Fascia therapy

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As Fasciatherapie or Faszientherapie various manual treatments for the connective tissue are fascial system of the body, respectively. Is common to you.

  • the treatment of the body-wide tension network of the fascia
  • the use of suitable manual techniques to relax fascial restrictions and promote increased adaptability to external stresses
  • their functional focus on restoring the most neutral and smooth movement sequences possible within the fascia network of the body
  • their gentle therapeutic approach, which relies on proprioceptive , nociceptive and interoceptive interactions,
  • their findings on sensitive palpation with the hands
  • their common roots in osteopathy
  • the inclusion of functional posture and movement factors in a therapeutic "sensorimotor reset" of the patient (similar to the Feldenkrais or the Alexander Technique )
  • and - unlike in articularly oriented structural osteopathy or in structural integration ( Rolfing ) - an orientation that is not primarily influenced by structural manipulation.

The name is made up of fascia ( Latin fascia , band, bandage ' ) and therapy ( ancient Greek θεραπεία therapeia , German ' service, care, healing ' ).

Therapeutic task of fascia therapy

The common therapeutic goal of the various forms of fascia therapy is, despite their different methodological nuances, to try to balance a tension imbalance in the interconnected connective tissue parts of the body as precisely as possible . Fascia therapists consider fascia with their basic collagenic structure to be the form organ of the body, i.e. the organic part that connects all structures. Improving the functionality of this body-wide organ thus represents the common therapeutic program. The main functions of the fascia can be summarized using the mnemonic of the "four P" :

  • P ackaging ( i.e. wrapping, structuring, meaningful delimitation)
  • P rotection (protection e.g. through sensible restriction of movement via tendons and ligaments)
  • P assage (fascia as functional tissue guide rail Triassic artery, vein and nerve)
  • P osture (fascia as entertainment formative factor)

According to the method, the body has the best prerequisites for self-regulation and recovery when the tension in the body's own fascia system is balanced.

According to the various authors, the above imbalances arise from

So-called somatic dysfunctions are treated instead of individual symptoms. The clinical relevance of these somatic dysfunctions is seen in unbalanced and altered function of related body systems; According to the findings in osteopathy, an expression of this is perceptible through the hands of the therapist

  • changed fabric texture
  • Restriction of movement
  • asymmetrical position or tension of the body part and
  • Sensitivity (or pain)

referred to as a measure of the extent of a somatic dysfunction.

In the musculoskeletal system, according to the methodology, this is reflected in the form of shortening, tension , conglutination (adhesion, fusing ) up to fibrosis of the various fasciae as well as changes in sensorimotor functions . Depending on the type of static challenge, this should then be B. the fascia lata , the plantar fascia , the thoracolumbar fascia , the rectus sheath or z. B. concern the fascia clavipectoralis . Even in smaller fasciae, tension can be noticeable in an unfavorable way and express themselves, for example, as myofascial pain syndrome .

Biomechanical models

Similar to Rolfing , the interconnected fasciae of the body are viewed as a "body-wide three-dimensional network". Unlike in Rolfing, however, fascia therapy does not focus on the structural treatment of this network with the aim of optimizing the reorientation of the client in the axis of gravity. The more economical use of the musculoskeletal system is a desirable side effect of fascia therapy, but in addition to the therapy of the musculoskeletal system, it also has self-regulation in the therapeutic focus: vascular promotion of hemodynamics, improvement of lymph flow and thus also the homeostatic improvement of the body's self-healing powers .

As an illustrative model for the therapeutic objective of the method is often used a mechanical model of the different protagonists: the tensegrity model of the American architect and philosophers Buckminster Fuller and the American sculptor Kenneth Snelson is based on a static, in the discontinuous compression elements from a continuous Spannungszug to an overall shape that derives its relative stability from a high adaptability to acting forces. Compared to the human or animal body

In this model, an unbalanced dynamic tension ratio corresponds to an unfavorable tension from one or more parts of this fascia network, which then puts the entire system, i.e. the body affected, under stress, which must then be compensated with the use of force .

Making compensations superfluous or being able to compensate for restricted functions more efficiently is one of the approaches: after palpation of the so-called tension pattern, the therapist tries to contribute to making the solidified structures more supple again through manual influence and / or through experience of movement.

