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Interview with Japanese publisher of “Fascial Dysfunction”

I heard today that the Japanese rights of Fascial Dysfunction  have been sold to :

IDO-NO-NIPPON-SHA, INC.

A few months ago a brief interview with this company was published in Japanese – see facsimile of it below the English version.

レオン・チャイトーD. O. に聞く

海外における筋膜研究

This is the English version:

  1. As you wrote in the preface of “Fascia: The Tensional Network of the Human Body” (Elsevier 2012) the International Fascia Research Congress (FRC) has been held since 2007, and the 4th FRC will be held in Washington DC, in 2015.

Could you tell us the how and why the congress started? What kind of latest researches will be presented in the conference?

In 2005 a small group of researchers, together with practitioners with backgrounds in Osteopathy, Massage and Structural Integration (Rolfing), began to organize the first International Fascia Research Congress, to bring together scientists, anatomists and clinicians, from different backgrounds, with a common interest in the connective tissues of the body. A primary hope was that scientists doing basic research might be able to explain their findings in ways that could offer clinically significant information for clinicians. Simultaneously it was hoped that the congress would provide a forum in which practitioners could explain their clinical work in order to stimulate scientists to investigate the mechanisms associated with the methods being used in practice.

To the surprise of the organizers of the 1st Congress (Harvard Medical School, Boston, 2007) almost all the invited scientists agreed to participate, and the event was a major success, with approximately 700 delegates attending, the majority being practitioners, from a wide range of disciplines. This event stimulated a great deal of new research and publication of numerous clinical articles, a process boosted by the 2nd Fascia Congress (Amsterdam 2009), and the 3rd (Vancouver 2012) – with the next one due in Washington DC in September of this year. http://www.fasciacongress.org/2015/

PHOTOGRAPH AT VANCOUVER 3rd FASCIA CONGRESS – myself with Gil Hedley and Carla Stecco

It is impossible to adequately summarize all the remarkable information that has emerged from these conferences – and the list below offers only a brief glimpse.

Fascia:

  • binds, packs, protects, envelopes and separates tissues
  • invests & connects structures, providing scaffolding and – when healthy – permits and enhances the transmission of forces – load transfer
  • has major sensory functions, from the microscopic level (e.g. cell to cell communication) to large fascial sheets such as the thoracolumbar fascia (TLF)
  • assists fascia’s sliding and gliding functions, aided in this process by hyaluronic acid, the importance of which has become clearer thanks to research which has also shown how some manual methods can stimulate production of this lubricant. (Okamoto et al 2014)
  • allows energy-storage – acting in a spring-like manner via large tendons and aponeuroses
  • is involved in fluid dynamics that influence both the stiffness of connective tissue as well as pain, edema and the effects of inflammation (Reed et al 2010)
  • supports the multiple functions of the connective tissue matrix, combining strength and elasticity – biotensegrity – a word that describes ways in which the architecture of connective tissue cells – such as fibroblasts – respond to different degrees and forms of mechanical load leading to rapid modification of chemical behavior and physiological adaptation – including gene expression and inflammatory responses. In Vitro studies modeling manual therapies such as Myofascial Release, and Counterstrain, have demonstrated the clinical relevance of mechanotransduction effects (Meltzer et al 2010, Hicks et al 2012)

In addition:

  • Proprioceptive and interoceptive mechanoreceptors in fascia monitor joint position, tendon load, ligament tension, fascial status, as well as muscle-tone and contraction.
  • Some researchers suggest that the fascial pathways are the likely physical manifestation of acupuncture meridians (Langivan 2002)
  • Imaging methods such as elastography and ultrasound are now able to demonstrate fascial changes before, during and after treatment.

….and much much more

  1. What are the main effects of the fascial approach?

A greater understanding of how fascia’s roles in the economy of the body has resulted from research such as that listed above.

For example, it is important to recognize that any interference with the sliding function of fascia is a potential cause of pain and dysfunction – and to know how to identify, modify and correct this, when it is reduced or lost.

It is also important to be able to evaluate possible influences on local symptoms – for example how excessive load reaching one area – say gluteus maximus (possibly due to thoracolumbar dysfunction) can place extraordinary stresses on the knee – because of fascial load transfer. (Stecco et al 2013)

The vital element of dosages of applied load (compression, stretch etc) is now better understood as a result of laboratory studies into the effects of mechanical changes in the architecture of cells. How much ‘load’, how strongly, for how long, in which direction(s) – all lead to different physiological effects?

