Want to Deform Fascia > 1%? Are You Super Human? | Modern Manual Therapy Blog

Want to Deform Fascia > 1%? Are You Super Human?

Do you work out? Are you strong? Do you hammer away at adhesions, tender or trigger points to release them?


 I hope you like making 1% changes (that are also transient). Thanks to The Awesome PT for his new series on Crazy Things in PT for the below slide.



To put it in perspective for you US readers, 9075 N is roughly 2040 pounds of force. To make ONE PERCENT DEFORMATION. I've shared it before and I'll share it again for those of you who continue to use movement based techniques, painful rolling, or CFM.

Why do painful manual therapy techniques work?
  • patient expectation of positive benefit (provider explanation, and/or previous experience)
  • the nervous system eventually realizes all that mashing is not a threat
    • yes, it literally gets tired of you or someone else mashing away at a certain area
    • I explain it to patients the same way accommodation was explained in school
    • keep tapping yourself on the arm at the same rate, eventually you do not feel the tapping
    • this is the same reason why TENS needs to modulate frequencies in order for you to be aware of the tingling
  • in other words, as long as the stimulation is rather constant, with little variance, you will no longer perceive it
You can still do you movement based releases, IASTM etc, but there is no need to go to town on your patients, or yourself to increase mobility.

Keeping it Eclectic...

5 comments:

  1. Ken Cieslak, DC, ATC, CSCSMay 19, 2015 at 9:27 PM

    Great to see you continue to drive home the point! Thanks Erson!

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  2. Patients and clinicians need to really hear, plus listen to this message, and ALSO adapt their forces on themselves and/or their patients. Repetition is key!

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  3. Question: What is the functional significance of lengthening the ITB or plantar fascia? In my experience, neither structure should necessary be increased in length. Foam rolling eliminates adhesions which restrict the glide of the ITB but don't necessarily lengthen it, only mobilize it. Plantar fascia on the other hand requires elastic tension to promote Windlass mechanisms of gait. Increasing the length of the plantar fascia may decrease this elastic potential energy. Thank you for your time in writing this article.

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  4. The point of the post is to show that you cannot lengthen or deform fascia without significant forces. Foam rolling may improve mobility, but it's not because it changes tissue, adhesions (which are difficult to cut with a scalpel) in any way. It's a neurologic change most likely from skin and mechanoreceptor stimulation, plus changes in tone. Any tissue in the body, if so easily changed would not stand up to the stresses of daily life, workouts, etc. The rapid changes we make are neurological, not mechanical.

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  5. Ah understood. Thank you very much for clarifying that is a profound difference. I appreciate your timely response as well.

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