Welcome to this brief summary of the 2009 Fascia Research Congress held late in 2009 in Amsterdam

Watch this video

Watch this video produced by Mark which takes us to the Vrije University Amsterdam where the congress was held. Mark speaks about his highlights of the congress and also interviews Tom Myers well known Rolfer and author of the Anatomy Trains Books from Maine USA, Dr Mathew Stewart an Osteopath from Auckland NZ , Donna McMurtry a Massage Therapist from Vancouver Canada and Debbie Creamer is a Physiotherapist from South Africa

Listen to the Interview

Listen as Rob Granter interviews Mark Finch in relation to his experience at the Congress

Resources

Mark’s suggestions of the names to watch in relation to the three main areas of his particular interest: Fascial Architecture, The Areolar Tissue and Strain Transmission

Fascial Architecture

Dutch Gross anatomist: Jaap van der Wall

Physiotherapist: Willem Fourle

The Areolar Tissue

Dr Helene M. Langevin

Strain Transmission

Physiologist: Dr Peter A. Huijing, PhD

Biomechanist: Prof Dr Yasuo Kawakami

Biomechanist: Dr. Can Yücesoy

Go the Fascia Congress site and click on the Speakers/Key Personel tab on the left hand side.

Once in this section click on the Bio and Pubs tab at the bottom of each Speaker to see their full details including their publications

Fascia Research Congress website: http://www.fasciacongress.org/2009/

Further fascial resources:

Robert Schlelp’s site (Robert has been a major contributor to fascial research and investigation) http://www.fasciaresearch.com/

Mark Finch’s site: Register to keep in touch with Mark’s upcoming courses.

http://www.markfinch.ca

To be notified of the details of Mark’s Australian, not to be missed November 2010 courses, join this website as a free member. This is very important as his courses will book out very quickly.

Articles from the congress website:

Supplied courtesy of the International Journal of Therapeutic Massage & Bodywork: http://www.fasciacongress.org/2009/articles.htm

There are some excellent articles here make sure you read Helene M. Langevin, MD and Peter A. Huijing, PhD excellent article

Communicating About Fascia: History, Pitfalls, and Recommendations

Journal links:

International Journal of Therapeutic Massage & Bodywork: Research, Education, & Practice:

The International Journal of Therapeutic Massage & Bodywork (IJTMB) is an open access, peer-reviewed publication intended to accommodate the diverse needs of the rapidly-expanding therapeutic massage and bodywork community.

http://journals.sfu.ca/ijtmb/index.php/ijtmb/index

Journal of Bodywork and Movement Therapies

http://www.elsevier.com/wps/find/journaldescription.cws_home/623047/description#description

Treatment
For the treatment of both CMP and FM, a multi-disciplinary approach that includes the patient’s participation is most likely to be successful.19,20,29 It is essential to identify and eliminate or correct perpetuating factors.16 When treating CMP, it is also important to remember that trigger points usually refer pain elsewhere. Therefore, the site that requires treatment may not reside in the area that is actually hurting.27 This point reinforces that the healthcare professional who is treating patients with CMP must have a good working knowledge of trigger point manuals.25

Nonpharmacologic: According to Travell and Simons, almost any physical intervention will affect (but not necessarily deactivate) a trigger point. On the other hand, positive thinking, biofeedback, progressive relaxation, meditation and any other nonphysical intervention will not help.27 If physical methods are applied too broadly, they, too, may fail.27 For example, conventional stretching exercises or yoga are not likely to be specific enough to improve trigger points, and, especially if overdone, may even make matters worse. Acupressure, shiatsu, craniosacral therapy, Swedish massage, deep tissue bodywork, myofascial release, and other forms of therapeutic touch may not be specific enough to successfully treat trigger points. Applications of heat and cold and electrical stimulation are likely to provide only temporary benefit.

