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Preface :
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
Very 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.
Prof. Dr. Hartmut Heine
Institutsleiter, Anatomisches und Klinisch-morphologisches Institut
Universität Witten/Herdecke
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.
Prof. Ivano Colombo, Milano
An admirable book with a different approach.
Prof. K. Lewit, Central Railway Health Institute, Prague
Fascial Manipulation for Musculoskeletal Pain presents to all people dealing with
Rehabilitation a new therapeutic tool that 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 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.
The fascia, with both its macroscopic and microscopic structure, is the map that
can help to orientate any research into the origin of the 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 book illustrates:
· 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.
Fascial Manipulation analyses muscles from a functional viewpoint rather than from
their external structure:
· It assembles unidirectional motor units (mono and biarticular fibres) into myofascial
units
· It describes the precise location of the centre of coordination (CC) of each myofascial
unit
· It highlights the correspondence that exists between each cc and the respective
trigger points and acupuncture points of each muscle.
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 motor activities.
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 proposed.
· 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 corre-sponds to a particular spatial plane, then treatment aims at
re-equilibrating postural alignment.
· 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 and treated.
These innovative theories are supported by many citations from anatomical texts
in order to highlight the marvellous structural design that exists within the fascial
system.
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