In preparation for next month’s Special Podcast Interview with Dr Carla Stecco, you might enjoy listening to the podcast where I interviewed Dr Larry Steinbeck, a PT from the USA who teaches Stecco Fascial Manipulation technique.
Larry provides a great overview of our understanding about fascia and perhaps provokes our thinking about how we might be able to reduce pain and increase range of motion by using Dry Needling directed at deep and superficial fascial layers.
He teaches the Stecco Fascial Manipulation technique which was developed by Luigi Stecco, an Italian physiotherapist from the north of Italy. This method has evolved over the last 40 years through study and practice. You can listen to the Fascial Manipulation podcast with Dr Larry by clicking here.
Luigi’s daughter, Carla is Orthopaedic surgeon and has also devoted much of her academic life to the study and understanding of fascia. I’ll be interviewing Carla next month and the podcast will be available through our iTunes Channel.
Here are some of the topics we covered when I interviewed Carla:
What is fascia? Give me a quick summary, the layers, deep/superficial, sub-layers.
Fascia is richly innervated, it has mechanoreceptors (Ruffini/Pacinian), it has free nerve endings, and nociceptors. What are the implications of having such innervation? E.g. you discovered, now more than 20 years ago, in 1995 years that the innervation is related to proprioception. Does fascia report positional information?
Are fascial patient presentations always chronic or can they be acute. One example that we’re all familiar with is and visualise is the fascia over the pectoralis major, this connects to the fascia overlying and investing the biceps brachii. The same ante brachial fascia also connects to the fascia overlying the forearm and the ulna. How does this influence how you manage fascial presentations and how they present?
How do patients who present with pain or reduced ROM that is related to fascial tension or strain present? Do they present with different pain characteristics, different motion patterns or are they the same?
If we hypothesise that it was possible to discriminate between superficial fascia and deep fascia with an acupuncture needle, based on depth of palpation and feel, could there be different therapeutic effects according to the layers we engage as Dry Needling therapists?
We have witnessed a reduction in muscle tension, local spot tenderness and a referral into the familiar pattern of the corresponding muscle using these techniques but not a Local Twitch Response. Given that the elicitation of a LTR is nor required for pain reduction, do you think that this alternative approach has possible therapeutic benefits in terms of pain reduction?
Most needling techniques involve a perpendicular insertion towards a palpable taut band. If the objective is to influence fascia and tension within it, would it be plausible to insert the acupuncture needle tangentially or parallel to the fascial plane rather than at 90 degrees to it?