Fascial Manipulation

 

Fascia is the soft connective tissue that intertwines and is a continuum throughout the human. It forms a 3D web like structure that is comprised of the superficial and deep fascia.

 

Superficial Fascia

Superficial fascia is composed of collagen fibres horizontally, oblique and transvers directions with dispersed elastin fibres. Innervated by free nerve endings, Pacini and Ruffini corpuscles.

 

Function of the superficial fascia:

  • Provides anchor points for superficial structures of the skin
  • Transmission of multi-directional forces and loads
  • Metabolic exchange
  • Gliding of the skin layers
  • Protection and conduction for blood and lymphatic vessels, and nerves

 

Deep Fascia

Deep fascia is composed of parallel collagen fibres in layers going in different directions. Innervated by free and encapsulated nerve endings.

 

Function of the deep fascia:

  • Provide anchor points for muscle tissue and other soft tissue to bony structures
  • Allows gliding and movements
  • Is an expansion of various muscles (e.g. pectoralis major, biceps brachii, palmaris)

 

“The wellbeing of any organ and apparatus depends on the balance that exists between its components. A harmoniously balanced posture is indicative of a healthy musculoskeletal apparatus.” (Luigi Stecco, 2004)

 

Disruption of the complex interactions and function of the fascial network will lead to altered movement, discomfort, pain and even reduction in performance. Main reasons of changes in fascia structure and consistency are:

Mechanicall (acute & chronic), physical (Psychological + thermal) and chemical (nutritional + endocrial)

 

Fascial Manipulation

Fascial manipulation is a manual therapy techniques used to restore mobility of this connective tissue by breaking down adhesions and improving tissue gliding at specific points.

 

How does it work?

By creating heat and stretching the fibroblasts, friction changes the structure of the ground substance in fascia, increases cell turn over and generates a minute inflammatory (myofascial inflammation) reaction which increases the rate of remodelling of the target tissue. This in return has been shown to reduce pain. What we look for is the densification, pain and referred symptoms.

 

Contraindications:

Fever

Skin lesions

Recent thrombosis

Severe immune depression

Edema or acute tendinitis

Lymphedema

Non-cooperative patient

Oncological patient

 

Indications:

Pain or the lack of mobility

 

Conditions that may benefit from Fascial Manipulation:

TMJ dysfunction

Cephalalgia

Tinnitus

Vertigo

Acute Torticollis

Whiplash

AC joint injury

Rotator Cuff pathology

Intercostal neuralgia

Epicondylitis

Carpal Tunnel

DeQuervain’s

Trigger Finger

Back pain

Coccydynia

Hip / Pelvic pain

Anterior knee pain

Chronic foot and ankle pain

Post fracture stiffness

Plantar fasciitis