There are of course also neurophysiological responses that will differ depending on whether load applied to fascia is light, repetitive, heavy, prolonged, brief etc etc – and research is making this more understandable. (Cao et al 2015)

How and why different forms of manual and exercise therapy produce their fascial effects is also becoming clearer, as scientists explore the work of manual therapists. For example we are also learning a great deal more about scar and adhesion formation and how to manage – and sometimes prevent – these processes. (Bove 2012)

Space does not allow a full response to this question – but these examples should hindicate the importance of understanding the vital role of this much-neglected tissue!

  1. Could you tell us the main fascial techniques? Thanks to your books and DVDs, muscle energy techniques and positional release techniques are well known in Japan. Could you recommend any other techniques?

Both MET and PRT involve fascial influences. A few other approaches are listed here:

  • Myofascial release: low-load acyclic long-duration stretch assists in injury repair and myotube development (Hicks et al 2012)
  • Frictional Myofascial technique: increases production of hyaluronic acid (Okamoto et al 2014)
  • Connective tissue manipulation: Methods including strong frictional strokes or ‘skin-rolling’ produce a wide range of neurophysiological effects, as well as modifying dermal collagen distribution and microcirculation. (Pohl 2010)
  • Fascial Manipulation®: A complex assessment protocol has been developed for FM® that helps to pinpoint major fascial coordinating areas, which are treated by deep frictional compression for several minutes. (Pavan et al 2014)
  • Eccentric isotonic stretching (MET variant): has been successfully used to prevent adhesions;when used rapidly, or slowly, this has different influences on range of motion and pain following surgery for fracture or joint replacement (Parmar et al 2011)

a manual approach to treatment of scar tissue  

  1. How do you think the fascial approach will be developed or evolved?

I believe that the stimulus from the fascia Congresses, as well as the development of the Fascia Research Society https://fasciaresearchsociety.org/ will help to improve our understanding of fascial involvement in a wide range of assessment and manual approaches used in physiotherapy, osteopathy, chiropractic, massage etc – and that this should improve clinical outcomes.

We are learning more about the mechanisms of what we do therapeutically, and how to translate science into practice, so refining our skills.

The Journal of Bodywork & Movement Therapies that I edit – which is offered as a benefit to all members of the Fascia Research Society, and which sponsors the Fascia Congresses, has a dedicated fascia Science and Clinical Practice section that promotes these trends. http://www.journals.elsevier.com/journal-of-bodywork-and-movement-therapies/

There are also a great many new books on the subject – including Fascia: The Tensional Network of the Human Body (Schleip et al 2012, Elsevier) and my new Fascial Dysfunction (Handspring 2014) that are helping to expand a worldwide interest in this long neglected tissue that is so intimately connected to all other structures of the body.

Fascia cover

 

REFERENCES

  • Bove G Chapelle S 2012 Visceral mobilization can lyse and prevent peritoneal adhesions in a rat model. Journal of Bodywork & Movement Therapies 16(1):68-­72
  • Cao T et al 2015 Duration and Magnitude of Myofascial Release in 3Dimensional Bioengineered Tendons: Effects on Wound Healing. JNL. American Osteopathic Association. 115(2):72-82
  • Hicks M et al 2012 Mechanical strain applied to human fibroblasts differentially regulates skeletal myoblast differentiation. J. Appl. Physiol.113(3):465-472
  • Langevin H Yandow J 2002 Relationship of Acupuncture Points and Meridians to Connective Tissue Planes. THE ANATOMICAL RECORD (NEW ANAT.) 269:257–265
  • Meltzer K et al 2010 In vitro modeling of repetitive motion injury and myofascial release. J. Bodyw. Mov. Ther. 14(2):162-171
  • Okamoto T et al 2014 Acute Effects of Self‐Myofascial Release Using a Foam Roller on Arterial Function. Jnl. Strength & Conditioning Research.28(1):69‐73
  • Parmar S et al 2011 Effect of isolytic contraction and passive manual stretching on pain and knee range of motion after hip surgery. Hong Kong Physiotherapy Journal 29:25-30
  • Pavan P et al 2014 Painful connections: densification versus fibrosis of fascia. Curr Pain Headache Rep. 18(8):441
  • Pohl L Changes in structure of collagen distribution in skin caused by manual technique. JBMT 14(1):27-34
  • Reed R et al 2010 Edema and fluid dynamics in connec/ve /ssue remodelling. J Mol Cell Cardiol. 48(3):518–523
  • Stecco A et al 2013 The anatomical and functional relation between gluteus maximus and fascia lata JBMT 17(4): 512-517

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