Treatment needs to be applied directly to the trigger points to successfully deactivate them.27-29 The two methods to treat trigger points that Travell and Simons discuss in most detail in their texts are “trigger point injections” and “spray and stretch.” Both treatments are usually carried out by doctors or physical therapists.

Trigger Point Injections: Trigger point injections are usually given using a local anesthetic, although the use of a dry needle, as in acupuncture, may be useful in some patients.1,27 These injections, however, are less likely to be beneficial in patients who have both CMP and FM.1,21 There are many doctors who perform trigger point injections, but “there are not many who can do them properly,” says one expert.1 Administering the injections requires a great deal of skill; lack of expertise can cause more harm than good.27 Even when properly done, trigger point injections can be very painful; premedication or a pre-injection block may be useful.1 Even brief exposure to considerable pain can cause long-lasting neuroplastic changes in the spinal cord that tend to enhance pain.1 Spray and stretch is safer and easier to use than trigger point injections, and is the method generally favored by Travell and Simons.27

Spray and Stretch: Spray and stretch differs from conventional stretching in that the trigger point is directly addressed before the affected muscle is stretched. The skin is sprayed with a refrigerant, then the affected muscle is stretched. A thorough knowledge of trigger point locations and referral patterns is essential, especially since the trigger point involved may not be within the area that is actually hurting. Several other steps, including correct chilling of the skin, rewarming and possible gentle movement through the complete range of motion, are essential.

Improper technique can do more harm than good. Travell and Simons believe that the safest and most effective therapy, however, is “deep stroking massage” directly to the trigger point.27 This has a more specific effect on the trigger point than spray and stretch, and poses less risk to muscle attachments. Deep stroking massage can be nearly as effective as, and in some cases superior to, trigger point injections. Perhaps most importantly, deep stroking massage can sometimes be adapted for self-treatment, which, in addition to providing pain relief, can return some degree of control to the patient.8,27

Pharmacologic: While NSAIDs do not appear to be beneficial in treating the symptoms of CMP, the use of low-dose antidepressants or narcotics may offer relief.

Antidepressants: Low-dose antidepressants (e.g., tricyclic antidepressants) may be prescribed for patients to take at bedtime, to help relieve symptoms.30

Narcotics: Narcotics (opioids) are not usually considered first-line treatment for CMP, but for most patients they may be an option–especially since NSAIDs are not n likely to be beneficial.1,18 As always, healthcare professionals and patients must be clear about the differences between addiction, tolerance, physical dependence and pseudo-addiction; there is ample data that the development of true narcotic addiction is extremely rare in patients who use narcotics for pain relief.9

Thankfully, the use of narcotics to treat terminal pain in patients who have cancer is finally gaining acceptance in the medical community. More education, however, is needed on the appropriate use of narcotics in patients with chronic, nonmalignant pain. It is hoped that the abuse of Oxycontin (oxycodone tablets, controlled-release) by a relatively small number of people will not have a deleterious effect on the treatment of patients who suffer from moderate to severe chronic pain. Likewise, a small group of unethical prescribers should not be allowed to compromise the ability of the vast majority of ethical, responsible, compassionate physicians who want to adequately treat their patients’ pain.9

The only thing more frustrating than having patients who are in pain worry about becoming addicted to narcotics, is having fellow health professionals share this unwarranted concern.9 Patients who take narcotics for chronic pain do not get “high” or “euphoric;” instead, they are usually relieved to regain a semblance of what they had once considered a normal lifestyle.

Narcotics seldom totally eliminate pain entirely, but they may reduce it to a level that allows the patient to add other modalities and adjustments to further reduce pain and facilitate a healthier lifestyle.1,18 When a combination of medications and other therapies is found that helps the patient’s pain, it is appropriate to continue using them; otherwise, symptoms will reoccur.1,18 There is increasing interest in adding dextromethorphan to narcotics, since this appears to increase analgesia, while decreasing constipation and possibly tolerance.31-33