History
In the 1980s, Stecco focused his fascial research on the treatment of recurring pain, pain which could not be alleviated by other treatments, and the recovery time of the injury. He developed a soft tissue manual technique aimed at treating myofascial dysfunction, and consequently, musculoskeletal disease. He named the technique Fascial Manipulation. He continued to focus his research on the method for the next four decades. Later on, it progressed with his children's collaboration, Antonio Stecco at New York University School of Medicine and Carla Stecco at Padua University. Stecco has written numerous books on Fascial Manipulation throughout his career. The idea was first coined by him in a 1988 booklet where he highlighted the similarities between myofascial sequences, and the energy channels, known as meridians which helps in identifying the painful regions with respect to points that are to be treated. Followed by this, he presented his findings on the Neuro-myofascial unit at the First International Symposium on Myofascial Pain and Fibromyalgia. He published his first book in 1990 entitled, ''Pain and Myo-Fascial Sequences'' that described the myofascial sequences, and the reflected pain across the fascia. The key fusion points, diagonals, and movement patterns were then addressed in the 2002 book, ''Fascial Manipulation for Musculoskeletal Pain''. Later on, he formulated a practical manual of the Stecco Method with Carla Stecco, and wrote the practical manual for internal organs that focused on internal dysfunction, which was published in 2007.Conceptual basis
Stecco considers the myofascial system as a 3D continuum, and believes that deep fascia consisting of layers of connective tissue that both cover and are within muscles throughout the body is essential as a coordinating, uniting, and connecting unit for the myofascial network. This system is related to proprioceptors andTechnique
Stecco has marked the critical points in the deep fascia through research on cadaver dissections in the recent years with the collaborations of Carla Stecco, and Antonio Stecco. The technique of this method focuses on creating manual friction on the specific localized deep muscular fascia which are often situated away from the pain site. For Fascial Manipulation, a thorough case history, especially including past injuries and surgeries is taken. The history is considered as crucial to determine whether the painful area is the cause of the pain or whether the painful area is compensating for a previous situation i.e., old ankle injury causing knee or hip pain. Next, movement testing is used to help determine painful ranges of motion, and to help decide on the specific fascial plain requiring treatment. The final decision as to treatment site is based primarily on the palpation of dense fascial acupuncture meridian points where the most receptors are located. Fascial Manipulation targets fascial points known as centers of coordination (CC’s) which help control muscle spindles that regulate unidirectional movement along sequences and centers of fusion (CF’S) that regulates motion in diagonal and spiral complex movements. Fascial Manipulation argues that the buildup of lack of shear within CCs, and CFs can adversely affect muscle, ligament and joint function including functional visceral conditions. Once the rigidity is relieved, and proper glide is acquired between the fascial layers, and surrounding tissues, reduction in pain, and eventual healing is observed.Effectiveness
Studies on the Fascial Manipulation (FM) method provide a statistical, and clinical significance of this technique on joint instability, skeletal and muscular pain arising from abnormal fascia function. In an early pilot study characterizing the clinical implications of applying Fascial Manipulation technique for the treatment of musculoskeletal pain, it was indicated from a study consisting of 28 subjects with chronic posterior brachial pain that the Fascial Manipulation technique could lead to effective reduction of chronic pain. Later on, a systematic review of research studies from 2005 to 2019 that followed Stecco’s Fascial Manipulation (FM) model was also conducted, and it was indicated that significant improvements were reported suggesting the effectiveness of FM in improving the pain in study subjects. The effects of the FM method for the treatment of rotator cuff tear disease have also been assessed in post stroke patients. It was demonstrated that mechanoreceptors in the deep fascia are activated with movement. However, rise in hyaluronon (HA) leads to an increase in deep fascia viscosity, which inhibits gliding of fascia, preventing normal muscle function. The effectiveness of Fascial Manipulation (FM) method for the treatment of carpal tunnel syndrome as compared to treatment with Low-Level Laser Therapy (LLLT) has also been measured. FM method was characterized as a valid alternative to LLT since the subjects receiving FM reported reduced pain perception, even after three-month follow up. A research study assessing the post-surgery pain focused on the effect of Fascial Manipulation for persistent knee pain following anterior cruciate ligament (ACL) and meniscus repair. In a 32-year-old male patient, clinically significant improvements were measured in follow ups at three, six, twelve, and twenty-four months. In another randomized controlled trial consisting of patients with a total hip arthroplasty, Fascial Manipulation was employed as a post-surgical care therapy, and compared to the standard care. It was demonstrated that with only two Fascial Manipulation sessions, significant improvements in pain reduction, and increased muscular capacity were measured. It was also proved as an effective, safe, and cost-effective approach to reduce facial pain, and has shown improvement in muscle force, and motor functionality. An early single blinded randomized controlled trial, showed that Fascial Manipulation (FM) reported significant improvements, both from a clinical and statistical viewpoint as compared to usual physiotherapy alone for the treatment of chronic aspecific low back pain (CALBP).References
{{reflist Manual therapy