• Tania Cucciniello

My Highlights of the Fascia Research Congress 2022

I am so grateful that this year’s Fascia Research Congress was held in right here in Montreal, my hometown! I will begin by saying there is no possible way I can cover the entire congress alone, with so many speakers and presentations going on at the same time, I chose to attend the ones that interested me the most and that will help me advance in my practice. I will also state that I did not attend any of the Pre-Congress workshops, such as the live cadaveric dissections.


I met so many like-minded people, who are all dedicated to working with fascia, from manual therapists to engineers. The research done and presented is important to understand and further our knowledge on this amazing body-wide system we call fascia.


I will try to keep it short and highlight some of the main concepts I grasped, followed by a list of everything I attended.


Let’s begin with, how we say in French: “La pièce de résistance!”


FR:EIA

The world’s first 3-D human fascia plastinate and the most outstanding item of art in Bodyworlds, is FR:EIA! It stands for Fascia Revealed: Educating Interconnected Anatomy.


Displaying the entire fascial system uninterrupted to help visualize and gain deeper insight into the human anatomy. Photos were not allowed in the exhibit, I was told only a photo of the poster was allowed, so this is all I can share with you. The rest was for my eyes only. Enjoy FR:EIA!


Highlighted Facts, Concepts, and Images: Day 1

  • The thoracolumbar fascia (TLF) and intra-abdominal pressure influences spinal stability more than lumbar muscles alone.

  • Bracing creates less pain and 2x more stability while loading the spine, like during a squat.

  • Unilateral low back pain causes or equals a symptomatic TLF (by palpation or force) to initiate stress-shielding.

  • To compensate, patients might experience irregular muscle activations and force balances, entrapping the soft tissue in cyclical stress-shielding!

  • Can manual therapy modify fascia? In short, the answer is yes! Dr. Stecco’s findings of manual therapy resulted in significant changes in bound vs unbound water concentration. Manual therapies increased viscosities at the pain/symptom site, but bodyworkers also need to rebalance the rest of the biomechanics for long lasting results.

  • There is a link between chronic stress and changes in fascial stiffness. Research of viscoelastic properties of fascia were conducted in patients with MDD: Major Depressive Disorder. After foam rolling, tension in the body decreased and did in fact have a positive impact on their cognitive filter.

  • Did you know? Foam rolling in Germany is called fascia rolling!

  • Movement models the retinacula, structuring the fascial system. Children should move in a proper way to create the best fascial system from the beginning.

  • Movement matters! Movement is life.

  • The role and quality of fascia between the musculoskeletal system and the immune system depends on many factors, divided here into 2 categories:

  1. Physiological factors= intracellular and molecular processes, microenvironment and interstitial cells, immune, autonomic, and neuro-endocrine systems.

  2. External factors= lifestyle, social determinants of health and cultural factors, macroenvironments (conflict, climate changes, pandemics).

  • Inflammation that infiltrates the body at 24 hours, can became chronic inflammation after 2 weeks, and at 10 weeks an area can become fibrotic.

  • Stretching promotes the resolution of inflammation overall, however inflammation in single cell analysis was insignificant in change and very close in numbers. Therefore, stretching is necessary but not for too long or too much.


Highlighted Facts, Concepts, and Images: Day 2

  • Dr. Peter Friedl’s presentation offered a visual of how cancer metastasis organizes itself amongst connective tissue and other tissues in 3D, presented in the following image.

  • Findings include that migrating tumor cells exploit space and take the path of least resistance to infiltrate. They also morph according to their space, whether collagenous, adipose, etc.

  • Massage near the tumor was also conducted and the pressure induced had created new and prolonged strands of cancer to reach out further and coming closer to blood vessels.

  • Remain conservative when massaging cancer patients by staying away from the area.

  • Dr. Yuval Rinkevich presented novel perspectives of injury repair by fascia, where I learned something new about fibroblasts. Different fibroblastic lineages exist between and within skin locations.

