The Impact of Fascial Manipulation® on Posterior Shoulder Tightness in Asymptomatic Handball Players: A Randomized Controlled Trial.

This prospective study aimed to determine the impact of Fascial Manipulation® by Stecco (FM) on the range of motion (ROM) of internal rotation (IR) and horizontal adduction (HADD) in asymptomatic handball players, representing significant risk factors for shoulder injuries. A randomized controlled trial was conducted, with participants randomly assigned to either the investigated group (N = 29) receiving a single session of FM or the control group (N = 27) receiving no treatment. The ROM for IR and HADD were measured before, immediately after, and one month after the FM session. The investigated group experienced a statistically significant acute increase in glenohumeral IR (14 degrees, p < 0.001) and HADD (14 degrees, p < 0.001) compared to the control group (p < 0.001). The positive effects of FM persisted one month post-treatment, with increased IR ROM by 12 degrees (p < 0.001) and HADD ROM by 11 degrees (p < 0.001). Participants in the investigated group reported lower subjective tightness/stiffness immediately after (p < 0.001) and one month after treatment (p = 0.002) compared to the control group. This study demonstrates that a single application of FM effectively improves glenohumeral ROM in the dominant throwing shoulder of asymptomatic handball players. It highlights the immediate and sustained positive effects of FM on IR and HADD. These findings support the use of FM as an effective method for enhancing shoulder ROM and reducing subjective tightness/stiffness. The study was registered at ClinicalTrials.gov (NCT06009367).

The Effect of Mechanical Stress on Hyaluronan Fragments' Inflammatory Cascade: Clinical Implications.

It is a common experience, reported by patients who have undergone manual therapy that uses deep friction, to perceive soreness in treatment areas; however, it is still not clear what causes it and if it is therapeutically useful or a simple side effect. The purpose of this narrative review is to determine whether manual and physical therapies can catalyze an inflammatory process driven by HA fragments. The literature supports the hypothesis that mechanical stress can depolymerize into small pieces at low molecular weight and have a high inflammatory capacity. Many of these pieces are then further degraded into small oligosaccharides. Recently, it has been demonstrated that oligosaccharides are able to stop this inflammatory process. These data support the hypothesis that manual therapy that uses deep friction could metabolize self-aggregated HA chains responsible for increasing loose connective tissue viscosity, catalyzing a local HA fragment cascade that will generate soreness but, at the same time, facilitate the reconstitution of the physiological loose connective tissue properties. This information can help to explain the meaning of the inflammatory process as well as the requirement for it for the long-lasting resolution of these alterations.

Effects of fasciatherapy versus fascial manipulation on pain, range of motion and function in patients with chronic neck pain.

BACKGROUND: Neck pain is among the common musculoskeletal problem that hinders a person's daily activities. Fascial tightness is a familiar cause of chronic neck pain that is often neglected and can further cause neck disability and a limited range of motion. OBJECTIVE: The purpose was to compare the effects of fascia therapy and fascial manipulation on pain, range of motion and function in patients with chronic neck pain. METHODS: A randomized clinical trial was conducted from February to August 2022 in the Riphah Rehabilitation Centre, Lahore, Pakistan. Fifty-two participants of both genders, aged 18-40 years with chronic neck pain of at least 3-6 months were included. Group A (n = 26) received fascia therapy along with a conventional physical therapy protocol of hot pack, strengthening and stretching, while group B (n = 26) received the fascial manipulation treatment with conventional physical therapy. All the participants were assessed at baseline and after 3 weeks (3 sessions per week). Numeric Pain Rating Scale (NPRS), Neck Disability Index (NDI) and Goniometer (range of motions) were the outcome measures. SPSS 25 was used for the data analysis and normality of the data through the Shaphiro-Wilk test (p > 0.05), and parametric tests were applied. RESULTS: The mean age of group A was 24.82 ± 2.64 years, and group B was 24.17 ± 2.20 years. The independent t-test result showed no significant difference (p ≥ 0.05) in all parameters except in cervical extension and right-side bending (p < 0.05). At the same time, the pair-wise comparison showed significant results (p < 0.05) for all outcome measures in both groups. CONCLUSION: DBM fascia therapy improved cervical extension and side bending (right) more than the fascial manipulation group.It is concluded that DBM fascia therapy shows more improvement as compared to other group. TRIAL REGISTRATION NUMBER: This study was registered at ClinicalTrials.gov ID: NCT05272111 on 09/03/2022.

