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Registration Desk Hours
The Fascia Research Society Presents: Understanding Research Fundamentals for the Congress and Beyond*Workshop Description
Anatomy Consensus in nomenclature - Carla Stecco, MD Description
- It is generally assumed that endings containing SP are nociceptive. This applies also to most of the CGRP-positive fibers, but some are mechanoreceptive. The great majority of the SP and CGRP fibers were located superficially in the fascia. This finding may be of interest to the therapists who use fascia release or similar techniques. Endings exhibiting the TRPV1 molecule in their membrane were likewise found. This receptor molecule is characteristic of nociceptive fibers. One important function of nociceptors is to induce a neurogenic inflammation around the ending. Such a neurogenic inflammation occurs, when in patients with a slipped disc dorsal roots are compressed. Our data show that a neurogenic inflammation can be induced in the TLF. This is clear functional evidence for the existence of nociceptors in the fascia.
- An experimental inflammation of the TLF caused changes in the fascia innervation, but the changes did not occur in all fascia layers alike. In the middle layer – which consists of massive collagen fiber bundles - the fiber density was close to zero for all fiber types. In inflamed fascia, CGRP-positive fibers showed a significant increase in the inner layer. In intact TLF, the nociceptive SP-containing nerve fibers were present exclusively in the outer layer. In inflamed fascia, SP-positive structures were also found in the inner layer. An unexpected finding was that sympathetic fibers did not show an increase, but a significant decrease, in fiber length. The meaning of this decrease is still obscure.
Sensory Aspects of Fascia - Robert Schleip, PhD, MA Description
Functional Anatomy - Can Yücesoy, PhD Description
Effects of scar tissue on force transmission - Peter Huijing, PhD Description
Lunch and Posters/Exhibitors
Concurrent Abstract Presentations
Concurrent Abstract Presentations
In Search Of Our Interior Architectures - Jean Claude Guimberteau, MD Description
The Functional Coupling of the Deep Abdominals and Para Spinal Muscles - Andry Vleeming, PhD Description
Hyaluronan- Preeti Raghavan, MD Description
Objectives or outcomes:
- Comprehensive discussion of the pathophysiology of connective tissue within and around muscles and its contribution to the evolution of spasticity and hypertonia after CNS injury.
- Rationale for emerging therapies that restore normal connective tissue architecture and tissue gliding mechanisms.
- Modality to assess spastic patients for hyaluronidase injection.
- Design an appropriate treatment algorithm.
Extracellular Matrix - Boris Hinz, PhD Description
Embryology and Genetics of Fascia - Mark Schuenke, PhD
Lunch and Posters/Exhibitors
FRC/FRS Interest Group Description
Concurrent Parallel Sessions
- Veterinary Aspects - Vibeke Sødring Elbrønd, PhD and Rikke Mark Schultz, DVM Session Description
- Clinical Studies - Leon Chaitow, ND, DO • César Fernández de las Peñas, PT, PhD • Eric Jacobson, PhD, MPH
- Surgery and Fasciatherapy - Thomas Hausner, MD and Jean Claude Guimberteau, MD Session Description
- Research Studies/Animal Studies – Paul Standley, PhD and James Bishop Session Description
- Philosophical Aspects - Jaap van der Wal, MD, PhD Session Description
Compared to the bipedal human, the quadrupedal domestic animals have quite a different posture, balance, weight distribution, functionality and coordination, which act differently on the fascial system.
Challenges in the daily veterinary work involve diagnostics and treatment of fascial interactions. Several of these are defined and accepted, for decades, as parts of biomechanical models. These veterinary biomechanical models comprise e.g. the bow and string theory developed by Slijper in 1946, the stomatognatic system, the passive/ mechanical stay apparatus, and the hoof mechanism. The two latter applies for ungulates only.