Visceral fascia

Fascia are not only found in the musculoskeletal system, but also very dense suspensions of the organs and meninges around the central nervous system . The view of the methodology is that there are cross-system - networked - tension imbalances that cause stresses in the capacity for homeostasis of the body. So in the methodology also interactions z. B. examined via the vegetative nervous system ( sympathetic and parasympathetic ) between the fasciae of the musculoskeletal system and individual organs (somatovisceral dysfunction). Not only the musculoskeletal system is treated, but also the "fascia" of the organ system, e.g. B. the suspension structures of various parts of the digestive system, e.g. B. the mesentery of the small intestine , ligaments of the liver ( ligamentum falciforme ) or the uterus ( ligamentum latum uteri , ligamentum sacrouterinum ). Due to the tensile stresses caused by ptosis (subsidence) and adhesions (sticking), according to the teaching of fascia therapy, there is also, conversely, strain on the musculoskeletal system and painful movement restrictions (viscerosomatic reflexes) or narrowing of blood vessels . This is postulated in a comparable form in osteopathy , from which the methodology partly originates.

History and myofascial focus

An important part of fascia therapy, the "myofascial release method", was removed from osteopathy after its initial development in the 1970s and used by physiotherapists and medical masseurs as a general manual treatment method outside of the osteopathic context. One of the best known representatives of this branch of the myofascial release methodology is John Barnes. This separation of methods from osteopathy can be traced back to the fact that osteopathy is not an independent, defined method, but is composed of several different individual methods. Since it has been a medical-academic discipline in its country of origin, the United States, from a medical-historical point of view, since it was founded by Andrew Taylor Still, the non-medical body therapists (physical therapists, medical masseurs and in the United States the "bodyworker") subsequently developed Interest in the application of the harmless functional osteopathic approaches - i.e. the methods which, if used correctly and responsibly by non-doctors, would not endanger their patients (e.g. through incorrect treatment of contraindications to be avoided). The Myofascial Release method was removed from osteopathy in the 1970s and used by physiotherapists and medical masseurs as a general manual treatment method outside of the osteopathic context. The methodology spread to Europe from Michigan, California and Pennsylvania in the 1980s and 1990s. Two of the best known representatives of this branch of the myofascial release methodology are Carol J. Manheim PT John Barnes, PT.

Procedure in the myofascial release

In the functional fascia therapy, which is strongly characterized by myofascial release, treatment is almost exclusively manual; active movement of the patient is only used occasionally, e.g. B. to use the therapist's active movement against pressure from the therapist (e.g. flexion or extension of the extremities) to reinforce the targeted therapeutic pressure.

Usually adequate pressure is applied against a restriction of movement of a fascia in a tangential form, e.g. B. in the area of ​​the superficial fascia. This pressure is kept at the elastic limit by the therapist until a tissue reaction sets in in the form of compliance. This flexibility of the tissue, also known as compliance, is recorded by palpation in real time and a new elastic limit is sought until the desired therapeutic result is achieved, i.e. greater flexibility in the fascia. This path through the "ease" is also referred to by practitioners as "fascial creep".

The functional fascia therapeutic approach is such that there is not only an active stress on the elastic limit, but the flexibility of the tissue is monitored under constant palpatory control in order to reach the so-called "point of balanced tension" and the tissue to relax Tension, the so-called "release" is caused. The method is of the opinion that a tension-neutral positioning via proprioceptive feedback leads to an improvement in the sensorimotor regulation of hypertension.

A third form is the combined approach, in which the positioning of body parts reduces regional tension while at the same time direct stretching pressure is applied.

Distribution and associated differences in naming

Fascia therapy is taught across Western Europe. In the French and German-speaking Switzerland and the francophone countries (Belgium, France) as fascia therapy - in Germany mostly as fascia therapy . The method is mainly practiced by physiotherapists, medical masseurs and alternative practitioners - there are only a few doctors who position themselves in complementary medicine.

Methodical characteristics

There are different methodological approaches that present themselves as fascia therapy or fascia therapy. Their treatment-related characterization usually differs gradually in terms of the type of manual therapeutic influence and the way in which movement is integrated as a therapeutic agent. In the following, the methodological characteristics that are included in fascia therapy are presented:

Functional fascia therapy

works with methods like that

  • Unwinding
  • Indirect and direct myofascial release
  • Lymphatic techniques
  • Strain-Counterstrain
  • Myofascial Induction Therapy (MIT)
  • Ligament-Articular Tension Techniques and with the
  • Treatment of thoracic, visceral and pelvical fascia.

All of these areas are more functionally oriented and thus also designed as a therapeutic approach for functional syndromes . As the term “(fascia) therapy” already indicates, this means a clear clinical focus on the medical treatment of physical complaints, e.g. B. from the orthopedic area such as plantar fasciitis or chronic back pain or unspecific tension headaches different from methodological forms that primarily focus on the general well-being of their patients.