Effectiveness of the Fascial Manipulation Approach Associated with a Physiotherapy Program in Recurrent Shoulder Disease.

Shoulder pain is a serious clinical disease frequently related to absence from work. It is characterized by pain and stiffness, probably connected to the presence of an inflammatory substrate involving gleno-humeral capsule and collagen tissues. A physiotherapy program has shown to be effective for the conservative treatment of this disorder. Our aim is to assess if a manual treatment directed to fascial tissues could obtain better improvement regarding pain, strength, mobility, and function. A total of 94 healthcare workers with recurrent shoulder pain were recruited and then randomized in two groups: the control group (CG) underwent a five-session physiotherapy program; the study group (SG) underwent three sessions of physiotherapy and two sessions of fascial manipulation (FM) technique. At the end of the treatment phase, both groups improved every outcome. Despite few statistical differences between groups, at the follow-up visit, a greater percentage of subjects in SG overcame the minimal clinical important difference (MCID) in every outcome. We conclude that FM is effective for treatment of shoulder pain and further studies should better assess how to manage this treatment to obtain better results.

Examination of the effect of fascial therapy on some physical fitness parameters in taekwondo athletes.

One of the objectives of this study is to determine the effect of the eight-week fascial therapy program on flexibility, vertical jump, standing long jump, speed and anaerobic strength parameters in taekwondo athletes. Another aim of the research is to create a therapy protocol that can be used in athletes related to performance development through the relaxation of the fascial system, which is considered an indicator of physical fitness and has numerous functions in the body. This study included 32 taekwondo players who were licensed, actively attending taekwondo training. In the study, two groups were formed as fascial therapy group (FTG) (n â€‹= â€‹16) and control group (CG) (n â€‹= â€‹16). After the groups were randomized, fascial relaxation techniques were applied to the fascial therapy group for eight weeks, up to twice a week, and for 30 â€‹min. According to the findings obtained as a result of the research, FTG ([-0.36 â€‹± â€‹0.17] seconds [s]) for the 20 â€‹m (m) Sprint (T2-T1) had a lower mean time than CG (0.00 â€‹± â€‹0.07) s, FTG (0.06 â€‹± â€‹1.95) for the Flamingo Balance Test (T2-T1) had a lower mean fall than CG (1.25 â€‹± â€‹1.13), FTG ([3.56 â€‹± â€‹2.37] centimeters [cm]) for the Sit & Reach Test (T2-T1) had a lower mean fall than CG ([-0.19 â€‹± â€‹1.28] cm), FTG ([5.75 â€‹± â€‹2.54] cm) had a higher jump distance than CG ([1.88 â€‹± â€‹8.11] cm) according to the results of Vertical Jump Test (T2-T1) and finally FTG ([9.13 â€‹± â€‹5.56] cm) had a longer distance than CG ([-0.31 â€‹± â€‹1.85] cm) according to the results of Standing Long Jump Test (T2-T1). The result of our study has shown that fascial techniques can be used safely by experienced physiotherapists and can be included in the training program. It is recommended that coaches of sports disciplines work with experienced physiotherapists on this subject and include fascial methods in their training programs.

Fascial Manipulation Method Is Effective in the Treatment of Myofascial Pain, but the Treatment Protocol Matters: A Randomised Control Trial-Preliminary Report.

