Fascial Manipulation

Fascial Manipulation© (FM) Series
The Fascial Manipulation course program consists of three level intensive hands-oncourses, combining theoretical lectures, demonstrations, and practice between
participants throughout each course day.
Participants will learn to evaluate musculoskeletal dysfunctions with specificreference 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 thefascial system, an explanation of the biomechanical model used in application of thistechnique, and the anatomical localization of key fascial points. Emphasis will beplaced on the evaluation of musculoskeletal dysfunctions (from history taking, to ahypothesis, to a verification and treatment) together with a methodology and strategy
for treatment.
This course series consists of three levels: FM-1: Level 1 Fascial Manipulation andFM-2: Level 2 Fascial Manipulation and FM-3: Level 3 Fascial Manipulation. Eachlevel is divided into two parts, FM-1a and FM-1b, FM-2a and FM-2b, FM-3a andFM-3b. Successful completion of FM Level 1 is required before being able to attend
the FM Level 2 course as well FM level 3. Completion of the FM Level 1 does
provide clinical proficiency for a wide range of common dysfunctions.
Each level is designed to give participants adequate time (4-6 weeks) to practice the
newly acquired assessment and treatment techniques before returning to the second
half of the course for fine-tuning of the method.
The Fascial Manipulation course series is intended for physical therapists, osteopaths,
chiropractors, medical doctors, and other licensed health care practitioners with agood working knowledge of musculoskeletal anatomy, physiology and notions ofpostural analysis. Massage therapists with a minimum of three years of experience
may be eligible but need to contact us prior to registering to review their eligibility.

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FM-1: Level 1 Fascial Manipulation

The FM-1 Level 1 Fascial Manipulation course consists of two three-day courses thatneed to be taken within 4-6 weeks of each other to assure a good understanding of theunderlying biomechanical rationale and mastery of the techniques.
Course FM-1a will review the basic principles of Fascial Manipulation, including
an introduction to fascial anatomy, and the biomechanical model employed in thismethod. 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.
Course FM-1b will consist in the physiology of the fascial system and theassessment and treatment of the myofascial units for the upper limbs, trunk, andthe lower limbs in the horizontal plane. At the completion of FM-1b all participants
will be capable of utilizing the Assessment Chart for a 3D examination of the humanfascial system. Proficiency in the comparative examination of Centers ofCoordination will be stressed, as well as streamlining of treatment strategies.
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.

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FM-2: Level 2 Fascial Manipulation®

In the FM-2 Level 2 Fascial Manipulation course, participants expand on theirunderstanding of the biomechanical model to treat patients with multi-segmental
dysfunctions more efficiently.
As part of the learning process, Level 2 students will be required to present
Assessment Charts of cases treated after Level 1 for discussion.
Level 2 also consists of two three-day courses taken within 4-6 weeks of each otherto allow time for clinical experience and practice and to assure a mastery of thetechnique as a whole.
Course FM-2a will focus on the role of Centers of Fusion as part of thebiomechanical model and the formation of Myofascial Diagonals. Elements ofcomparative anatomy studies will be introduced to assist the evaluation of adaptivecompensations within the fascial system. The involvement of fascia in motor control
will discussed and the Assessment Chart used in Fascial Manipulation© will be
updated with new elements.
Course FM-2b will introduce the Myofascial Spirals to complete understanding ofcomplex movement patterns and mechanisms and the latest fascial research projects
will be presented. Numerous treatment demonstrations and practice will highlight thiscourse as comparative assessment of Centers of Coordination and Centers of Fusion,
Assessment Chart analysis, clinical reasoning, hands-on skills, and treatment
strategies will be emphasized.

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FM-3: Level 3 Fascial Manipulation®

In the FM-3 Level 3 Fascial Manipulation course, participants expand on theirunderstanding of the internistic dysfunctions and alteration of the superficial fascia.
Course FM-3a will focus in the Tensile structure, Apparatus-fascial sequences andcatenaries Tensile structures extend over body cavities guaranteeing the patency oftheir internal space, which allows both motility and mobility of the organs containedwithin. At the same time, tensile structures must allow adaptation to external stressand to the motor needs of the musculoskeletal system. A can alter due to densificationof the external fasciae, due to a problem within the musculoskeletal system, or due toan internal organ dysfunction that reflects its tension onto the container (wall ofabdominal canister) via its fasciae. Organ dysfunction manifests with pain andsymptoms that are often generic but they can be located within the body segment thatcontains the organ.

