What is the fascial system?
The fascial system refers to the three dimensional continuum of soft, collagen containing, loose and dense fibrous connective tissue that permeates the human body. The fascial system interpenetrates and surrounds all organs, muscles, bones and nerve fibers, endowing the body with a functional structure, and providing an environment that enables all body systems to operate in an integrated manner. Myofascia refers to the deep fascia covering the muscles, tendons and its associated structures.
Myofascia has a multitude of functions, including:
- Force transmission
- Proprioception (joint position sense)
- Facilitating movement -by promoting sliding and reducing the friction associated with movements.
What is Fascial Manipulation?
Fascial Manipulation (FM) is an evidence-based treatment for pain relief which involves manual therapy of the myofascial system. This method was founded by a physiotherapist Luigi Stecco from Italy.
How does Fascial Manipulation work?
The aim of the Fascial Manipulation therapy is to restore gliding between the fascial fibres by addressing precise points or key areas with a friction type of massage to address fascial densifications with in the myofascial layers. A brief understanding of the structure of a muscle would help to understand this better. A muscle belly is made up of several bundles of fascicles and each fascicle is made up of several myofibrils, as shown in the picture. Each entity is covered by fascia which forms the myofascial layers which gives them the form and structure. The myofascial layers have a lubricant named Hyaluronan that enables sliding of the muscle fibers during movement. With injury/over-use this lubricant becomes thickened called fascial densifications. Fascial densifications may cause weakness, tightness and improper movement patterns resulting in pain and dysfunction. Mobilization of this dense myofascia followed by appropriate exercises and ergonomic strategies may help in restoring the strength, mobility and movement patterns therefore decreasing pain and improving function.
What do I expect with Fascial Manipulation?
A thorough assessment of the presenting problems, which includes:
- An interview of the current situation, medical history and previous injuries to understand the compensations
- Physical assessment to assess posture, range of motion, strength, and coordination.
- Manual palpation of specific points on the body to determine the location of fascial
Treatment consists of,
Friction type of massage on specific areas in the body where the muscles work together in order to move body parts in specific directions or in complex patterns. These areas are located in the muscles, tendons, ligaments and joints.
To improve the strength, mobility and agility commensurate with the functional and recreational goals.
Discussions on ergonomic strategies to maximize the efficiency of the work/activity.
Post Treatment Care:
As Fascial Manipulation involves friction type of technique to restore gliding of adherent tissue, a mild inflammatory state occurs after manipulation which in some cases presents with pain and localized swelling. This is a normal part of the healing process and is necessary for the body to bring in various substances and specialized cells to clean up, nourish and rebuild the injured loose connective tissue and collagen fibres that make up the fascia. You may feel some discomfort for 24 to 72 hours after treatment. It is advisable to be well hydrated and refrain from heavy unaccustomed physical activities immediately after a treatment session.
Why do you work far from the region of the symptoms?
The fascia forms a very intricate network of connections of the connective tissue throughout the body. After an injury, our body may try to compensate for a problem, changing postures or body mechanics, shifting strain onto another area of the body causing pain and dysfunction. Proper analysis of the cause of a problem allows the therapist to find and treat the “root of the problem,” not just the symptoms related to it.
How long would it take for me to get better with this treatment method?
Each person is different from one to another and the recovery is dependent on several factors affecting the individual and the underlying problem. The therapist will re-assess and discuss with you and determine the appropriate course of action based on your response to the treatment.
Who would benefit from Fascial Manipulation?
Myofascial dysfunction is associated as a primary contributing factor in several musculoskeletal conditions. Some of the common conditions include,
Pain with a mechanical origin: Low back pain, sciatica, knee pain, Neck pain, hip and groin pain, frozen shoulder, tennis elbow, golfers’ elbow, plantar fasciitis, Temporo-mandibular dysfunction.
Entrapment syndromes: Carpal tunnel syndrome, Piriformis syndrome, Intercostal neuralgia, Thoracic outlet syndrome.
Referred pain: Tension-type headache. to name a few.
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Magesh provides fascial manipulation as one of the services at Physio Care Owen Sound. He has participated and completed level 1 and level 2 courses in fascial manipulation in Toronto, Canada.