Background: There are many therapeutic methods targeting fascia. However, the only method whose basic assumption is to eliminate the densification of fascia is Fascial Manipulation. Objective: To evaluate the effectiveness of various Fascial Manipulation (FM) protocols in reducing myofascial pain. Design: Randomized control trial. Subjects: A total of 54 individuals, aged 18-29 years, with musculoskeletal pain for at least 1 week. Methods: The patients were divided into four groups subjected to different treatment protocols: group 1-underwent the standard FM treatment protocol (STP), group 2-modified protocol (MTP), group 3-modified protocol 2 (MTP2), and the control group (CG)-did not undergo any therapy. Each protocol involved three treatments at intervals of 7-10 days and a follow-up examination after 30 days. The outcome was pain level measured using the VAS. Results: In the STP, all the measurements showed a significant decrease in pain level-the mean difference was 2.077 after the first treatment, 3.462 after the third treatment and 3.385 in the follow-up. In the MTP, a significant mean difference was noted after the third treatment, 3, and in the follow up, 2.4. In the MTP2, it was noted after the third session, 2, and in the follow up, 2.25. Only the CG group did not display significant changes. Conclusions: FM-based therapy results in pain relief. However, there are differences in the dynamics and durability of the results depending on the chosen protocol.

Facial Pain: RCT between Conventional Treatment and Fascial Manipulation® for Temporomandibular Disorders.

Background: To investigate the effectiveness of a specific manual therapy, Fascial Manipulation® (FM), in comparison with conventional treatments in temporomandibular disorders (TMD) patients using a two-arm randomized controlled trial. Methods: The study consisted of 28 patients that were divided in two groups (Group 1: Fascial Manipulation® vs. Group 2: conventional TMD treatment). The Verbal Rating Scale (VRS), RDC/TMD, electromyography (EMG) and Pression/Pain Evaluation on Masseter and Temporalis Muscle were assessed with different times. Results: In both groups, the improvement in pain was evident on the VRS scale (p < 0.0001) and pain-free opening (p < 0.001). In Group 1, the recovery of the function was faster; maximum unassisted opening T0 vs. T1 (p = 0.001). Conclusions: FM® can be used as an effective method for facial pain, being a rapid, safe and cost-effective approach to reduce pain, gain function and mouth opening that can be used prior to occlusion stabilization appliances.

Fascial manipulation as an adjunct to physiotherapy management in obstetric brachial plexus palsy: A case report.

The integrity of connective tissue sheaths surrounding the nerves influences both the severity and the potential for recovery of brachial plexus lesions. This study presents an innovative, early onset, multidisciplinary approach to obstetric brachial plexus palsy. This approach is aimed at functional recovery of the nerve lesion and includes mobilization of the fascia using the Fascial Manipulation® method. This case study discusses how, in addition to conventional treatment, interventions aimed at the fascial system can potentially affect tension around the neural sheaths, enhance proprioceptive input and facilitate movement to influence obstetric brachial plexus palsy outcomes.

Evaluating the Effectiveness of Soft Tissue Therapy in the Treatment of Disorders and Postoperative Conditions of the Knee Joint-A Systematic Review.

The term "soft tissue therapy" (STT) refers to mechanical methods of treatment involving passive kneading, pressing and stretching of pathologically tense tissues in supporting the process of recovery after surgery or trauma to the musculoskeletal system. The objective of this study was to review current scientific reports evaluating the effectiveness of the use of STT in patients with diseases or after surgical procedures of the knee joint. A systematic search of the popular scientific databases PubMed, Scopus and Embase was performed from inception to 15 October 2021. Eight articles met eligibility criteria and were included in the review. Six papers were related to disorders of the knee joint, while the remaining two studies were related to dysfunctions associated with the conditions after surgical intervention. The findings presented confirmed the effectiveness of STT in orthopaedic patients who showed an increase in lower limb functional parameters. The research has shown that the use of various methods of STT has a significant impact on increasing muscle activity and flexibility as well as increasing the range of motion in the knee joint. The physiotherapeutic methods used had a significant impact on reducing pain and increasing physical function and quality of life. The techniques used reduced the time to descend stairs in patients with knee osteoarthritis. This review summarises the effectiveness of STT as an important form of treatment for orthopaedic patients with various knee joint dysfunctions.

