International Fascia Research Conference 2012

“What Do We Notice? What Do We Know?”

By Diana L. Thompson

The Third International Fascia Research Congress was held in Vancouver, British Columbia, April 28–31, 2012. Some 800 scientists and clinicians from 37 countries attended the sold-out conference, stretching their knowledge of fascia—slowly and gently, of course.

In five short years, great strides have been made in fascia research,1 and the three Fascia Research Congresses have had quite an impact on where research is today. Each congress had a unique theme and personality, beginning with basic science, as so much of the information about human anatomy and biomechanics was cutting edge and provided new ways of understanding connective tissue as a whole system. Congresses progressed to include translation, which helped clinicians make the scientific data meaningful and applicable to their practice. The paradigm was shifting significantly, requiring all to come together and share the newfound knowledge in order to productively move forward; by the end of the first congress, scientists and clinicians alike realized we were in this intellectual journey together and had much to learn from each other.

First International Fascia Research Congress

The First International Fascia Research Congress, at Harvard University in 2007, was heavy on basic science; clinical implications were not discussed from the podium until the final panel. Even then, questions from clinicians such as Leon Chaitow, Diane Lee, and Thomas Myers were plentiful, but answers from scientists were lacking. Out of necessity, the breaks throughout the congress were alive with conversations speculating on the impact the newfound scientific data would have on clinical practice. Excitement was palpable and heads nodded in confirmation, pleased that science was finally catching up with what our hands had been feeling all along.

My “aha” moment came while watching slides and videos on dissection, with the proposed concept that ligaments are, in many cases, the by-product of cutting away the fascia. I used to believe that the sole purpose of ligaments was to stabilize joints, and that muscles were the only soft tissues with contractile ability, but no more. Ligaments (and fascia) are sensory organs that have significant input to sensation and the reflexive/synergistic activation of muscles.2 I vowed never to touch a muscle, ligament, or tendon in isolation again without considering the fascial links. I began to bridge joints with my hands and work related muscle groups simultaneously. I worked the fascia more consciously from then on, stretching it slowly with broad, not just local, intent.

Second International Fascia Research Congress

The Second International Fascia Research Congress in Amsterdam in 2009 had presenters including clinical implications: the basic-science researchers were a bit more prepared to consider the impact of their findings on treatment applications. Clinicians also presented visual confirmation of treatment effects, such as ultrasound images of fascia pre- and posttreatment. Postcongress workshops provided opportunities to tie the research into clinical practice, and translational research was more prominent.

My “aha” moment in Amsterdam built on what I learned in Boston. Not only does fascia transfer force across joints and communicate with muscles, I learned that it is a dynamic, multitasking network, connecting and communicating with lymph, nerves, and organs.3 Fascia is constantly adapting to signals from all systems in the body, influencing more than just bones, ligaments, muscles, and tendons. Combine this with the knowledge that our brain is adaptive—neuroplasticity is the lifelong ability of the brain to reorganize neural pathways based on new experiences—and that the fascia is constantly sending information to the brain, and we begin to understand how the manipulation of fascia can influence these new, adaptive neural pathways.

The translational takeaways: humans develop adaptive patterns of movement in response to repetitive tasks, and dysfunctional, compensatory patterns in response to trauma or pain, but we can help people develop new movement pathways just as easily. Through the integration of movement education techniques, we can influence the fascia and send signals to the brain inviting alternative neural pathways for movement: potentially more functional, graceful, pain-free ways to perform our daily activities.

This new concept of fascia—as a communication tool, directly influencing the brain—stimulated me to find treatment techniques that address the nervous system through the fascia. Joints contain the highest concentration of nerve endings (areas of greatest stress).4 Therefore, it made sense to me to begin using bones as levers for compressing and stretching fascia. Correspondingly, movement therapies such as the Alexander Technique, the Feldenkrais Method, and Thai massage have meaningful applications in fascia work.

These research findings have profoundly influenced my work. What else could I possibly learn by attending another fascia congress?

Third International Fascia Research Congress

The Third International Fascia Research Congress was translational from the start. Rolfer Tom Findley, MD, PhD, opened the proceedings with the theme “What Do We Notice, What Do We Know: Continuing the Scientist/Clinician Dialogue.” He acknowledged that all clinicians are researchers—we gather information, form a hypothesis, apply a treatment, and observe the results. We learn from our experiences, adapting future treatment sessions based on the results. He encouraged us to share our experiences with researchers at breaks and through posters and case reports.

My “aha” moment was immediate. Inflammation and fluid dynamics were prominent topics. Conditions typically thought of as noninflammatory disorders were shown to have origins in acute inflammatory responses (potentially quelling the tendonitis/tendonosis debate). Repetitive movement, for example, degrades the myelin in the nerves and strains the muscles and fascia, causing inflammation. Fibrosis, the body’s response to inflammation, compresses the inflamed nerves, causing pain, and traps the fluid, compromising the lymph. Chronic inflammation persists as a chemical response even if there is no visible heat, redness, swelling, or loss of function.

