Hello, this is my first ever blog – I’m sure I’ll get the hang of it but please bear with me as I find my feet. My name is Jane Haydon, I am a physiotherapist (of 30 years and counting), a fully certified Fascial Manipulation specialist, Stecco Method, a mother to two amazing children and wife to a workaholic!
I have always loved soft tissues and how they hold our incredible bodies together. When I trained, back in the 80’s, I was taught the Maitland treatment regime. It consisted of minute detail, teaching us how the joints were aligned and supported by the ligaments, and how to mobilise these joints to increase range of movement and reduce pain – but not much about how the rest of the body worked. It was a good technique but it only worked some of the time, and it did not help all of my patients.
Then over the years our profession has had some notable musculoskeletal breakthroughs…
A physio in New Zealand, Robin McKenzie once told a man with low back pain to lie face down on his physio couch while he sorted out an appointment for his previous patient. He was horrified when he came back into his treatment room to see that he had forgotten to lower the end of his physio couch, and that his patient had been lying face down but in an arched back extension position! Luckily for him the patient reported that he was ‘cured’ by the position, and thus a new concept of back extension exercises was born. Again – a brilliant technique but only effective on a select few patients.
Then a few years later in the early 90’s, Dave Butler, an Australian physio, published a groundbreaking book explaining that our nerves are supposed to slide like a telescope, extending so that the nerve fibres inside are never really on stretch. This new method allowed us to treat a whole new group of people that until then had been fairly treatment resistant, but sadly still not all of them.
Around the same time, Pilates was introduced into the UK. Joseph Pilates designed the concept of rehabbing bed bound soldiers during WW1, using springs and slings attached to their beds. This was then extended to ballerina’s routine exercises in order to maintain ‘perfect posture’ whilst moving their arms and legs. From there to Pilates it has been further progressed to how we now know it now today – to improve trunk stability and very specific muscle strengthening which is particularly helpful for patients with hyper mobility, poor trunk control or those who are rehabbing from surgery or illness.
This now leads me on to one of my passions in life – all things FASCIA! No, its nothing to do with faces, but instead the connective tissue found throughout our bodies.
About 45 years ago an Italian physio, Luigi Stecco, noticed very specific points on his patients that were extremely painful to touch and felt quite stiff to him on palpation, but after mobilising them, he noticed his patients had remarkable reduction in their pain levels and increased range of movements.
Luigi lived (actually still does) in Padua, a city that has historically been in the forefront of human dissections since the 1590’s and still has extensive dissection rooms. He began dissecting cadavers, and noticed the points he was mobilising on his patients corresponded to very specific areas on the fascia. Then over the next 20 years or so he drew in biochemists and scientists, and began mapping and exploring characteristics the fascial system of the body.
They found that virtually every single structure in our body is surrounded by a layer of this fascia; every single muscle fibre, every muscle and group of muscles, the same for tendons, ligaments, nerves, blood vessels, every internal body organ, brain, heart, digestive tract etc. and even a whole body layer just under our skin!
Between the layers of fascia they found a lubricant called ‘Hyaluronan’ or ‘Hyaluronic Acid’ (HA) – yes the very same substance found in make-up! This lubricant is vital for our tissues to be able to slide freely over each other. It is a small molecule that absorbs water to make it like a skiddy film of WD40. All is well as long as there isn’t a problem with the lubricant!
Luigi’s two children, both surgeons, Carla and Antonio Stecco, have now picked up the mantle of their father’s fascia work and are among some of the world leaders in fascia research and treatment.
Relatively recently Carla and her team discovered a new cell in the fascia (a fasciacyte) that has been proven to be responsible for the production of the lubricant HA. They published it an article in Clinical Anatomy 2018 *(see below).
So essentially, as long as the fascia’s lubricant stays as small HA molecules in water (in fascia speak – the sol state) then we will feel free to move and stretch our bodies, but if the body is traumatised, chronically stressed, or immobilised for more than three weeks then these molecules start aggregating together and they can reach staggering 5,000,000 long chains – in fascia speak the ‘gel state’ – as they repel water and become sticky causing us to feel pain and stiffness. So no, it’s not just your age after all!
In this state our muscles cannot switch off and are permanently contracting and tugging on our joints and pulling us out of alignment. The nerve endings embedded in the fascia (of which there are millions and millions throughout are body) become stressed and over sensitive to everything – movements, light pressure and even the weather … it’s not just an old wives tale after all!
The great news is that these “densifications” can be treated, not just to give short term relief but lasting pain relief and freedom of movement both to our insides and or musculoskeletal system.
I will endeavour to keep you posted on future groundbreaking fascia news as I hear it as we are in a fast-evolving science with exciting breakthroughs all the time. Over the next few posts I will give you some of the, quite frankly unbelievable, patient treatment results I have had and try to explain why they have got so much better.
Well I think I’d better stop writing now – I’d love to say I was off to have a cuppa with a friend but in these strange times no such luck!!
So, remember Stay Safe and keep moving
*The fasciacytes: A new cell devoted to fascial gliding regulation.
Stecco C1, Fede C1 Et al. (Jul;31(5):667-676. doi: 10.1002/ca.23072. Epub 2018 Apr 14)