Pilot Study of Sacroiliac Joint Dysfunction Treated with a Single Session of Fascial Manipulation® Method: Clinical Implications for Effective Pain Reduction.

Background and Objectives: Sacroiliac joint dysfunction (SIJD) generally refers to pain in the lower back due to abnormal sacroiliac joint movement, either from hypomobility or hypermobility. It is considered to be the principal cause in up to 40% of low back pain cases. In literature, it emerges that the "fascia", by its anatomical continuity, if altered or densified in different regions of the body with respect to the sacroiliac joint and its surroundings, may have a fundamental role in the genesis of SIJD and low back pain. The purpose of the present study is to evaluate the effectiveness of incorporating a single session of Fascial Manipulation®-Stecco method®, treating the muscular fasciae at distance from the painful region. Materials and Methods: Twenty patients with acute and chronic sacroiliac joint dysfunction (SIJD) were recruited (16 males and 4 females, mean age of 46.6 ± 12.98 years). Patients underwent a predefined assessment protocol, followed by an evaluation of myofascial pain and subsequent manipulation of the fascia at points at least 20 cm away from the posterior inferior iliac spines (PIIS). Each patient underwent three pain evaluations: pre-treatment (t0), post-treatment (t1), and at a 1-month follow-up (t2). For the evaluation in t0, t1 the numerical rating scale (NRS) for the intensity of pain and the algometer for the pain threshold at the PIIS were used; in t2 only the NRS scale. Results: The results obtained by comparing the algometer measurements with the NRS values between t0 and t1 were in both cases statistically significant (p < 0.0001), whereas the comparison between the NRS values at t1 and at t2 was not statistically significant (p > 0.05). Conclusions: A single Fascial Manipulation treatment, even when applied at least 20 cm from the PIIS, can potentially decrease pain around the SIJ. The inclusion of this type of approach in SIJD can allow for improved patient management, better tolerance for other treatments and a more rapid application of pain-free exercise programs.

Fascial Manipulation Technique in the Conservative Management of Morton's Syndrome: A Pilot Study.

BACKGROUND AND OBJECTIVE: Morton's syndrome (MS) is a common cause of neuropathic chronic forefoot pain, characterised by the development of a swelling of the common digital plantar nerve, whose aetiology is not fully known. There is currently no gold standard of treatment; nonoperative management commonly involves manual therapies, orthoses therapy and infiltrative techniques, while surgery is indicated after failure of conservative measures. The present preliminary study prospectively evaluates patients affected by MS treated by Fascial Manipulation technique (FM), a noninvasive manual therapy, focused on the release of the deep fascia, reducing its stiffness. MATERIALS AND METHODS: Patients with clinical and sonographic diagnosis of MS with at least a 4-month history of neuropathic symptoms underwent a cycle of three weekly FM sessions. Clinical follow-up, including VAS and AOFAS scores, was performed 21 days (T1) and 3 months (T2) after treatment. RESULTS: Nine patients, among 28 recruited initially, completed the manual therapy sessions and relative follow-up points. This noninvasive pain treatment led to significant improvement of VAS (p = 0.0034) and AOFAS scores (p = 0.0240) at the first follow-up (T1). At 3-month follow-up (T2), both scores decreased slightly, remaining however superior to the pre-treatment values. Only VAS was still significant (p = 0.0184). CONCLUSIONS: Despite the small size of the case series, this pilot study is unique in supporting Fascial Manipulation in the nonoperative treatment of MS. Further studies are needed with a large cohort of gender balanced patients to confirm the encouraging results obtained.

T1ρ-Mapping for Musculoskeletal Pain Diagnosis: Case Series of Variation of Water Bound Glycosaminoglycans Quantification before and after Fascial Manipulation® in Subjects with Elbow Pain.