There are more structurally oriented methods, which are primarily aimed at the structural integrity of the body, e.g. B. Rolfing or also known as structural integration. Their ideal is to align their clients with the vertical line in gravity and achieve greater suppleness in order to improve their wellbeing .

Fascia therapy is a manual regulation therapy and often uses the method of myofascial release, a term that was first used in the 1960s by Robert Ward DO to relate painful fascia sections of the body to other areas and to specifically bring them into tension it indirectly via approach or directly via tightening and increasing tension. The first targeted treatment approaches for fascia are attributed to Andrew Taylor Still, the founder of osteopathy.

Fascia therapy using myofascial release is characterized by

  • a targeted contact transfer to areas of the body, a striking fabric texture ( texture ), and a movement limitation ( restriction ) comprise the fasciae located there,
  • a networked approach that does not primarily address the body region of the complaints as well
  • a permanent check of the appropriate therapeutic pressure via palpation .

Fascia therapy / fascia pulsology

Fasciapulsology is a manual therapy and was developed in France by Christian Carini based on functional osteopathy. He taught her for about thirty years. The therapeutic goal is very similar to that of functional osteopathy. It is mainly about improving the circulation - in osteopathy also formulated as the "law of the artery ", the principle that a zone that is better supplied and disposed of (arterial, venous , lymphatic ) can also develop increased self-healing power. The techniques used in fasciapulsology are therefore often geared towards the fascial guide rails (septa) that hold the vessels in place. The teaching of fasciapulsology has as a didactic goal to refine the sensitivity of the fascia therapists learning it in order to be able to diagnose the fluctuation of the blood vessels and to improve their hemodynamics . Another goal of Carini was to harmonize the “ trauma memory of the body”.

Christian Carini founded the Lemniscate Academy in France in September 1979 , where he taught his method under the name Fascia Therapy. In 1988 he renamed the method Fasciapulsology in order to further specify its content and to differentiate it from other methods. Christian Carini passed away in 2018. Most of his methodology is used in French-speaking regions.

Fascia therapy according to the "Danis Bois Method"

A physiotherapist and osteopath, Danis Bois, founded the method named after him in the 1980s based on osteopathy. The method is based on the principle that fasciae are omnipresent in the body and that physical, emotional or stress traumas influence their biodynamic properties and cause functional diseases of the musculoskeletal system, the viscera and the vascular system.

The implementation of this form of fascia therapy is just as gentle in the sense of structurally influencing the fascia as the other functional approaches mentioned. The therapeutic technique aims at the self-regulating forces

  • by touch and
  • so-called "sensory gymnastics"

mobilize and revitalize. This "sensory gymnastics" is similar to the unwinding approach in functional osteopathy, or the so-called écoute techniques, which are used to detect dysfunctions through sensitive manual accompaniment of apparent deviations in spontaneous movement behavior and neutralize them through proprioceptive experience. The practitioners of the Danis Bois method state that they use four main "instruments" in their treatment:

  • the relationship touch
  • Sensory gymnastics
  • Awareness Meditation
  • Interviewing

It is precisely the meditative aspect of this work that fundamentally distinguishes it from functional fascia therapy and fascia pulsology. The awareness and emphasis on mindfulness conveyed via so-called perceptual pedagogy are the characteristic of this methodology - not so much the clinical-complementary therapeutic form as in the two other methodical forms of fascia therapy, which also use very gentle manual palpation.

literature

  • Danis Bois: Le moi renouvelé. Introduction à la somato-psychopédagogie. Point d'Appui Publishing House, 2006, ISBN 2-913514-19-7 .
  • C. Carini (in collaboration with Micheline Bourgoin): Les mains du coeur. Robert Laffont, 1995, ISBN 2-221-07641-9 .
  • Jean Claude Guimberteau, Colin Armstrong: Fasciae - architecture of the human fasciae tissue. KVM der Medizinverlag, Berlin 2016, ISBN 978-3-86867-318-0 , Chapter 5, pp. 141–170.
  • WL Johnston: Functional Techniques. Urban & Fischer / Elsevier, Munich 2009, ISBN 978-3-437-57770-3 , pp. 24-29.
  • Serge Paoletti: fascia, anatomy - structures - techniques. Urban & Fischer, Munich 2001, ISBN 3-437-56100-6 .
  • R. Schleip, TW Findley, L. Chaitow, PA Huijing (Ed.): Textbook fascia - Basics - Research - Treatment. Urban & Fischer / Elsevier, 2014 Munich, ISBN 978-3-437-55306-6 , pp. 58–80 and pp. 217 ff.
  • Louis Schultz, Rosemarie Feitis: The Endless Web: Fascial Anatomy and Physical Reality. North Atlantic Books, Berkeley, CA 1996, ISBN 1-55643-228-3 .
  • T. Spinaris, EL DiGiovanna: Myofascial release. In: An Osteopathic Approach to Diagnosis and Treatment. 3. Edition. Lippincott Williams & Wilkins, Philadelphia, PA 2005, ISBN 0-7817-4293-5 , pp. 80-82.

