I recently returned from a 9 day trip to Italy.  No, I did not see much of the sights, drink lots of wine, or eat gondola- loads of amazing food (I resorted to canned tuna one day for lunch).  But I did learn a lot more about one of my favorite topics:  FASCIA!  All events were through the Fascial Manipulation (FM)® Institute in Padova, Italy, the birthplace of this method.  There Italian physiotherapist Luigi Stecco continues to develop his concepts, aided by his son, Antonio, and his daughter, Carla, who are both physicians, researchers, instructors, lecturers, and authors known all over the world.

My first 3 days were consumed with what they call the Level III Master Class. Course attendees were from all over the world:  Poland, Korea, Japan, UK, Kenya, Austria, Russia, China, Italy, and 5 of us from the US. Many different professions were represented including physicians, acupuncturists, kinesiologists, chiropractors, and physical therapists, also called physiotherapists or physios. The course was for those who have had the 1st  and 2nd levels of training in FM® evaluation and management of musculoskeletal dysfunctions arising from the deep fascia, as well as the 3rd level on internal dysfunction (all the other things that go wrong with the body that don’t seem to be musculoskeletal) related to the deep and superficial fascia. I have attended the 1st and 2nd level courses multiple times, and feel relatively comfortable with that material and approach.  The 3rd level I attended once in 2016, and since then have been challenged with implementing the complex information presented on managing issues with metabolism, digestion, lymphedema, circulation, thermoregulation, endocrine, skin, and so much more.  While you may be wondering how in the world those can be approached in physical therapy, I can tell you how in one word:  FASCIA!  Who knew?   It was a great review and helped me wrap my brain around the enormity of problems potentially arising from fascial dysfunction and how to approach them.

After the 3 day class was THE EXAMINATION.  This was optional for those wishing to be certified as practitioners and listed on the FM® Association website.  Written, oral, and practical elements covered basically anything we had ever been taught about fascia and the FM® method.  I studied hard and felt ready, but my nerves that day brought me close to losing my tuna.  It is a bit intimidating to be verbally quizzed one-on-one by Dr. Carla Stecco, one of the world’s leading anatomists.  The questions I drew pertained to the superficial fascia as well as the role of hyaluronan in the deep fascia.  Fortunately I answered them quickly and correctly, leaving us “ample time,” as she said, to “chat” before I had to move on to the next testing station.  We had a lovely conversation about the recent media attention being given to the “new organ” – the interstitium, which is not really a new organ at all.  I moved through the rest of the test and felt I did satisfactory although not perfect.  We were not to learn the outcome until the next day.

Some of us opted to seize the afternoon and took a 30 minute train ride to Venice. It was an amazing venture and I got real food, saw sights, and enjoyed a study break. I felt like I was in Disneyworld but had to remind myself that this was what Disney was imitating!  My great afternoon was topped off as I returned late to my hotel and read the email congratulating me on passing the exam!  Texts, emails, and phone calls flew across the Atlantic including my supportive husband, Bill, and my mentor Larry.  The next day we were awarded our certificates, and it was another day full of events, lectures, and rubbing elbows with people who have very sharp elbows like mine.  I also had the privilege of receiving treatment from one of my FM® teachers®, Italian physio Andrea Pasini.  It hurt like heck (as some of you know) but I was glad to put up with it to make some changes in my gondola-load of issues.  For those of you who may be surprised, us physios need treatment too and have a hard time getting it due to schedules.  The day wrapped up with a formal evening and dinner at an Italian restaurant that rivaled any wedding I have been too.  It was amazing and delicious – no canned tuna.

The next 3 days were spent in teacher training meetings as well as following an Italian physio around for a day in his clinics, which helped me learn more about using FM®.  I finally left for home feeling tired but satisfied at having accomplished the goals of my trip:  to learn more about fascia, understand how to treat better, and possibly become certified.  I checked all off my list!  Now to avoid canned tuna….

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