Diagnosis and management of musculoskeletal pain is a major clinical challenge. Following this need, the first aim of our study was to provide an innovative magnetic resonance technique called T1ρ to quantify possible alterations in elbow pain, a common musculoskeletal pain syndrome that has not a clear etiology. Five patients were recruited presenting chronic elbow pain (>3 months), with an age between 30 and 70 years old. Patients underwent two T1ρ-mapping evaluations, one before and one after the series of Fascial Manipulation® (FM) treatments. After the first MRI evaluation, a Disability of the Arm, Shoulder and Hand (DASH) questionnaire was administered to quantify the symptoms and pain intensity. Patients then received three sessions of FM, once a week for 40 min each. A statistically significant difference was found between bound and unbound water concentration before and after FM treatment. Our preliminary data suggest that the application of the manual method seems to decrease the concentration of unbound water inside the deep fascia in the most chronic patients. This could explain the change in viscosity perceived by many practitioners as well as the decrease of symptoms due to the restoration of the normal property of the loose connective tissue. Being able to identify an altered deep fascial area may better guide therapies, contributing to a more nuanced view of the mechanisms of pain.

Inter and Intra Operator Reliability of Motor and Palpation Evaluation in Fascial Manipulation in individuals with coxarthrosis.

OBJECTIVE: An inter and intra rater reliability (INTERR and INTRAR) study was designed. METHODS: 71 subjects, with primary hip coxarthrosis, were included and randomly divided in a study group (SG= 36) and a control group (CG= 35) to assess the efficacy of the Fascial Manipulation® (FM®) method. The primary objective was the assessment of INTERR and INTRAR about movement verification (MV) and palpation verification (PV) of FM® performed by two physiotherapists (PtA and PtB). The secondary objective was evaluate the efficacy of FM® through MV, PV and pain score. Pain was assessed using the Numeric Rating Scale (NRS). SG received three weekly sessions of FM® byPtA. PtB re-evaluated all the subjects at the end of the study. RESULTS: Results of the INTERR analysis showed for SG: MV (ICC= 0.92, k= 72.7%); PV (ICC= 0.91, k= 75.7%). For CG : MV (ICC= 0.95, k= 84.2%); PV (ICC= 0.90, k= 75%). Results of the INTRAR analysis for SG reported: MV (ICC= 0.82, k= 74,8%); PV (ICC= 0.60, k= 46.8%); for CG: MV (ICC= 0.93, k= 78.7%); PV (ICC= 0.84, k= 53.3%). Statistical significance were reported in NRS (p = 0.001), MV (p = 0.0003) and PV (p < 0.0001) with better results for SG using "Intention To Treat" method. DISCUSSION: This study demonstrates that FM® assessment procedures have a high reliability even if applied by practitioners with basic experience. Furthermore FM® treatment can improve pain and ROM in individuals with primary coxarthrosis.

Observation using thermography of post-operative reaction after fascial manipulation®.

INTRODUCTION AND OBJECTIVE: Fascia Manipulation® is one of the methods focusing on the deep fascia. The assumption is that fascial manipulation is carried out on precisely determined points - coordination centres (cc), and on a limited area so as the friction occurring during manipulation would cause a local rise in temperature due to the inflammatory reaction. Rise in temperature influences modification in consistency of elementary matter in the manipulated area, and by the same token causing a decrease in the negative effects of fascia densification which stems from accumulation of hyaluronic acid. The purpose of the research is to prove the thesis that fascial manipulation causes local rise in temperature due to inflammatory reaction. MATERIAL AND METHODS: For the research, 25 individuals with densification in lower limb area were qualified. They were exposed to a single, 3-minute facial manipulation®. By means of a thermal-imaging camera, changes in the temperature of the body in the examined area were evaluated. The body's temperature evaluation was carried out 8 times: before the treatment, 5 minutes after the treatment, and, next, 6, 12, 18, 24, 36, 48 hours after the treatment. RESULTS: The average surface temperature of the treated area before mobilization was 33.4°C. A statistically relevant increase in temperature was already observed 5 minutes after the treatment (increase of 0.5°C; p<0.001). However, the highest temperature was observed 24 hours after mobilization (increase of 2.4°C). The difference between the first and 7 other measurements was statistically relevant (p<0.001). CONCLUSIONS: The statistically relevant increase in temperature under the influence of fascial manipulation® in the treatment area can confirm the occurrence of inflammatory reaction.

