Unlocking the cage - an introduction to fascial manipulation
My introduction to Fascial Manipulation, or FM for short, has changed the way I view injury and dysfunction in human movement. From originally approaching bodywork with the mindset that the muscles are the primary source of causation of pain, FM gave me the scope to look further and seek other contributing factors (beside psychological and mechanical factors) to dysfunctional movement patterns that are causing someone pain, and in some cases, long term unresolved pain.
So what is fascia?
The deep fascial network is a web of connective tissue that winds its way throughout the body. Wrapping muscle into muscle, muscle into bone, bone into joint, muscle into tendon and tendon into retinaculum in a continuous spiral-like web throughout the body. It suspends our visceral organs like puppets on a string, and is the birthplace of major muscles such as lattisimus Dorisi and forms crucial attachments for major muscles like gluteus maximus (through the Ilio Tibial Band) to perform its function (lower back pain anyone!!). It separates structures and allows them to function symbiotically with each other.
So why is the Deep Fascia so important to function in movement?
It is because this deep fascia is designed not only to bag and hold things in place, but to also allow the structures it separates to glide and slide against one another. It is elastic and pliable in some parts of the body while thick and stiff in others.
Our understanding of the fascia, both the superficial and deep fascia is only in its infancy, and certainly could hold much more relevance to the body and disease than ever thought. It's lubricating fluid is called hyaluronic acid (I like to think of it as the body's natural engine oil) and its ability to remain constantly lubricated depends on a number of factors, some of which are exposure to movement or lack of (such as immobilisation or compensation), injuries and so forth.
Certainly life isn't perfect, and through our adoption of certain postures and compensations throughout life this deep fascia changes in its ability to function correctly and fluidly until the eventual result is pain, particularly focused at the joint or around the muscles. The mechanism for changes in consistency in the deep fascia lies in the hyaluronic acid, and when this acid cools and ceases to assist in glide (think of thickened cold oil in a pan), pliability and elasticity is reduced in the deep fascia and a sticking or "scarring" occurs where the deep fascia "sticks" to the surrounding structures, reducing movement and mobility, increasing pain, and paving the road to compensations that will eventually lead to other dysfunctions down the track.
About Fascial Manipulation (FM)
Luigi Stecco, an Italian physiotherapist has developed a method to identify and treat certain "key" points in the fascia to restore proper movement in the tissue, and by restoring the glide between the deep fascia and surrounding structures and "unlocking the cage" that is our body, we can restore proper glide between the tissues and allow the body's cage to resume its one of possibly many roles.