. The photos were taken dur-ing a planned surgery, thus there is a time limit of 30
An IntervieAn IntervieAn InterviewithwithwithDr. JeanDr. JeanDr. Jean---ClaudeClaudeClaudeGuimberteauGuimberteauGuimberteau 
Pictures taken from Strolling under the Skin, courtesy of Endovivo.
Terra Rosa e-magazine, No. 7 (March 2011)
minutes so that the surgical team were not disturbedduring their work. Surgeries were performed either witha garrot (a stick used for tightening a bandage, in orderto compress the arteries of a limb), which allows ratherdull observation in terms of colour, or without a garrotwhich gives more lively images but is disturbed by bloodextravasation (leakage). Then after, we extend to skinflaps and abdominal surgeries.I don’t know why this has not been done previously butsome of my experiences can explain that. For many years, I have performed microsurgery transplants and Ihave used microscope very often. Moreover, surgery isperformed without bleeding using a tourniquet, so theobservation is easier, and finally I love to understandthe processes that have been going on.
What are the challenges in making these pic-tures using endoscopic camera?
The main challenge is to understand how tendon andskin are sliding, but also all these fascinating imageshave to be shared. They look so beautiful with their aes-thetics, colours, varied and sparse shapes. Sharing themseems to be a good way to arouse the interest of peopletoday.
What is the scale (magnification) we are lookingat?
Generally magnification is 25 times.
In ‘Strolling Under the Skin’, you described theSliding system and architecture of the connec-tive tissue that looks chaotic in organisationcomposed of microvacuoles that are able toadapt itself to various stress. Can you briefly describe about this microvacuole form?
All the tissues observed were developed within theframework of multifibrillar architectures and resultingfrom the intertwining of fibrils : there are the mi-crovacuoles which in fact are intra fibrillar micro vol-ume, and which are the basic elements combining apolyhedral fibrillar frame enclosing multiple microvacuolar spaces of varying sizes between 10
m and 100
m, with a gel inside.
* Note: 1
m or micro meter is a millionth of a meter.
These microfibrils have a diameter of about ten totwenty microns and are made up predominantly of col-lagen type I and III. By intertwining, in an irregularfractal manner, they determine the volume of the micro-vacuole, which is filled with a glycosaminoglycan gel. By accumulation and superposition, these multi micro-vacuolar polyhedral patterns will build an elaborateform.
In ‘Muscle Attitudes’, you proposed that there isa global tissue continuity around or inside themuscle. Can you tell us the implication of this.
The essential implications of these microsopic and en-doscopic observations are the fibrillar continuity. Thereis no break in the tissue continuity, be it within muscle,tendons, or around the arterial and venous structuresand the structures surrounding the adipocytes. All thesestructures are formed in the same manner and are con-tinuous.We have discovered the same continuity of tissue withinthe sub-cutaneous tissue in
Strolling Under the Skin
,the epidermis and dermis and the muscles. The conceptof the organisation of living matter into stratified layers,hierarchical layers of sheaths, lamellae and strata can-not satisfy an anatomist who studies precise, endo-scopic, functional anatomy. Even though they may be of different colours, textures and shapes, they are all
Interview with Dr. Guimberteau
Pictures taken from Muscle Attitudes, courtesy of Endovivo.

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