Sport injury prevention in individuals with chronic ankle instability: Fascial Manipulation® versus control group: A randomized controlled trial.

Chronic ankle instability (CAI) is one of the most common syndromes that occurs following an initial ankle sprain. Sprains are often correlated with recurrent sprains, loss of range of motion (ROM) and deficits in proprioception and postural control. The objectives were to evaluate the effectiveness of Fascial Manipulation® (FM) as a preventative measure in semi-professional athletes with CAI, and to monitor the symptomatology, equilibrium and ROM of the injured ankle. A single-blinded randomized controlled trial was conducted in the rehabilitation department of a medical centre. Twenty-nine semi-professional male footballers were recruited. Nine subjects with no previous symptomatology, were assigned to a baseline group, twenty symptomatic subjects were randomized into either the study or the control group. All three groups followed a specific training program. The control group followed normal training protocols and received standard medical care. The study group received an additional three FM treatment sessions. Symptomatology and ROM outcomes were recorded for all players at baseline, before each treatment for the treatment group, and at 1-, 3-, and 6-month follow-ups. At one year, an additional follow-up on was performed via phone. Four severe ankle traumas and one mild ankle trauma were reported in the control group during the trial period. The 6-month outcomes in the study group showed statistically significant improvements. The 1-year follow-up reported the absence of any reported trauma in the study group. FM was effective in improving ROM and symptomatology in footballers with CAI. FM intervention was effective in preventing injury in the study sample.

Fascial manipulation vs. standard physical therapy practice for low back pain diagnoses: A pragmatic study.

BACKGROUND: Connective tissue mobility alters motor unit recruitment, but the restoration of fascial mobility allows for optimal motor function. The Fascial Manipulation® (FM®) method is a multiplanar approach that assesses and treats the mobility of deep fascia in specific anatomical locations where motor units converge. OBJECTIVES: To assess the effects of FM® vs. standard physical therapy treatment (SPT) in patients with low back pain (LBP). DESIGN: Six-months controlled clinical trial. METHOD: 102 participants with LBP received SPT or FM®. Numeric Pain Rating Scale (NPRS), 15- point Global Rating of Change (GROC), and Oswestry Disability Index (ODI) were used to monitor progress. RESULTS: The FM® group had a significantly lower ODI (p < 0.009) and NPS scores (p < 0.0001) and significantly higher GROC scores (p < 0.003) once their means were adjusted for initial scores. When comparing the SPT to FM®, the final ODI decreased by at least 1 category in 48.9% of the SPT cases, while in 36.2% of the cases was no change. ODI minimal clinical importance difference (MCID) change of 10% decrease in scores occurred in 70.2% of the SPT group compared to 96% of the FM® group (p = 0.003). ODI MCID change of 50% decrease in scores occurred in 40% of the SPT group compared to 64.6% of the FM® group (p = 0.02) 44.7% of the participants in the SPT group had final GROC values above +5 at discharge, compared to 92% of the participants from the FM® group (p = 0.0001). The FM® subjects had almost three times the change in NPRS compared to SPT counterparts (-4.3 ±â€¯2.2 to -1.5  ± 2.4, p=0.0001). CONCLUSIONS: FM® appears to improve NPRS, GROC, and ODI more than SPT. FM® may provide an effective treatment technique for LBP.

Successful treatment of rotator cuff tear using Fascial Manipulation® in a stroke patient.