In the veterinary world speaking of fascia automatically directs the focus towards the locomotion system. Limited body regions e.g. the back, the neck and especially the distal part of the limbs have been brought into focus and fascial structures such as tendons, ligaments and synovial sheets have been highlighted. The equine research has gained from a large attention to the extremities in order to understand and treat the structures here because pathology in this region is the most commonly recognized problem in sports horses. Studies have mainly focused on limited tasks e.g. the superficial flexor tendon and often only on the tendon itself and not even on the muscle with/to which it is connected.
Studies of how the research and the biomechanical models can be integrated into a full/whole body functional fascia model have, up to now, been limited. In this session parts of the equine fascia system will be presented and related to the generally accepted veterinary biomechanical models. Additionally recently published studies of the full/whole body equine myofascial kinetic lines, results of specific equine dissections, provisional and detailed histological descriptions of the equine fascia as well as bioimpedance studies of the effect of manual and mechanical fascia manipulations will be presented and discussed. The studies were performed at University of Copenhagen, Vet. Faculty in collaboration with internal and external veterinary colleges R.M.Schultz, (DVM), T. Due, (DVM), A.P. Harrison, (Ass. Prof.,Ph. D. Scient), M. J. Krasnodebska, (master student of animal science).
More detailed studies of fascia morphology, topography and integrity in conjunction with the already present and accepted models will improve the overview of the full/whole body fascia system in animals. These can lead to better diagnostics and thereby treatment of patients with both somatic and visceral problems.Hide Description
1. Leon Chaitow - What evidence of efficacy can we gather from clinical studies relative to fascia-focused modalities?
2. Cesar Fernandez de las Penas - Efficacy of various fascia related therapeutic interventions in relation to the extremities.
3. Eric Jacobson will present on his recent study involving Structural Integration and nonspecific chronic low back pain.
4. Cesar Fernandez de las Penas will present on his recent study that compared myofascial release versus surgery, in treatment of carpal tunnel syndrome.
Two different professions at the service of human living matter.
These two non-allopathic therapeutic methods, often considered to be in opposition to each other, are in fact underpinned by the same uncertainty of action because they both come into direct contact with living matter without the intermediary of drugs.
Surgery, through direct observation and the recording of images is currently the scientific approach most able to explain what fasciatherapists feel when they are working with living tissue. Films of living tissue help to provide an explanation for sensations which manual therapists find difficult to describe. Visual images of the mobilization of living tissue and of specific techniques such as stretching and petrissage of the soft tissues are a precious aid in the search for a biomechanical explanation for the action of these techniques. The effect of the techniques on groups of cells is clearly visible and this indicates areas where further research is needed to investigate changes in cell protein production which might result from the dynamic constraint imposed on the tissues by manual therapy.
Fasciatherapy introduces the surgeon to a method of treatment that is at first disconcerting, but gradually becomes more understandable through the visual evidence of the effects of these techniques on living tissue.
The non-linear organization of living tissue and the observation that it appears to obey laws which have more in common with Quantum than Newtonian physics permits us to attempt a broader explanation of its behaviour, and to move away from the tutelage of dogmatic rationalism.
