by Luigi Stecco
The fascia, with both its
macroscopic and microscopic structure, is the map that can
help to orientate any research into the origin of locomotor
apparatus’ disorders. This book, which is the outcome of
thousands of treatments carried out over the last
twenty-five years, provides the necessary guidelines for
reading this map. Up until now, perhaps due to its intrinsic
complexity, the role of the fascia has been relegated to
that of containment.
The connections of the
fascia with muscles, bones, articulations and nerves
(anatomy of the fascia),
The coordinating function
of the fascia with regards to all components of the
locomotor apparatus (physiology of the fascia),
The way to manipulate
densified or condensed fascia in order to restore it to
its physiological state (treatment of the fascia).
This new vision of the
anatomy, physiology and histology of the fascia allows one
to have an effect on soft tissue dysfunctions in an
efficient and long-lasting manner.
This book specially imported
from Italy is in Hard Cover, 252 pages, and 188 colour
Fascial Manipulation is a
manual therapy that requires a good knowledge of anatomy and
physiology. Only by comprehending the origin of a problem,
one can resolve the problem rapidly and efficiently (Manus
sapiens potens est). The wellbeing of any organ depends on
the balance that exists between its components.
The logo of
Fascia Manipulation shows a correct posture with the
alignment of the head and the scapula with the vertebrae.
Fascial Manipulation has been brought
to focus through many years of study and clinical practice
by Luigi Stecco, an Italian physiotherapist and it is now
being practiced by a growing number of therapists in Europe.
Theoretically it is based on anatomical aspects of the
The continuity of fascia throughout the whole body, from
superficial to deeper myofascia (epymysium, perimysium,
2) A certain
capacity of the epimysial fascia to perceive and
consequently “direct” movement through it’s proprioceptive
3) When traumatized, irritated or inflamed the fascia loses
it’s characteristic elasticity forming granulation tissue (neocollagen)
is also based on anatomical aspects of the musculoskeletal
Muscles are surrounded by epimysial fascia and are also
divided by fascia into myofascial units. Each myofascial
unit contains muscle fibres that when they contract move the
corresponding joint in only one direction (ipsodirectional
fibres). Many muscles are made up of more than one
myofascial unit as they have the capacity to move a joint in
more than just one direction.
2) In a healthy state part of the fascia slides freely over
muscles and part has certain fixed points of anchorage or
bone “insertions” via tendons, ligaments and intramuscular
3) For each myofascial unit it’s possible to localise a
specific small area of it’s fascia (called Centre of
Coordination or CC) where the tractions of the various
muscles of the MF unit converge and which, when inflamed,
blocks or limits movement at the corresponding joint.
consideration the above concepts Fascial Manipulation
consists in manual techniques applied to these Centres of
Coordination in order to free the fascia of any neocollagen
tissue. The rise in temperature caused by manual friction
dissolves the neocollagen formations restoring tissue
elasticity and joint range.
Prior to initiating any treatment an accurate analysis of
all impeded movements indicates the most appropriate
myofascial unit (and thereby it’s specific CC) to be
treated. This assessment procedure which involves both a
subjective and an objective examination also provides the
basis for an immediate evaluation of treatment
effectiveness, allows for treatment planning and is a vital
aspect of a successful treatment.
which has been clinically tested over the last 20 years is
proving to be a useful in Orthopaedics, Rheumatology and
Fascial Manipulation analyses muscles from a functional
viewpoint rather than from their external structure:
unidirectional motor units (mono and biarticular fibres)
into myofascial units,
It describes the precise
location of the centre of coordination (CC) of each
It highlights the
correspondence that exists between each cc and the
respective trigger points and acupuncture points of each
In the first part of
this book the relationship of the endomysium, perimysium and
epimysium with the deep fascia is analysed; this analysis is
extended to all of the 84 myofascial units (mf) in the human
body. It is the continuity of the fascia that regulates and
coordinates the tensioning of the muscles spindles and Golgi
tendon organs located within each of these mf units.
