Sometimes abrupt and other times imperceptible, science moves along an undetermined path towards clarity and perhaps a notion of truth. In March 2017, practically unnoticed even in the larger somatic community, some of the world’s foremost experts in the science of fascia attending the International CONNECT Conference  in   Ulm,   Germany   released a consensus statement articulating the current fascia research in respect to sports medicine. Titled “Fascial Tissue  Research in Sports Medicine: From Molecules to Tissue Adaptation, Injury and Diagnostics: Consensus Statement,” it was published in the British Journal of Sports Medicine in July 2018. Significantly, their statement is, as the title implies, a declaration not only of the theoretical results from laboratory research but also its practical application as applied to sports medicine – developments of obvious interest to our community. I should note that there are thirteen authors to the statement, including well-known scientists Andy Vleeming and Jan Wilke, presenters at past meetings  of  the  international Fascia Research Congress  (FRC),  and two signees will be quickly recognized as our own, Rolfing® Structural  Integration  (SI) instructor Robert Schleip and Certified Advanced Rolfer Thomas Findley.

Although the article is open  access  and available at https://bjsm.bmj.com/ content/52/23/1497, its significance to our profession merits reprinting in our Journal and some commentary to guide the reader.

First, take heed of two words in the title: Consensus Statement. In previous FRCs, there had been an unremitting tension between those scientists that presented fascia as tissue and others that presented fascia as system. For a discussion of  this tension, please read my report “An Overview of the Fourth International Fascia Research Congress,” which was published in the November  2015  issue of Structural Integration: The Journal of the Rolf Institute® (pages 46-49). That tension was seemingly bridged in the aftermath of this conference with the issuance of this consensus statement.

While definitions may seem irrelevant to the SI practitioner, in the scientific world  of information, exacting definition, often arrived at through discussion and polemic, is a critical aspect of communication between researchers in the same field. Thus, the definition as presented is of supreme importance for  the  continuity  of work in the field of fascia research. A definition of fascia is thus presented in the abstract of the Consensus Statement as the first item of information: “The fascial system builds a three-dimensional continuum of soft, collagen-containing, loose and dense fibrous connective tissue that permeates the body and enables all body systems to operate in an integrated manner.” Simply put, this statement, and further elucidation in the paper, validates the consideration of fascia as a body-wide system enabling the efficiency of all other systems in the body.

This enlarged understanding paves  the way for consideration of fascia as  critical for overall health and  also  as  significant  in the body’s breakdowns, particularly musculoskeletal. While this size of this paper is relatively small, it is full of noteworthy pronouncements and declarations concerning the role of fascia in health, as highlighted in the following examples:

1. The concept of myofascial force transmission, a favorite conceptual model within the SI community, particularly the Tom Myer’s Anatomy Trains branch, is in dispute, or at least unproven at the moment.
2. Loading of fascial tissues is important for tissue repair but can also lead to compromised function of healthy tissue. At issue is the inflammation response. Short lived, it can benefit; Prolonged, it can create fibrotic changes in tissue. The researchers note inflammation as being a central problem in health and disease.
3. Some of the present medical treatments in relation to fascia are questionable; certainly surgeries, but also certain drugs such as NSAIDS, corticosteroids, and estrogen, which may impair regeneration and tissue adaptation.
4. Foam rolling is deemed beneficial, but with admitted uncertainty as to the scientific underpinning for its therapeutic results.
5. The researchers’ pronouncements on the relationship between aging and fascia – i.e., densification and stiffness of fascia tissue

– are particularly interesting. Generally, the problem is how to train to build strength without increasing inflammation.

6. There is also a discussion of imaging techniques for fascia, including  MRIs, and a renewed interest in other techniques, particularly ultrasound.

All in all, this paper marks another important step from theory to practical considerations, an unquenchable craving within our community.