Evidence Based Medicine, which relies on research findings to influence decision making in patient care must now accept the evidence of the apparent chaotic organization and random character (behaviour?) of the microanatomy of living matter.Hide Description
In this session Dr. Standley will review how various manual treatments are modeled in vitro using bioengineered human tissues resembling fascia and tendons. In particular, proof of concept data will highlight optimal dosing of manual treatments by exploring tissue strain directions, frequencies, magnitudes and durations. Various effects of strained fibroblasts will be explained including those related to wound healing as well as myoblast-to-myotube differentiation, a key process in muscle repair and regeneration. This session will offer a translational perspective on current basic research relevant to manual and movement-based therapies.Hide Description
New concepts about function and architecture of fascia have come up. Questions like Is the Muscular, Connective Tissue, Skeletal System (MCS) a Tensegrity System?, reveal the need for a new framework of definitions and notions that might replace the outdated anatomical analytical approach of the fascia in which it is dissipated into various separate elements (of the so-called musculoskeletal system, of the visceral organization, of the general body fascia and so on). There is a need for an overall concept of the fascia as organ or system. Moreover there is the quote by AT Still mentioning the fascia as the domain “where soul is dwelling”. In this lecture a reevaluation of the concept of fascia will be tried, based upon a phenomenological approach. Departing from a functional approach of the embryonic germ layers and the meso(-derm) in particular the fascia will be introduced as The Inner Tissue or The Organ of Innerness. A more organic or holistic concept on fascia as the matrix organ will be presented.Hide Description
Posters / Exhibitors
Observation, assessment & evaluation of fascial dysfunction
- Micro - Julie Ann Day, P.T. and César Fernández de las Peñas, PT, PhD Description
Julie Ann Day - The functional assessment of fascial dysfunction based on Fascial Manipulation® methodology As knowledge concerning the human fascial system evolves, clinicians are encouraged to adopt models for the interpretation of fascial dysfunction that incorporate evidence-based information.
The Fascial Manipulation® (FM) method for musculoskeletal and internal fasciae dysfunction is based on a theoretical model for the human fascial system. Developed through systematic clinical observation and fascial anatomy studies, this model is subject to on-going investigation and modification via cadaver dissections, histological, biomechanical and clinical studies. Clinicians refer to this model throughout the assessment procedure and the application of the FM method.
Using short videos and references to available evidence, this presentation will outline the FM assessment procedure, which includes history taking, the formulation of a hypothesis regarding dysfunction and possible compensatory mechanisms, movement and palpatory tests and post-treatment outcome evaluation.
César Fernández - Manual assessment of fascial tissue for application of myofascial release Myofascial Release methods focus on addressing fascial dysfunction, which presupposes that fascial dysfunction can be assessed clinically. The question arises as to whether it is possible to differentiate fascial dysfunction from - for example - muscular or neural problems? How accurate and reliable is manual assessment of fascia?This presentation offers clinical and evidence-informed data regarding manual assessment in relation to ultrasound imaging and cadaver correlations, in the context of myofascial release (induction) methodology. Hide Description
Outcome studies offer us evidence of the clinical usefulness of particular fascia-directed modalities. Evidence will be presented based on evaluation of available evidence relating to mechanisms associated with those modalities where such efficacy is strongly suggested, including compression, torsion, shear-force, vibration, and isometric/isotonic stretching. Human, animal and in vitro studies suggest that mechanisms include a variety of processes, possibly involving fluid-dynamics, neurophysiological, biomechanical, biochemical and other effects. Evidence relating to the influence of dosage (degree of load, frequency etc) in respect of particular fascia-related modalities, will also be presented. It is suggested that detailing what is not yet known in relation to therapeutic mechanisms is potentially as important as what is known. Is it all about the interfaces? Updates from the lab. The specific pathophysiological processes leading to pain and dysfunction remain elusive, as do effects of many manual therapy treatments. Fibrosis formed within and between structures has been associated with pain and dysfunction. Our recent findings demonstrate preventive effects of manual therapies on the fibrosis associated with repetitive motion disorders and post-operative adhesions. Using these and other findings as support, a hypothesis will be presented that fibrosis between structures may be a key pathophysiological process in these and other disorders, rather than pathology in any specific structure. Hide Description
- Macro - Serge Gracovetsky, PhD
Lunch and Posters/Exhibitors
Future Directions in Fascia Research - Tom Findley, MD, PhD Description
- Kwong, E. H., & Findley, T. W. (2014). Fascia-Current knowledge and future directions in physiatry: Narrative review. Journal of rehabilitation research and development, 51(6), 875-884.
- Findley TW. Shalwala M. (2013). Fascia Research Congress Evidence from the 100 year perspective of Andrew Taylor Still. J Bodyw Mov Ther 17(3):356-64, 2013 Jul.