In the second part the
macroscopic structure of the fascia is analysed. The
intermuscular septa form compartments that surround the
unidirectional muscular chains or myofascial sequences. The
mf sequences that control movement on one spatial plane are
all connected together by the fascia, allowing for
synchronised maintenance of the body’s verticality.
The third part of the book
highlights the arrangement of the endofascial collagen
fibres. There are longitudinal fibres arranged according to
the traction of the mf sequences as well as spiral form
fibres, which have assumed this type of arrangement due to
traction of the oblique muscle fibres involved in complex
This volume not only presents
an in-depth analysis of the fascia but also offers useful
indications for identifying the origin of its dysfunctions.
A particular method of data collection that can provide
immediate indications of the points to be manipulated is
If pain is present in only
one body segment then identification of the exact part
of the joint where the disorder is manifest will
indicate the dysfunctional mf unit.
If pain is present in a
number of segments and analysis demonstrates that their
distribution corresponds to a particular spatial plane,
then treatment aims at re-equilibrating postural
If the pain is poorly
defined and exacerbated by complex motor activity, then
the particular mf spiral, which is dysfunctional during
that specific motor activity or gesture, is identified
innovative theories are supported by many citations from
anatomical texts in order to highlight the marvellous
structural design that exists within the fascial system.
Who is it for?
Fascial Manipulation for Musculoskeletal Pain presents
to all people dealing with Rehabilitation a new
therapeutic tool which gives very good results for the
treatment of musculoskeletal pathologies. Such
pathologies usually involve joints, nerves, muscles, yet a
proper therapy should first of all focus on the most
malleable tissue: the fascia. Fascial manipulation is indeed
the best treatment for the rehabilitation of patients
affected by myofascial pain and fribromyalgia, which
are the most common impairments
reported by patients to Rheumathologists.
Sport physicians, Bodyworkers,
Massage Therapists and Physical Education Teachers
as well take often care of athletes suffering
from musculoskeletal recurrent diseases. In this book they
will find the necessary know-how to efficiently take care of
the underlying myofascial structures. By knowing the origin
of the problem, they’ll be able to give proper
instructions to modify the athletic
gesture and prevent recurrences.
As Acupuncture researchers have
found, there is a parallelism between the meridian
path and the nerves, veins, and lymphatic vessels paths. The
Author’s innovative proposal in Fascial Manipulation is that
each space direction corresponds to a meridian. Hence the
motor impairment towards a certain direction can be a guide
to locate the blocked point to treat.
Last but not least Family
Physicians, who are daily confronted with
patients suffering from musculoskeletal pain, will find in
Luigi Stecco’s book the opportunity to go beyond the usual
radiological exams and drug prescription by inserting also
manipulation in their therapeutic approach.
Few books achieve the fond hopes of
their authors and their admirers.This is just one that
succeeds, making a genuine and profound contribution to the
fields of biomechanics, orthopedics and rehabilitation. It
moves with easy grace from any topic to its neighbor,
shedding warmth and life to them all.
As one who
has experienced both the high and low points of medical
writing and editing over several decades, I see in these
pages a true work of genius. It deserves a very wide
readership and enthusiastic application of its lessons.
John V. Basmajian Professor
Emeritus in Medicine, McMaster
University, Hamilton, Ontario, Canada
impressive, an analytical masterwork, Luigi Stecco’s
findings on coordination centres will be of strong interest.
This work will be a great stimulus for investigations in all
kind of rheumatic diseases.
Hartmut Heine Institutsleiter, Anatomisches und
A new and valid interpretation of the
function of the muscular fasciae as a part of locomotor
organisation, based on both practical and rational aspects.
Clearly written and easily comprehensible. A useful book for
all those who are involved in rehabilitation.
Ivano Colombo, Milano
admirable book with a different approach.
Lewit, Central Railway Health Institute, Prague