But wait—it gets better. This chronic inflammation is found to be a systemic response involving the entire body, not just the limb performing the repetitive action.

The takeaway: even if there is no visible or palpable evidence of inflammation, we should consider the presence of chronic inflammation and treat accordingly. Nerve compression injuries, such as brachial plexus, carpal tunnel, or thoracic outlet syndromes may all be inflammatory conditions, even if we do not see or feel the cardinal signs of inflammation. Based on the new information, multiple sclerosis and Parkinson’s disease patients could benefit from lymphatic massage. Before the congress, I wondered if lymph drainage shouldn’t always be included in a treatment plan. I now strongly believe it should, and the evidence exists to back up this treatment strategy.

The second takeaway was to treat the entire body. Mary F. Barbe, PhD, professor of anatomy at Temple University in Philadelphia, Pennsylvania, spoke about repetitive movement disorders. Her recent study looked at the inflammatory response to repetitive stress and the resulting fibrosis of repair.5 Rats were trained to perform a repetitive reaching, grasping, and pulling movement in four categories: low repetition-low force, high repetition-low force, low repetition-high force, and high repetition-high force. While rats subjected to low repetitions and low force adapted and recovered without injury, the others did not fare as well.

After 12 weeks, the rats were dissected.  Inflammation and the fibrosis of repair were found to be full-body response, not confined to the limb subjected to the repetitive stress. While the dominant limb had the most fibrotic tissue, fibrotic tissue was found in the opposite limb and both hips. These same findings were not present in the control group.

The inflammatory process caused an increase in fibrotic tissue—a thickening of collagen—not only in the arm that performed the repetitive movement, but also in the opposing arm and in both hips. This response became chronic as the epitendons and paratendons merged and could no longer slide over each other. Nerve compression resulted due to the thickening tissues, and myelin of the nerves degraded and frayed due to the lack of gliding, driving further inflammatory reactions. Peripheral nociceptor endings were sensitized, and spinal cord inflammation was found, potentially contributing to an increased pain response. Translation: address inflammation, even in chronic cases, and treat the whole body.

It was also shown that intervening early in the pain cycle of potential repetitive movement injuries, or soon after a traumatic injury, can lessen the chronic inflammatory response, making the fibrotic repair response more functional and the chemical response less prolonged. Also, ibuprofen, while limiting the inflammation, caused the tissue to be less strong and more prone to reinjury. Translation: treat early, as soon as the pain begins, or treat preventatively when engaging in repetitive activities.

Living the Paradigm Shift

Science is challenging. It can be frustrating when years of research and millions of taxpayer dollars are used to fund a study that tells us what we already know about the benefits of massage. But it is all worth it when the light bulb goes off and you hear something for the first time that shifts your paradigm and changes your clinical practice.

I encourage you to purchase the videos of past fascia congresses, view them in groups, and discuss the findings.6 Despite the grooves in our nervous system formed by years of massage doctrine, we can adapt to new information.


1. L. Chaitow, T.W. Findley, R. Schleip, eds., Fascia Research III: Basic Science and Implications for Conventional and Complementary Health Care (Munich: Elsevier GmbH, 2012).

2. T.W. Findley, R. Schleip, eds., Fascia Research: Basic Science and Implications for Conventional and Complementary Health Care (Munich: Elsevier GmbH, 2007).

3. P.A. Huijing, P. Hollander, T.W. Findley, R. Schleip, eds., Fascia Research II: Basic Science and Implications for Conventional and Complementary Health Care (Munich: Elsevier GmbH, 2009).

4. J. van der Wal, “The Architecture of the Connective Tissue in the Musculo-skeletal System—An Often Overlooked Functional Parameter as to Proprioception in the Locomotor Apparatus,” in Fascia Research II: Basic Science and Implications for Conventional and Complementary Health Care, eds. P.A. Huijing, P. Hollander, T.W. Findley, R. Schleip (Munich: Elsevier GmbH, 2009).

5. J.B. Driban, A.E. Barr, M. Amin, M.R. Sitler, and M.F. Barbe, “Joint Inflammation and Early Degeneration Induced by High Force Reaching Are Attenuated by Ibuprofen in an Animal Model of Work-Related Musculoskeletal Disorder,” Journal of Biomedicine and Biotechnology (2011), doi:10.1155/2011/691412.

6. International Fascia Research Congress, “Purchase DVD Recordings/Proceedings Books,” accessed June 2012,

A licensed massage practitioner since 1984, Diana L. Thompson has created a varied and interesting career out of massage: from specializing in pre- and postsurgical lymph drainage to teaching, writing, consulting, and volunteering. Her consulting includes assisting insurance carriers on integrating massage into insurance plans and educating researchers on massage therapy theory and practice to ensure research projects and protocols are designed to match how we practice. Contact her at