Description: Fascia is a tissue whose composition and material properties are constantly evolving in response to its changing mechanical environment. Mechanotransduction, or the ability of cells within fascia to perceive and respond to mechanical forces, is a key mechanism responsible for this fascia “remodeling”. In this session, we will discuss challenges associated with the application of recent advances derived from cell culture systems to the understanding of mechanotransduction in whole tissues, and eventually living organisms.

Description: Myofibroblasts in fascia are connective tissue cells with smooth muscle-like contractile capacities. Originally discovered in the 1970’s, these cells are now known to play a major role in wound healing, tissue fibrosis, and pathological fascial contractures. Their evolution–usually seen as from regular fibroblasts to proto-myofibroblasts, to fully differentiated myofibroblasts, to final apoptosis–is influenced by mechanical tension, cytokines, and specific proteins from the extracellular matrix. Given its relatively recent discovery, many questions still exist about this new cell type. This session will review what is currently known about the biology of this cell, the interactions with its environment, and its presence and role in collagenous connective tissues.

Description: The various viscoelastic tissue that constitute fascia(ligaments, tendons, capsules, discs, etc..) are also sensory organs. Various types of receptors capable of monitoring tension, elongation, pressure, velocity, pain , etc are located in such tissues and create a neurological feedback mechanism by which reflexive interaction with muscles is provided to maintain joint stability and safety as well as coordination of movement. Disruption of the fascia due to injury or overuse also results in corrupted feedback signals and neurological disorders that are exposing the tissue to additional potential for injury or movement disorders.

Description: Pain is a complex phenomenon, including subjective and objective components. The objective component includes nociceptors, the neural components in the peripheral nervous system that can generate signals that can be interpreted by the central nervous system as pain. Most structures are innervated by nociceptors, which are responsive to changes in their environment that are damaging or potentially damaging. In this session, data related to the mechanisms of nociception arising from nerve fascia, muscle, and ligament will be presented.

Description: The Clinician-Scientist Panel will offer an opportunity for interaction, dialogue, and the sharing of information between two groups, Clinicians and Scientists. Panelists represent a variety of backgrounds: including education, acupuncture, osteopathy, medicine, chiropractic, naturopathy, physical medicine, massage therapy Rolfing / Structural Integration, and pure science.

Clinicians
Joseph Audette MA, MD
Leon Chaitow ND, DO (Co-chair)
Diane Lee BSR, FCAMT, CGIMS
Thomas Myers IASI
Michael M. Patterson, Ph.D., DO(Hon)

Scientists
Peter Huijing PhD
Partap S. Khalsa, DC, PhD, DABCO (Co-chair)
Helene Langevin MD
Jay Shah MD
Moshe Solomonow, PhD, MD(hon)

Description: Density and stiffness of fascial sheets is regulated by connective tissue cells, which are responsive to mechanical stimulation, genetic factors, and chemical messengers. A wide spectrum of fascial tonicity expressions exists. On one end of the spectrum are chronic tissue contractures like palmar fibromatosis (Morbus Dupuytren), hypertropic scar, or frozen shoulder, which are associated with an increased fascial stiffness and a high density of contractile cells. Similar contractile cells, although in much lesser density, have also been found in fascial tissues of normal patients. On the other end of the spectrum are patients with chronic hypermobility, as they usually express hyperextensibility of the skin and delayed wound healing. This session will look at the interactions between active cellular contraction and chronic fascial contractures, and how their interactions may be involved in fascial stiffness adaptations.

• The integrity of the anterior abdominal fascia (rectus diastasis) and thus the function of transversus abdominis.
• The integrity of the endopelvic fascia and thus the function of the pelvic floor.
• The respiratory diaphragm which can lead to altered breathing behavior.
• The impact of disordered breathing and chemistry on Fascia will be discussed.

The session will be evidence-based according to Sackett's definition (current scientific evidence combined with clinical expertise and patient values). The information presented will be clarified through short case studies.

• Fascia as living collagen matrix and considerations of energy medicine.
• The roots of fascia as living collagen matrix.
• Considerations of energy medicine and matrix configurations into the clinical setting.
• Biomarkers from the endocannabinoid system as indicators of fascial treatment in low back pain and trigger points.
• Fascia of the body and cranial fields.
• Craniosacral motion dynamics and manipulation phenomena.