From the opening ceremony featuring native Squamish drummers and chanters to the low-key closing three days later I have to say that this third edition of FRC is going to be hard to beat. The principle FRC organizer, Dr Tom Findlay, coined the phrase ‘ bench to beside and back’. This summed up the gathering of scientists, anatomists, and researchers on the one hand and the various clinicians from all walks of manual therapy life. At FRC I in 2007, the gap was monumental. In 2012 it has narrowed considerably.
FRC3 was sold out when the 800th person signed up. Our hosts in Vancouver were the Massage Therapy Association of British Columbia, who along with New Zealand are the only places in the world that have three year degrees in place. The depth of questioning by RMTs (LMTs) fully proved their high standard of understanding.
With successive blogs I will describe you some presenter views that are related to the material taught in our own Manual Trigger Point Therapy (MTT) seminars.
The first speaker was Mary Barbe, from Philadelphia. Her subject was Changes in Fascial Tissue With Repetitive Motion Disorders (or RSI). With performance of high repetition tasks, early inflammation was observed that was accompanied by musculoskeletal tissue adaptive remodeling.
However, with continued task performance, pathological remodeling was induced, such as fibrotic repair in tendons, muscles, nerves and their fascial sheaths. Damage included neuronal damage (moth-eaten and kinked fibers), connective tissue changes (thickening of the matrix), tendon changes (disruption of the tendon – paratenon separations), muscle (collagen type 1 build up) and bone (osteopenia). Generally these changes are accompanied by pain from release of cytokines, substance P, TNF-alpha etc.
The take home message was that early intervention is key. Tendonitis responds early to anti-inflammatories, but subsequent morphing to tendinosis doesn’t. Barbe’s team has now embarked on an exploration of interventions strategies to target the early inflammatory responses and promote non-fibrotic tissue repair.
Personally, I would like to marry the bench research showing these pathophysiological changes found in her rats to the studies of the Hoyle and Treaster (human rats) that we quote in MTT pain sciences. Here, workers were exposed to postural stress, visual stress, or both. Treaster found myofascial trigger point build up mostly in the high visual stress cases (www.ncbi.nlm.nih.gov/pubmed?term=Treaster%20postural%20visual). Hoyle found trigger point development in multiple trapezius sites after one hour of typing (www.ncbi.nlm.nih.gov/pubmed?term=Hoyle%20postural%20visual).
I thought that this was a fantastic start to the conference. Pathology from Repetitive Motion Disorders is only going to get worse (think texting). We need to convince sufferers that early intervention is the way to go. Can we get an app for that? One that measures how many keystrokes you can do before an alarm goes off telling you its time to see a manual therapist.
For more free information use pubmed, and search using ‘Barbe and Coq’