Web links

Individual evidence

  1. ^ WL Johnston, HD Friedman: Functional Techniques . 1st edition. Elsevier, Munich 2009, ISBN 978-3-437-57770-3 , pp. 190-205 .
  2. ^ A b R. Schleip, WT Findley, L. Chaitow, P. Huijing: Textbook fascia basics, research, treatment . 1st edition. Urban & Fischer / Elsevier Verlag, Munich August 2014, p. 234 ff .
  3. ↑ Alexander S. Nicholas, Evan A. Nicholas: Atlas Osteopathic Techniques. Urban & Fischer, 2009, accessed March 23, 2019 .
  4. ↑ Philipp Richter, Eric Hebgen: Trigger points and muscle function chains in osteopathy and manual therapy . Georg Thieme Verlag, 2007 ( google.de [accessed on March 22, 2019]).
  5. ↑ Educational Council on Osteopathic Principles (ECOP): Glossary of Osteopathic Terminology, p. 53. (PDF) 2011, accessed on March 22, 2019 (English).
  6. ↑ HM Langevin, KJ Sherman: Pathophysiological model for chronic low back pain integrating connective tissue and nervous system mechanisms . In: Med Hypotheses . tape 68 , 2007, p. 74–80 , doi : 10.1016 / j.mehy.2006.06.033 , PMC 3189915 (free full text) - (English).
  7. ^ R. Louis Schultz, Rosemary Feitis: The Endless Web: Fascial Anatomy and Physical Reality . 1st edition. North Atlantic Books, Berkeley, CA 1996, ISBN 1-55643-228-3 .
  8. ↑ Jean-Claude Guimberteau: Fascia: architecture of the human fascial tissue . 1st edition. KVM - der Medizinverlag, Berlin 2016, ISBN 978-3-86867-318-0 , p. 141-170 .
  9. ↑ Somatovisceral sensors . In: Basic knowledge of physiology, online . Springer, Berlin / Heidelberg 2007, ISBN 978-3-540-71402-6 , doi : 10.1007 / 978-3-540-71402-6_16 .
  10. ↑ Andrea Vetter: The influence of pain in visceral dysfunction on somatic structures and its significance for physiotherapy . Bachelor thesis. Zurich University of Applied Sciences (CH), 2009 ( zhaw.ch [PDF; accessed on March 22, 2019]).
  11. ^ Jean-Pierre Barral, Alain Croibier: Manipulation of visceral vessels: osteopathy in theory and practice . 1st edition. Urban & Fischer Verlag / Elsevier, 2011, ISBN 978-3-437-58204-2 .
  12. ↑ Carol J. Manheim: Practice book Myofascial Release . 1st edition. Verlag Hans Huber, Bern 2011, ISBN 978-3-456-84873-0 .
  13. ↑ Serge Paoletti: Fascia . 2nd Edition. Urban & Fischer Verlag / Elsevier, 2011, ISBN 978-3-437-56101-6 .
  14. ^ Thomas Findley: Second International Fascia Research Congress . In: Int Journal of Therapeutic Massage and Bodywork . Multimed, 2009, PMC 3091466 (free full text) - (English).
  15. ↑ Budiman Minasny: Understanding the Process of fascial unwinding . In: Int J Ther Massage Bodywork . tape 2 , no. 3 . Multimed, 2009, p. 10–17 , PMC 3091471 (free full text) - (English).
  16. ↑ MS Ajimsha: Effectiveness of direct vs indirect technique myofascial release in the management of tension-type headache. In: Journal of Bodywork and Movement Therapies. Elsevier, 2011, accessed March 23, 2019 .
  17. ^ C. Carini (in collaboration with Micheline Bourgoin): Les Mains du coeur . 1st edition. Robert Laffont, 1995, ISBN 2-221-07641-9 .
  18. ↑ Isabelle Eschalier: La fasciathérapie: Une nouvelle méthode pour le bien-être . Guy Trédaniel éditeur, 2010, ISBN 978-2-8132-0145-4 .
  19. ↑ Hélène Courraud-Bourhis: La Biomechanical sensorial method Danis Bois . 1st edition. Edition Point d´appui, 1999, ISBN 2-913514-03-0 .