Fascia Manipulation for Muscle and Joint Pain

Fascia is a connective tissue that surrounds nearly everything in our body and connects it all. Restrictions in one area of the body can cause pain in areas further away. Doing massage part time while attending naturopathic medical school I was fortunate to come across a technique that targets fascial restrictions in the body.  “The Fascial Manipulation© technique is based on the concept of myofascial units (mf units) united in myofascial sequences, and involves manual friction over specific points (called Centres of coordination and Centres of fusion) on the deep muscular fascia .” The CC are the same as meridian points in Chinese medicine. The technique was developed by Luigi Stecco, an Italian physiotherapist from the north of Italy. Luigi Stecco realized that the body can be divided into 14 segments and that each body segment is essentially served by six myofascial units (mf units) consisting of monoarticular and biarticular unidirectional muscle fibres, their deep fascia (including epimysium) and the articulation that they move in one direction on one plane. So how does this actually work?

Technique

When the tissue feels dense, Stecco uses compression, friction, heat and gliding restoring freedom of movement between the layers of fascia. When the movement is restored to a more fluid pre-stressed state, the pain emitted from the knotted connective tissue ceases and no longer sends nociceptive signals to the nervous system. The tissue has a certain amount of Hyaluronic acid that allows the fascia to glide, and if theres too much, it will stick together and cause restrictions making it viscous or “sticky”. By eating up the tissue to 108 degrees the bonds in the hyaluronic acid will break and become more fluid. You should not treat more than 6 points in one setting or it could induce a fever due to inflammatory products being released.

Range of motion assessment

I assess the range of motion to hone in on the restriction and the associative points that run along the plane. You preform 3 planes of movement for each segment and look for quality, quantity, and pain. Use AROM, PROM and RROM. This is similar to TP therapy but includes an initial assessment to identify the correct plane to work on.

Treatment

The plane that shows more restriction is treated as it is most likely the origin of the dysfunction. Next you treat points from closer to further away from the site of pain. Then you move to points opposite to the area you just worked. The goal is to balance the entire plane by reducing its tension. Pain can be ascending or descending so it is important to get an accurate timeline of pain onset. With just the first treatment there is symptom improvement of 30-80%.

Stecco may not be for everyone due to the amount of friction that is necessary to break the restrictions free. For more information resources are provided below.

ManipolazioneFasciale.ManipolazioneFasciale.http://www.fascialmanipulation.com/. Accessed July 5, 2017.

SteccoL, Day JA. Fascial manipulation for musculoskeletal pain.Padova:Piccin; 2004.