Jane Sato thought she understood the abdominal muscles. For the first decade that she taught Pilates and yoga in New York City, she would tell her students to pull their belly button into their spine to strengthen their core.
But when she saw what actual abdominal muscles looked like during a human cadaver dissection workshop at Mount Sinai Hospital โ the crisscrossed layers of tissue, the way the muscles also ran back to front and up and down โ she realized her words werenโt nearly as instructive as they could be.
โThereโs just a lot more to the picture,โ she said. โWhen you see it in real life, your cues automatically change.โ
Now, instead of telling clients to suck in their belly button, she tells them to draw in all their core muscles, โlike a hug.โ
Ms. Sato is one of thousands of fitness professionals who have sought out cadaver workshops to better understand anatomy and improve their teaching skills. Over the past two decades, at least a dozen dissection courses โ most outside the traditional medical system โ have popped up, catering to people like yoga teachers, massage therapists and Peloton trainers.
While most of these professions require some anatomy training to become certified, it can vary widely and usually relies on two-dimensional pictures, plastic models and even anatomy coloring books, which can create a misleading picture of how the body works.
โThey are looking for more information,โ said Rachele Pojednic, the director of exercise science at Norwich University and a research associate at Harvardโs Institute of Lifestyle Medicine. But often, she added, โthey donโt know who to go to.โ Why not โarm these professionals with as much knowledge as possible?โ
Two students and a lab assistant examining a knee joint during a dissection course. For many fitness professionals, such classes are a way to better understand the human body.Jesse Barber for The New York Times
Fauna Moore said that studying the bones and muscles of cadavers informs the way she thinks about how to manipulate whatโs under the skin of her clients, as shown here in her studio.Jesse Barber for The New York Times
A visceral experience
Experts say you canโt fully understand the value of a dissection until you participate in one. So on a sunny Saturday in October, fueled partly by morbid curiosity, I went to a lab called Experience Anatomy, in an office park near the Charlotte, N.C., airport. I was both excited and nervous, and keenly aware that I might not be able to unsee what I observed.
The two-day dissection was led by Fauna Moore, an Ashtanga yoga instructor and massage therapist who began attending, studying and then teaching dissections after being disappointed with the anatomy instruction she received during training. (One does not need a special certification to oversee a cadaver dissection, though she has spent years shadowing experienced dissectors.)
After a short orientation, the courseโs five students gathered around the cadaver, scalpels in hand. While some courses for fitness professionals teach with bodies (or body parts) that have already been dissected, in this workshop the students would be dissecting a full cadaver themselves. In all cases, the donors or next of kin have specifically donated the body to scientific learning โ though they donโt always know whether it will be used to teach medical students, physical therapists or yoga instructors.
As the group stood in silence under the glare of fluorescent lights, Ms. Moore removed a white sheet covering the body. Dissecting a human being can be an emotional and jarring experience, she said, so she suggested that the students give the cadaver, a 75-year-old female, a name, in recognition of her humanity.
The group decided on โBetty.โ
New technologies, such as three-dimensional virtual software, have made the human body easier to study โ and, some argue, rendered cadavers unnecessary. But medical students still say that seeing, touching and holding real human tissue is far more instructive than pictures or models. And it leads to better, more compassionate care, said Jeffrey Laitman, who has helmed Mount Sinaiโs anatomy lab for more than 40 years.
โItโs an enormously humbling experience,โ he said. โWhen you hold a heart in your hand, you are never the same again.โ
In the dissection room, Ms. Moore demonstrated how to properly hold a scalpel (โlike a penโ). Then she made the first cut, on the upper thigh, showing how to delicately pull back one layer at a time โ first the skin, then the sticky white fascia, then the bright yellow fat and so on. The body had been โsoft embalmed,โ a technique that relies on very little formaldehyde, preserves colors and textures and, I quickly learned, makes things very messy.
โI donโt know where to start,โ one student, a massage therapist, said.