- Chaudhry, H., Bukiet, B., Ji, Z., Stecco, A., & Findley, T. W. (2014). Deformations Experienced in the Human Skin, Adipose Tissue, and Fascia in Osteopathic Manipulative Medicine. JAOA: Journal of the American Osteopathic Association, 114(10), 780-787.
- Findley, T., Chaudhry, H., & Dhar, S. (2014). Transmission of muscle force to fascia during exercise. J Bodyw Mov Ther. In press
Post Conference Parallel Presentations*
- Manual Therapies - Leon Chaitow, ND, DO and César Fernández de las Peñas, PT, PhD Description
- Myofascial Release/Induction variations,
- Muscle Energy Techniques and eccentric and pulsed variations,
- Neuromuscular Techniques,
- Positional Release methods,
- Connective tissue manipulation, and others, time permitting.
- Fascial treatment of Myofascial scars - Raul Martinez Rodrigues, DO PT
- Fascial Manipulation® - Julie Ann Day, PT
- Fascial treatment for nerve tissues - Cesar de las Penas, PhD PT DO
- Muscle Energy Technique (isolytic and slow eccentric variations) - Leon Chaitow, DO
- Myofascial release (Induction) - Andrjez Pilat, PhD
- Structural Integration version of MFR - Tom Myers, LMT
- Counterstrain positional release - Leon Chaitow, DO
- Q&A - all presenters
- Tool Assisted Therapies - Roptrotherapy: Andre Farasyn, PhD, PT, DO and Instrument Assisted Soft Tissue Mobilization (IASTM): Warren Hammer, DC, MS, DABCO Description
- Visceral Manipulation – Peter Schwind, PhD, MA and Carla Stecco, MD Description
- Fascia in Sports and Movement Therapies - Robert Schleip, PhD, MA • Paul Grilley, PhD, MA • Stephen Gangemi, DC • Klaus Eder • Bernie Clark Description
- Stephen Gangemi: Natural Movement: Moving our bodies the way they're designed to move
- Paul Grilley: Yoga, fascia and meridians
- Bernie Clark: What stops me? The role of connective tissue and human variation on range of motion
- Robert Schleip: Principles of a fascia oriented training approach
- Klaus Eder: Fascia oriented support for world champion soccer players
- Ultrasonography and Ultrasound Elastography - Jouko Heiskanen, MD, Pt and Wolfgang Bauermeister, MD, PhD Description
- theoretic base: how valid and reliable is ultrasound as an assessment tool in fascial evaluation?
- practice: an objective assessment for normal myofascial anatomy, its thickness, consistency, as well as facial connections to bones, tendons and ligaments and
- applying: dynamic, functionally applied sonopalpation for structures and movement patterns of myofascial system.
- free fascia: in lying, sitting and standing, breathing, relaxation (transmitting force and load),
- active fascia: effects of local/global muscles, inhibition, kinetic chain, fascial lines, standing/walking
- modified fascia: light/heavy pressure, stretching, taping, massage
- education: technique portion how to use ultrasound in teaching
- Current research: Theory, Shear wave, vibrational and compression Elastography, Shockwave therapy and their effect on fascia and muscle
- Practical application: Clinical Elastography for imaging the different parts of the Anatomy Trains detecting mTrPs in the fascia and muscle
- Findings: Putting the results together, relating them to muscle imbalance and pain threshold measurements
- Treatment effects: Elastography shows the immediate effects of any therapeutic intervention. The effects of manual techniques, percussion massage and Frequeny Specific Microcurrent will be demonstrated.
Detailed demonstration of methods of major fascia-directed manual approaches, with interactive discussion.
