Fascial Manipulation is a manual therapy technique developed by Luigi Stecco, an Italian physical therapist, over the last 40 years. The treatment focuses on deep muscular fascia and how restoration of normal fascial length can help increase range of motion, decrease pain, and increase strength. The key to this technique is the understanding that one’s past medical history and unique circumstances through their lives can correlate to their current complaints of pain even if at first, they seem unrelated.
Fascial Manipulation looks at the human body as three lines on the anterior side (front of body) and three lines on the posterior side (back of body) to determine if there are any connections that can be drawn between two or more segments. Though these segments may not be side by side, pain and limitations in one area can adversely affect the other.
Such a case presented to Dynamic Sports Physical Therapy in New York City when Anne, a CrossFit athlete, injured her lower back. Anne came in to see us with a chief complaint of left-sided low back pain that radiated down into her left hamstring. She reported that these symptoms were worse while standing, jumping, and especially when waking in the morning. Anne also told us that she had previously injured her left shoulder, and although she had significantly improved after a course of physical therapy, she was still experiencing limitations when moving her shoulder in several directions.
After Anne described her injury history and current issues, her therapist, Jon, performed a thorough evaluation to identify any impairments or areas of tension in the fascia—a connective tissue found in bones, muscles, nerves throughout the body—which are called densifications. This process revealed that she had densifications along two important lines of the shoulder blades and both the mid-spine and lower spine.
Focusing on the mid-spine as the common link between conditions
Based on these findings, Jon targeted the mid-spine (thoracic spine) with Fascial Manipulation since it was the common link between Anne’s two primary issues (low back pain and shoulder pain). In addition to Fascial Manipulation as the manual therapy component, Anne’s treatment program also included various exercises to strengthen and stabilize her core muscles, which served as the primary therapeutic component. These drills were performed in a variety of postures with the focus on moving from least stable (lying down) to most unstable (standing on one leg). Anne’s range of motion improved after completing these treatments, and she was able to move through more challenging exercises without pain. Eventually, this allowed her to continue progressing, and further improved her overall stability and strength.
Anne has returned to CrossFit and participated without any low back pain or symptoms radiating down her leg. Without full resolution of her shoulder symptoms and recognition of how her shoulder pain was creating compensations and led to her low back pain, she would not be performing at the level she is today. Additionally, her story highlights the importance of the individualized care patients receive at Dynamic Sports Physical Therapy, and how our integrated approach of manual care and therapeutic exercises can return a patient to full function sooner and with less pain.
Anne had this to say about her experience with physical therapy: “Jon has been fantastic to work with and he has helped me get back to regular movements.”
We’re thrilled to see Anne performing at these heights once again and wish her continued success in CrossFit and all of her other athletic endeavors. If you’re being held back by pain or injury and would like to get back in the game, we can help. Contact Dynamic Sports Physical Therapy in New York City at 212-317-8303 to schedule an appointment today or click here to read our last blog for more information on Fascial Manipulation.