โYou canโt mess it up,โ Ms. Moore replied. โEven if you go a little bit too deep, you can start over somewhere else.โ
A new perspective on the body
For people who lay hands on clients โ like massage therapists and Pilates, yoga or strength trainers โ touching actual tissue offers unparalleled learning, said Dr. Carrie McCulloch, a physician and Pilates instructor who co-founded the Mount Sinai dissection course in 2006 with her husband, a Pilates instructor and former dancer named Matt McCulloch, as well as Dr. Laitman.
โThey are working with real human bodies,โ Dr. McCulloch said, โand they should learn from real human bodies, too.โ
A more experienced dissector working on a cadaver while a student looks on. Classes like this are not cheap, but many fitness professionals say they see it as a mark of commitment to their profession.Jesse Barber for The New York Times
Ms. Moore with a client in her studio. After taking her first dissection workshop, she spent years shadowing other experts before leading her own classes. โIt just blew the doors off my world,โ she said.Jesse Barber for The New York Times
Courses range from about $1200 for a weekend workshop to $4500 or more for a six-day program. Anna Kaiser, who owns two popular cardio dance studios in New York and attended the Mount Sinai course in 2012, said the class made her feel better equipped to help certain postpartum clients.
Ms. Kaiser was able to study a donor body that had undergone a C-section and was struck by just how many layers of abdominal muscle were severed. This deepened her appreciation for the seriousness of the recovery, as well as for the work needed to rebuild core strength, layer by layer.
Now, โI can visualize what that looks like,โ she said. โItโs very different than seeing a picture in a book.โ
Back at the dissection table, the students had begun to reach muscle. โItโs so much more delicate than I imagined,โ one commented, pulling apart the four long strands that made up the quadriceps.
In contrast, they noted the toughness of the fascia, or connective tissue, that surrounds every muscle. โItโs very flexible but very durable,โ one student said. โYou have to put a little pressure on your scalpel.โ
One student handed me the iliotibial (or IT) band, which ran from Bettyโs hip to her knee and felt strong but surprisingly light and thin, almost like duct tape. For all the years I aggressively foam rolled mine, I pictured it as thicker and knottier. I made a mental note to go easier.
The case for cadavers
Over the past twenty years, as research around the health benefits of exercise has expanded, more and more primary care doctors are recommending exercise to their patients, according to the National Center for Health Statistics. As a result, many fitness professionals now find themselves working with clients who have complex conditions, from knee replacements to high blood pressure.
โHealth, fitness, treatment, doctors are part of a continuum,โ Dr. Laitman said. โFitness professionals โ they see people ofttimes before theyโll go to a doctor.โ
Sometimes, after taking a dissection course, โinstructors realize that some of the choices they were making for their clients were not well enough informed,โ said Mr. McCulloch, who has co-written books about anatomy. For example, some students, after seeing the bones of cadavers with osteoporosis, realized that the bends and twists in their workouts may be too aggressive for a clientโs fragile body.
Natasha Standley, a massage therapist and former step aerobics instructor in Ms. Mooreโs course, told me later that she learned what is โ and isnโt โ in her hands when she works with clients.
โSome of the muscles are really, really deep,โ she said. The dissection made it clear that the psoas and quadratus lumborum (QL) muscles, which can cause back, pelvis and hip pain, arenโt accessible, despite what diagrams might suggest. Instead of trying to reach them through massage, she said, she plans to incorporate more stretching into her work.
After the students finished lunch (most opted for vegetarian), they returned to their posts at the dissection table. Ms. Moore and a lab assistant had flipped Betty over and put on music to reinvigorate the group. As R.E.M.โs โLosing My Religionโ began playing through an overhead speaker, everyone picked up their scalpels.
The day went smoothly, but afterward I felt shaken. When I arrived at the airport that night, I didnโt see travelers โ I saw walking cadavers.
But as time has passed, I have come to appreciate the intricacy and interconnectedness of every muscle, tendon and bone. Spending time with a body that will never move again gave me a new appreciation for my own bodyโs ability to move. When I got home, I couldnโt wait to go for a run.
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