  • Scarring and regeneration observations across skin locations are outcomes of separate fibroblast lineages. For example, oral tissues can repair scarless while dense connective tissue, like on the back, will repair as dense scars.

  • Techniques like ablation can lead to scarless repair.

  • Surgical scars and deep wounds come from the fascia under the muscle tissue and not in the superficial dermis layer.

  • Light manual manipulation at early stages is now showing benefits of healing.

  • We can massage scar tissue sooner than believed to speed up healing of the connective tissues.

  • I got a chance to participate in a study that was testing kinesthetic skills and force displacement, seen in the images below.

  • Fascia Illuminated: An Evening of Fascia in Art: A wonderful evening that, in my opinion, ended up having the theme of dance! I submitted a poem to the Fascia Research Society thinking that it would be printed and handed out during the art night… but to my surprise, Barbara asked me to read it aloud! I wrote the poem intuitively and wanted to capture some of the mystique behind fascia, along with those quiet moments I have with the tissues in my practice.

Here is my poem called Fascia, Fascia:


Highlighted Facts, Concepts, and Images: Day 3

We begin with Professor Stuart McGill’s presentation called: Superstiffness!

  • Prof. Stuart McGill’s journey started with the Borelli muscle system

  • “Borelli calculated the forces required for equilibrium in various joints of the human body. Borelli was the first to understand that the levers of the musculoskeletal system magnify motion rather than force, so that muscles must produce much larger forces than those resisting the motion.” From<https://pubmed.ncbi.nlm.nih.gov/16227900/>

  • Muscle creates force and stiffness.

  • Muscle activation tunes the spring.

  • It's not activation that makes the muscle strong, it's elasticity.

  • Posture migrates load between tissues.

  • Stiffness controls movement and posture.

  • Proximal stiffness or stability is needed for distal performance.

  • Stiffness eliminated micromovements in joints that can lead to pain and tissue degeneration.

  • It’s fascia that reduces stress concentrations and enhances performance.

  • Optimal stiffness and velocity modulation:

  1. Brace

  2. Tune

  3. Spring

  4. Eliminate energy leaks


His conclusion according to his journey:

  • Dr. Maribel Miguel-Pérez’s presentation had some of the most detailed and up-to-date images of anatomy! I’ve included a few of them here:



Next,

  • Shun Otsuka presented the association between the human fascia lata thickness and underlying muscles' morphology and function.

  • Thigh muscles play an important role during exercise and the size and function depend on the sites.

  • Results prove that the fascia lata alters its properties associated with the underlying muscles’ size and function.

  • Deep fascia gets thicker with aging.

  • Bodybuilders have thicker, deeper fascia than general males.

  • The research by Kyra De Connick and Claire Boucher looked the role of exercise vs sitting time as potential determinants of thoracolumbar fascia (TLF) in people with lower back pain to determine if the more we sit, the more disorganized our fascia is.

  • Results: inconclusive! The research did not show major changes between sitting time and active time. The TLF varied from thin to thick in the participants but no major changes or disorganizations in sitting time.

  • It’s important to publish and share inconclusive data, because it shows the work that has already been done.

Lastly,

  • Dr. Jean-Claude Guimberteau presented a whimsical fascia related film called "Anatomical Adventures in Fibrillar Island."

  • Anatomy seen in living tissue vs cadavers bring new elements to understanding the organization of living matter. Described in the image below.

  • Now all films, sequences, animations, and images of fascia by Dr. Jean-Claude Guimberteau are available at www.endovivo.com.

  • Purpose of this new film, which I love: See image below.

Bravo!


A Complete List of What I Attended

Day 1:

  • Dr. Mark Driscoll: Fascia- The unsung hero of spine biomechanics.

  • Dr. Antonio Stecco- Can manual therapy modify fascia?

  • Isabelle Gilbert- Exploring the effects of standardized soft tissue mobilization on viscoelastic properties, pressure pain thresholds and tactile pressure thresholds of the Caesarean section scar.

  • Dr. Robert Schleip: Myofascial tissue and major depressive disorder.

  • Dr. Carla Stecco- Structural and functional changes in fasciae during development and aging.

