This is a podcast interview excerpt (Ben Greenfield with Sue Hitzmann) focused on connective tissue (fascia) and its role in chronic pain. Ben notes limited coverage of fascia in formal anatomy training; Sue describes discovering that fascia is not passive packing material but an active system—transporting nutrients, hosting cell activity, and responding to movement/compression/tension—after studying layer-by-layer dissection work by Gil Hedley. The exchange reframes connective tissue as central to understanding chronic pain and manual therapy effects.
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I did a master's degree in physiology and biomechanics and even spent time in the anatomy lab dissecting cadavers. But there weren't really any very intensive courses on how fascia work and. That's right, works. And how connective tissue works. So. So what was your method? How'd you learn about this stuff?
Well, that was just it, you know, in every hands on methodology that I had learned from neuromuscular therapy to cranial sacral therapy, visceral manipulation, there was always one common thread was in conversation, which was connective tissue. And using it sort of as a vehicle to alter other systems because the tissue is three dimensional and you can. And it's kind of connected and seamlessly attached to everything. You can actually manipulate organs through fascia. So I was learning things like that. And so there was always a curiosity about it. But I was like you. I had a master's in physiology and anatomy. I had already done dissections. And. And the thing about connective tissue is it's really kind of considered by the general consensus of doctors kind of just a passive packing material. And in the dissections I had done in school, we had basically either we never saw it because the medical students got to the bodies before we did, or you just chuck it in the bucket to get to the good stuff and look at the nerves and the muscles and the bones, so that those were supposedly the important things. And as I started to kind of come up with an understanding of what was it that causes pain to become chronic, had found this research on connective tissue and gaining a better understanding about the fact that connective tissue is not only just the supportive infrastructure of muscles and bones, but is actually the environment that every nerve ending, blood vessel and cell lives in. And when I started seeing it as a system, I found Gil Headley, who did this layer by layer dissection course, and he defined connective tissue as a system. And I said to him, well, it's not a system. I mean, it doesn't have active things going on in it. And he looked at me and goes, why would you say that? I said, it's just a passive packing material. And he looked at me and goes, no, my friend, your entire world is about to change. Because I'm going to tell you something that nobody else has. That connective tissue is in fact an active system. And it's actually where most nutrients are transported. The cells are proliferating, they're reacting and responding to movement and compression and tension every day. And it is in fact an active system, and that literally unraveled a decade and a half of education and schooling behind me.