The workshop will include Video + Practical Demonstrations of:
Both doctors will discuss the rationale behind the use of these instruments, including the differentiation between fascial densification and scar tissue/fibrosis. They will demonstrate the use of specific instrument soft tissue methods for a variety of soft tissue injuries. This will include nonspecific low back pain, tension headaches and extremity lesions, including iliotibial band syndrome, rotator cuff, Achilles tendinosis and generally any myofascial condition that responds to this specialized type of mechanical load.Hide Description
During the workshop a new way to organize the inner fasciae will be presented, based on the results of several anatomical dissections. In addition, their relationship with the muscular fasciae will be investigated, to understand how the various manual techniques can affect the function of an organ. Furthermore, the internal fasciae’s anatomy is always seen in correlation with the physiology, and in particular the close relationship with intra and extramural ganglia and plexus is emphasized. This new integrated vision between internal fasciae and autonomic nervous system allows us to better comprehend the internal fasciae’s function and it provides a key of interpretation to see how to approach them from a therapeutic point of view.
During the practical part of our workshop Peter Schwind will demonstrate techniques of visceral manipulation, based on the concepts of Jean-Pierre Barral D.O. (UK). Special emphasis will be given to various modalities of treating the kidneys within the context of the fascia of the psoas and the supporting fat of the kidneys and the arterial supply of the organ. Then, Carla Stecco also will demonstrate the Fascial Manipulation approach for the same problem. In this way the participants can appreciate the analogies and the differences between the two techniques.Hide Description
How do sports, exercise and daily movements influence the remodeling of fascial tissues? How can movement related overload syndromes be best treated and prevented? What scientific evidence as well as practical innovations are most relevant in the fields of yoga therapy, foam rolling, athletic performance, stretching and sports rehab?
Several informative presentations, mixed with brief practical instructions, will open this intriguing new field of inquiry, with space for audience participation and discussion in order to foster networking, curious questioning, and new creative ideas among all involved:
A. Jouko Heiskanen, MD, Pt
In this dynamic ultrasonography workshop we visualize the structures of fascias, movements of its layers in relations to muscles as they occur in real time. This sonopalpation workshop has three goals:
Diagnostic ultrasound has been used by radiologists within radiology departments as a diagnostic tool for decades. Musculoskeletal therapists have used ultrasound imaging (ultrasonography, sonopalpation) as a part of muscle assessment and “biofeedback” in therapeutic exercise and in facilitation of patient’s optimal motor learning. This dynamic ultrasonography workshop applies a review to:
The clinical aspect of this workshop is to visualize the continuous interplay of articular, myofascial, neural, visceral systems in healthy body for manual therapists, masseurs, doctors, athletes and scientists Combined with manual palpation it creates a more realistic conception of the fascial system. This ultrasonography could be a new way to improve teaching results in functional anatomy in various professions. Characteristics of adhesion and other pathologies are important but not the main focus in this instruction. In this workshop we work in small groups so that everyone act as an ultrasound researcher and will be investigated by the colleagues.
B. Wolfgang Bauermeister, MD, PhD - Ultrasound Elastography: Anatomy Trains Assessment of the elastic properties of fascia and muscle related to myofascial trigger points
Myofascial Pain caused by trigger points in the fascia and the muscles is mostly not considered because it is difficult to objectively prove the existence of myofascial trigger points (mTrPs). Their related patterns like the Anatomy Trains as perceived by Thomas Myers in the late 1990’s are based on structural connections. Stiffness of fascia and muscle can be palpated and measured to a certain extent, but it cannot be visualized by conventional means like MRI or conventional ultrasound. Ultrasound Elastography has emerged as a tool not only in research but in everyday practice too for the imaging of the Anatomy Trains and the underlying pathophysiology such as mTrPs and fibrosis.
The participants will learn to perform the Elastography exam, to interpret the findings and incorporate them into a therapeutic strategy.Hide Description
Please note that while speakers and topics were confirmed at the time of publishing, circumstances beyond the control of the organizers may necessitate substitutions, alterations or cancellations of the speakers and/or topics. As such, the Fourth International Fascia Research Congress reserves the right to alter or modify the advertised speakers and/or topics if necessary without any liability to you whatsoever. Any substitutions or alterations will be updated on our web page as soon as possible.