  • Dr. Helene Langevin- Fascia mobility, inflammation, and musculoskeletal pain.

  • Emily Newell & Mark Driscoll: The investigation of physiological stress-shielding within the lumbar musculoskeletal soft tissues affected by unilateral low back pain through finite element analysis.


Day 2:

  • Dr. Peter Friedl- Mapping interstitial conduits for fluid transport and cell migration.

  • Anastasia Dubinskaya- The Myofascial Fascial Massage as an Instrument for Psychological Status Correction.

  • Practitioner utilization and perceptions of the clinical utility and value of Danis Bois Method (DBM) Fasciatherapy to pain management: a survey of French physiotherapists.

  • Dr. Tina J. Wang- Physical medicine and rehabilitation. Correlation of fascial continuity between riders and their horses.

  • Dr. Yuval Rinkevich- Novel perspectives of injury repair by fascia.

  • Fascia Illuminated: An Evening of Fascia in Art.


Day 3:

  • Professor Stuart McGill- Superstiffness.

  • Dr. Maribel Miguel-Pérez: The relation of the nerves and the muscles with the fascia and its clinical importance.

  • Jan Wilke- Of muscles, cats, and hangovers: a tale of fascia and its role in recovery.

  • Kyra De Connick- The role of physical activity and sitting time as potential determinants of thoracolumbar fascia in people with lower back pain.

  • Shun Otsuka: The association between the human fascia lata (TFL) thickness and underlying muscles' morphology and function.

  • Claire Boucher- The impact of exercise and an increase in movement on the thoracolumbar fascia in people with low-back pain (LBP)- interim findings.

  • Justine Benoit-Piau: Age-related changes in transversus abdominis activation and myofascial structure in healthy adults using ultrasound imaging.

  • Christopher DaPrato- Muscle Shear Effects of Various Cupping Devices on the Lumbar Spine Myofascia using MR Imaging.

  • Awards + Findley Scholarship. The scholarship went to Physiotherapist Larissa Sinhorim attaining her PhD.

  • Jean-Claude Guimberteau presents: A Fascia Related Film called "Anatomical Adventures in Fibrillar Island"

  • Final Farewells + the next FRC will be in New Orleans in August 2025.


Further Investigation and Research

At the end of each presentation, all the researchers alluded to further investigating fascia and some of the main themes were fascia in relation to hormones, the endocannabinoid system, traumas, surgery, and nutrition.


As a nutritionist, I am most-definitely interested in the quality of fascia in relation to nutrition, along with the different stages of cellulite, because one is associated with the other.


I would also like to see more on lifestyle factors, as they were touched upon only a couple of times during the whole congress. It is our lifestyle choices that determine a healthy immune system. Since the immune cells run through our collagen, then nutrition must play a role on the thickness and health of the connective tissue. Whether we address the appearance of the skin or the quality of gliding through the tissues, our body needs proper hydration, essential fatty acids, amino acids, vitamins, and minerals to efficiently transport these nutrients to our cells.


Another reason why nutrition is important in the role of fascia is because we live in a society driven by fast food and processed foods. Consuming these foods not only hinders transport of nutrients to our fibers and cells, but they can drive up inflammation. So, can this possibly cause disorganization in the fascia? To be continued…


I am also interested in how lightwork therapies, such as Reiki, can influence fascia.


Conclusion

There was so much to cover, and I hope this summarized a lot of the events and findings. If you spotted anything that needs correcting, please let me know or leave a comment. Conversely, if you agree, if you enjoyed these highlights, or if learned something new, comment on that too!


I had a lot of fun and didn't want it to end, probably like most people there. I even got a photo with Dr. Schleip and my book signed by Tom Myers. I'm very thankful.

Now, as I continue my practice, I continue with the motivation I got from this congress and with the confirmation that manual therapy does in fact keep the properties of connective tissue healthy, and can rebalance biomechanical structures, which results in decreasing pain symptoms.


All this beautiful research was conducted so that we can all better understand the human body and help others with this information.

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