Fascial Manipulation© (FM) Series

The Fascial Manipulation program consists of two separateintensive hands-on courses: Level I and II. Each course consists of theoretical lectures, demonstrations, and practice between participants throughout each course day.

The Fascial Manipulation course series is taught by Italian physiotherapists who work directly with Luigi Stecco. The courses will be conducted in English.

The Fascial Manipulation course series is intended for physical therapists, osteopaths, chiropractors, medical doctors, and other licensed health care practitioners with a good working knowledge of musculoskeletal anatomy, physiology and notions of postural analysis. Normally Massage Therapists need a minimum of three years of experience.

The October 21-26 2013 Course will be Level I. Each day will begin at 8:30 am and finish around 6:00 pm. Each level will conclude with an examination to appraise the level of understanding and skill level.

The first part of Level I will review the basic principles of Fascial Manipulation, including an introduction to fascial anatomy, and the biomechanical model employed in this method. The myofascial units that form the myofascial sequences of the upper limbs, trunk, and the lower limbs in the sagittal and frontal planes will be presented. The Assessment Chart used in Fascial Manipulation© will be reviewed in detail.

The second part will present the physiology of the fascial system and the assessment and treatment of the myofascial units for the upper limbs, trunk, and the lower limbs in the horizontal plane.

At the completion Level I, all participants will be capable of utilizing the Assessment Chart for a 3D examination of the human fascial system. Proficiency in the comparative examination of Centers of Coordination will be stressed, as well as streamlining of treatment strategies. Completion of the FM Level 1 provides clinical proficiency for a wide range of common dysfunctions.

Participants will learn to evaluate musculoskeletal dysfunctions with specific reference to the human fascial system, and to apply the Fascial Manipulation method as taught by Luigi Stecco, PT. Lectures include the anatomy and physiology of the fascial system, an explanation of the biomechanical model used in application of this technique, and the anatomical localization of key fascial points. Emphasis will be placed on the evaluation of musculoskeletal dysfunctions (from history taking, to a hypothesis, to a verification and treatment) together with a methodology and strategy for treatment.

Fascial Manipulation© is a manual therapy that has been developed by Luigi Stecco, an Italianphysiotherapist from the north of Italy. This method has evolved over the last 30 years through studyand practice in the treatment of a vast caseload of musculoskeletal problems. It focuses on the fascia, inparticular the deep muscular fascia, including the epimysium and the retinacula and considers that themyofascial system is a three-dimensional continuum.

In recent years, via collaboration with the AnatomyFaculties of the René Descartes University, Paris, France and the University of Padova in Italy, Dr. CarlaStecco and Dr. Antonio Stecco have carried out extensive research into the anatomy and histology of the

fascia via dissection of unembalmed cadavers. These dissections have enhanced the pre-existingbiomechanical model already elaborated by Luigi Stecco by providing new histological and anatomicaldata.

This technique presents a complete biomechanical model that assists in deciphering the role offascia in musculoskeletal disorders. The mainstay of this manual technique lies in the identification of aspecific, localized area of the fascia in connection with a specific limited movement. Once a limited orpainful movement is identified, then a specific point on the fascia is implicated and, through theappropriate manipulation of this precise part of the fascia, movement can be restored.

In fact, byanalyzing musculoskeletal anatomy, Luigi Stecco realized that the body can be divided into 14 segmentsand that each body segment is essentially served by six myofascial units (mf units) consisting ofmonoarticular and biarticular unidirectional muscle fibres, their deep fascia (including epimysium) and thearticulation that they move in one direction on one plane. Numerous muscle fibres originate from thefascia itself and, in turn, myofascial insertions extend between different muscle groups to form myofascialsequences. Therefore, adjacent unidirectional myofascial units are united via myotendinous expansionsand biarticular fibres to form myofascial sequences.

While part of the fascia is anchored to bone, part isalso always free to slide. The free part of the fascia allows the muscular traction, or the myofascialvectors, to converge at a specific point, named the vectorial Centre of Coordination or CC.The location ofeach CC has been calculated by taking into consideration the sum of the vectorial forces involved in theexecution of each movement. The six movements made on the three spatial planes are rarely carried outseparately,but more commonly, are combined together to form intermediate trajectories, similar to thePNF patterns. In order to synchronize these complex movements other specific points of the fascia (oftenover retinacula) have been identified and, subsequently, named Centres of Fusion or CF.

Deep fascia iseffectively an ideal structure for perceiving and, consequently, assisting in organizing movements. Infact, one vector, or afferent impulse, has no more significance to the Central Nervous System than anyother vector unless these vectors are mapped out and given a spatial significance. In human beings, thecomplexity of physical activity is, in part, determined by the crossover synchrony between the limbs anda refined variability in gestures. Whenever a body part moves in any given direction in space there is amyofascial, tensional re-arrangement within the corresponding fascia. Afferents embedded within thefascia are stimulated, producing accurate directional information. Any impediment in the gliding of thefascia could alter afferent input resulting in incoherent movement. It is hypothesized that fascia isinvolved in proprioception and peripheral motor control in strict collaboration with the CNS.

Therapeutic implications

The fascia is very extensive and so it would be difficult and inappropriate to work over the entire area.

The localization of precise points or key areas can render manipulation more effective. An accurateanalysis of the myofascial connections based on an understanding of fascial anatomy can provideindications as to where it is best to intervene.

Any non-physiological alteration of deep fascia could causetensional changes along a related sequence resulting in incorrect activation of nerve receptors,uncoordinated movements, and consequent nociceptive afferents.

Deep massage on these specific points(CC and CF) aims at restoring tensional balance.

Compensatory tension may extend along a myofascialsequence so myofascial continuity could be involved in the referral of pain along a limb or at a distance,even in the absence of specific nerve root disturbance. In clinical practice, cases of sciatic-like pain andcervicobrachialgia without detectable nerve root irritation are common.

This technique allows therapiststo work at a distance from the actual site of pain, which is often inflamed due to non-physiologicaltension. For each mf unit, the area where pain is commonly felt has been mapped out and is known asthe Centre of Perception (CP).

In fact, it is important to place our attention on the cause of pain, tracingback to the origin of this anomalous tension, or more specifically to the CC and CF located within thedeep fascia.