Course FM-3b will introduce the Quadrants and the Systems.
Anatomical divisions of the superficial fascia form a quadrant. These divisions, bothin horizontal and longitudinal directions, are due to thickenings of the retinacula cutisthat cause adhesion to the deep fascia. The area of a quadrant usually corresponds tothe distribution of the cutaneous nerves and the angiosomes. Within each quadrant,
there are the three superficial components of the three internal systems: receptors,
lymphatic vessels and adipose cells

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FM Course Objective
The primary objective is to develop an understanding of the Centers of Coordination(CC) that are responsible for the normal function of related monoarticular andbiarticular muscles. By the end of the course, clinicians will:

Learn anatomy and physiology of the fascial system.
Learn how to evaluate myofascial planes: upper and lower extremities, spine.
Determine functional testing of areas of complaint.
Develop skill and understanding to assess abnormal functional findings with
fascial points of involvement to restore normal function.

Can you give an example of how Fascial Manipulation works?
Tough question to answer in short form. Here are some general points:
1. Thorough case history emphasizing past, concurrent and present complaints. It isoften necessary to evaluate and treat older injuries since the current complaint may becompensatory.
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 ofmanipulation).
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 postcheck to see if the painful movement was relieved.

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Fascial Manipulation® assessment and treatment
Assessment of the presenting problems is very important and may consist of severalparts  history taking to understand the unique set of circumstances that you and yourbody have experienced throughout your life movement tests to understand how your body parts move in relation to eachother testing of muscles and joints for strength and range of motion
 manual palpation of very specific regions of the body in order to determine thelocation of fascial alterations which may be involved with your problem
Pre-treatment and post-treatment assessments give us subjective (what you feel) andobjective (what we measure) verifications of the outcome of treatment.
Treatment consists of deep tissue manipulation of very specific and focused areas ofthe deep fascia where muscular forces converge in order to move body parts inspecific directions or in complex patterns. Some are located in the muscles
themselves, others around the tendons, ligaments and joints. Treatment may betargeted at a single area of the body or it may be necessary to treat several areas inorder to achieve balance within the system.
Why is the treatment sometimes painful?
The areas that are manipulated during treatment, where the fascia is “stuck”, containthe very same kind of nerve endings that were described earlier - including free nerve
endings that transmit pain signals. When we find a densification, we compress thetissues enveloping it and move back and forth to create friction, heat and gliding.
This helps to change to consistency of the chemical substances within the fascia thatare responsible for its gliding characteristics from a sticky glue-like state to a fluid
lubricating state – thus restoring freedom of movement between the layers of fascia.
As this freedom of movement is restored, the pain transmitting nerve fibers becomeunrestricted and quit sending nociceptive (pain) signals to the nervous system.
A mild inflammatory state occurs after manipulation. This is a normal part of thehealing process and is necessary for the body to bring in various substances andspecialized cells to clean up, nourish and rebuild the injured loose connective tissue
and collagen fibers that make up the fascia.

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It is important to avoid strenuous activity after a treatment, although most patients
experience a great deal of relief immediately afterward and want to get back tocurtailed activities as soon as possible. Mild exercise is fine – we want to move theaffected structures to aid in restoration of normal movement – but too much may
complicate recovery.
Why are you work far from the region of the symptoms?
Sometimes the area of treatment is distant from the area of pain, discomfort ordisability. The reason for this is that the fascia forms a very intricate network
throughout the body and each area of the body is connected in some way to every
other area. We want to find and treat the root cause of an ailment - not the symptoms
related to it. The symptoms are merely the feedback systems of the body letting us
know something is wrong. Treating a symptom without addressing its root cause may
leave underlying problems undetected, which could allow recurrence of the problem
or other future complications.
Wrapping it all up…..
The uniqueness of Fascial Manipulation® is that we are looking at the body as awhole, not just "where it hurts" or where the problems appear to be. Most of the time,
fascial alterations away from the affected painful area are the actual cause of theproblem. In most cases, we are able to treat acutely painful conditions and not eventouch the area that hurts. In other words, the fascial structures in other areas may becausing abnormal (or unbalanced) pull or stress on the muscles, joints or nerves thatcause you to feel pain, limited movement or even altered sensations in a different partof your body. Your therapist or doctor may be testing and treating areas that you
might think have nothing to do with your problem, but since the body is one complex
and complete unit, it is very important to assess all aspects of the workings of thebody in an effort to achieve balance and allow the body to do the job of healing itself
more accurately.
For more information, including how to find a qualified Fascial Manipulation®
practitioner in your area, please visit the official website–
http://www.fascialmanipulation.com/en/

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