When pain develops anywhere in the body, the most common approach is to address it by focusing primarily on that region or body part. Treating painful conditions in this manner makes sense and can be effective for reducing pain levels, but in some ways, it fails to account for the deep and complex innerworkings of the entire body. This approach could be shortsighted because no injury occurs in isolation, and therefore, no treatment should only target the specific area in which the injury or pain is located.
This philosophy is at the foundation of Fascial Manipulation, a manual therapy technique developed by a physical therapist named Luigi Stecco. Instead of narrowing the focus exclusively on, say, the knee or shoulder, Fascial Manipulation focuses on how these joints connect to the rest of the body through the fascia and treats them with a strategic set of manipulations.
A key connection throughout the body
Fascia is connective tissue made mostly of collagen that covers just about everything in your body—including bones, muscles, and nerves—and holds these parts together. It consists of several layers and provides a smooth pathway for tissue to slide and glide, which it does incredibly well when healthy and intact. Fascia is also unique because it is part of both the musculoskeletal system and nervous system, making it an integral connection between the two systems that helps to initiate and regulate movement.
As you can see, fascia is an ideal target due to its central role in movement, which is precisely what Stecco recognized when he developed Fascial Manipulation. Fascial Manipulation considers pain to be an important clue that should be investigated to identify the specific cause of each patient’s dysfunction rather than masked and suppressed with medications. Another key characteristic of the technique is to garner a clear understanding of one’s entire medical history and any other unique circumstances, all of which can contribute to pain in various ways.
Therefore, the therapist will look for the root cause of the patient’s dysfunction, particularly by searching for tense parts of fascia called densifications. Once identified, the practitioner will then create a personalized treatment program targeting the deep fascia to help restore their normal length, with the goal of increasing range of motion, decreasing pain, and increasing strength. Here’s a closer step-by-step look at how the process typically works:
- 1) Data collection: first, the therapist will conduct a detailed interview that asks the patient about their history with injury and other health conditions, with a focus on any past experiences that could be contributing the current problem
- 2) Motor and palpation examination: next, the therapist will perform a variety of assessments to measure how well the patient moves and to identify any impairments or limitations throughout the body; a key component of this step is palpation, which involves pressing on the fascia to see if it’s tender to touch (this can reveal a densification, which is often associated with dysfunctional movement patterns)
- 3) Development of a plan: once the therapist has a clear understanding of the patient’s history, current condition, and the source of the dysfunction, he/she will create a customized treatment program with a precise objective that addresses the limitations identified
- 4) Treatment: the therapist will then perform a manipulation technique on one fascia point that has a densification for 2–5 minutes; this is repeated on any other densifications that have been found in any other regions of the body; the patient may notice a gradual and significant reduction in tenderness after this initial session, and the therapist will reassess movement patterns to see if there have been any improvements; if necessary, additional manipulations are performed on any other areas of tension
Patients may notice some minor soreness or tenderness for 24–48 hours after the first session due to inflammation, but with each additional session, tension and resulting pain levels decrease while movement patterns continue to improve. Fascial Manipulation can be used to treat a variety of conditions, including, but not limited to:
- Low back pain
- Neck pain
- Hip pain
- Knee pain
- Shoulder pain
- Foot and ankle pain
- Jaw pain
- Tension headaches
Contact us to learn more about Fascial Manipulation
We’re proud to announce that our owner Jon Diamond, PT, DPT, OCS, CSCS, is now certified to administer Fascial Manipulation here at Dynamic Sports Physical Therapy. So if you’re dealing with pain of any sort and are curious about Fascial Manipulation, contact us at 212-317-8303 to schedule an appointment today, or click here to learn more about this technique.