Q & A Regarding Fascial Manipulation©

How does Fascial Manipulation (FM) differ from other techniques such as fascial release, friction massage, Graston Technique®,  FAKTR, Active Release Technique® and others?

FM emphasizes concepts about evaluating the fascia in terms of functional testing, movement and direction in specific spatial planes and the location of specific areas to treat. Most of the time, you will be palpating and treating areas that the patient never realized was involved in the complaint. FM adds information that will improve the results already attained by the above methods.

What is so special about these points?

These points have clinically been found to be the source of most muscle and joint pain problems.  See question below.

What do you mean by Center of Coordination (CC) and Center of Fusion (CF)?

The following are definitions, but require further discussion not included in this answer. A CC is located in a precise location of deep muscular fascia in the belly of a muscle, in a myofascial unit (i.e., arm). Each CC is located at the point of convergence of the vectorial muscular forces that act on a joint during a precise movement. Densification of this point will adversely affect muscle mechanoreceptors, especially spindle cells resulting in abnormal motor unit activation. A CF is located in the intermuscular septa, retinaculum and ligaments. It monitors movements in intermediate directions between two planes and three dimensional movements.

Can you give an example of how this system works?

Tough question to answer in short form.  Here are some general points:

1. Thorough case history emphasizing past, concurrent and present complaints. It is often necessary to evaluate and treat older injuries since the current complaint may be compensatory.

2. Functionally evaluate areas of complaint (active, passive, resistive) to determine which areas require treatment.

3. Decide what fascial plane or planes appear to be most involved.

4. Palpate FM points that relate to the painful movements for densification, tenderness and referral pattern (referred pain may occur after a few minutes of manipulation).

5. Decide what plane you will treat based on the most involved points. Also, palpate antagonists of plane or planes we decide to treat.

6. After treating each point that was related to a painful functional test, do a post-check to see if the painful movement was relieved.

What type of treatment is involved?

Hands, elbows and instruments have all proven to be effective. Begin with minimum pressure and slowly attempt to go deeper. A maximum of eight fascial points can be treated at each visit. Again, the points chosen are based on movement and palpation tests.  As stated in Stecco’s text, FM Practical Part, a precise location is necessary to transform friction into heat (2 to 10 minutes) to modify the consistency of the deep fascia’s extracellular matrix. The aim is to restore gliding between the endofascial collagen fibers, rupture adhesions between the layers of the deep fascia, and recreate the elasticity of the connective tissue of the epimyseum, perimyseum and endomyseum.