Rotator cuff tear is a common disease affecting patients after stroke. It's a cause of pain and dysfunction that may compromise normal stroke rehabilitation. For many cases there is still controversy between whether to use surgical or conservative intervention. Treatment for cuff tears range from physical therapy to surgery. This paper describes for the first time the effect of Fascial Manipulation® (FM®) on rotator cuff tear in a post stroke patient. A 69 year old female stroke patient with full absence of distal components of the tendons of the rotator cuff, functional limitations on active movement of shoulder flexion and abduction of the left arm and perceived pain scored 10/10 on the Visual Analogic Scale, was assessed and treat with one session of FM® A basic theory that explains the healing results of FM® is that mechanoreceptors, such as spindle cells and other receptors, are located in the deep fascia and activated when movement are performed. Increased viscosity of the deep fascia and muscles due to increased viscosity of hyaluronic acid (HA) molecules prevents the normal gliding of fascia during movement inhibiting normal proprioception and muscle function.

Fascial Manipulation® for persistent knee pain following ACL and meniscus repair.

Fascial Manipulation® (FM) is a manual therapy approach for the treatment of musculoskeletal pain. Anomalous fascial tension is common following surgery due to surgical scar, inadequate mobility and fear of movement. Fascial tension may result in pain and loss of mobility. This case report aims at investigating the effectiveness of FM® on pain and function in a patient following knee surgery. A 32 years old male patient, with persisting knee pain following anterior cruciate ligament reconstruction (hamstring graft) and meniscal repair, underwent the systematic FM® assessment process, the selected centers of coordination of myofascial units were treated. Knee Injury Osteoarthritis Outcome Score (KOOS) questionnaire was obtained prior treatment and after 4 treatment sessions. Results showed clinically significant improvements in all subscales of KOOS after 4 weeks, the effect was maintained in subsequent follow-ups at 3 months, 6 months, one year and two years.

Hip and groin pain in a cyclist resolved after performing a pelvic floor fascial mobilization.

Pelvic floor muscle assessment in situations of hip/groin pain in both male and female patients can be a key element in treatment success. We present herein, a 32 year old male professional cyclist, exhibiting right hip and groin pain during cycling and prolonged sitting. The pain commenced after the patient suffered a right hip severe contusion in 2013 causing a tear in the tensor fascia lata and gluteus medius muscle. The patient did not complain of pelvic floor dysfunctions. After receiving several series of conventional physical therapy for the hip/groin pain, the patient experienced partial pain relief and slight improvement of hip range of motion. His pelvic floor muscles and fascial involvement were subsequently assessed. Two sessions of Pelvic Floor Fascial Mobilization (PFFM) were performed and the patient fully recovered. The authors suggest that PFFM, a novel fascial-oriented manual therapy of the pelvic floor approach, can be used for both hip/groin and pelvic floor pain or dysfunction.

Conservative treatment of carpal tunnel syndrome: comparison between laser therapy and Fascial Manipulation(®).

The etiopathogenesis of Carpal Tunnel Syndrome (CTS) is multifactorial and most cases are classified as idiopathic (Thurston 2013). A randomized controlled trial was performed to compare the effectiveness of Fascial Manipulation(®) (FM) and Low-Level Laser Therapy (LLLT) for CTS. This prospective trial included 42 patients (70 hands with symptoms) with clinical and electroneuromyographic diagnosis of CTS. The patients were randomly assigned to receive multiple sessions of FM or multiple session of LLLT. The Visual Analogic Scale (VAS) and Boston Carpal Tunnel Questionnaire (BCTQ) were performed at baseline, end of treatment and after three months. The group that received FM showed a significant reduction in subjective pain perception and an increased function assessed by BCTQ at the end of the treatment and follow-up. The group that received LLLT showed an improvement in the BCTQ at the end of the treatment but the improvement level was not sustained at the three month follow-up. FM is a valid alternative treatment for CTS.