How much time is required to modify a fascial fibrosis?
How much time is required to modify a fascial fibrosis?
Borgini Ercole MD, Stecco Antonio MD, Day Julie Ann PT and Carla Stecco MD
Various authors suggest that trauma or overuse syndromes can alter the connective tissue and that, in particular, it could become tighter, altering its histological, physiological and biomechanical characteristics. Some suggest an alteration of the collagen fibre composition, while others evidence the alteration of the fibroblasts with their transformation into myofibroblasts, meanwhile others suggest an alteration in the ground substance due to neurophysiological influences and changes in biochemical fluid relationships could be involved.
It is also theorized that different manual and physical techniques could restore the normal physiological state of the fascia, but there is very little scientific evidence about the mode of action of manual therapies in general.
The perception of what appears to be connective tissue fibrosis, and its consequent modification during therapy, is a daily experience for most manual therapists.
The aim of this study was to evaluate the time required to modify a palpatory sensation of fibrosis of the fascia in correlation with changes in levels of patient discomfort in 40 subjects with low back pain utilizing the Fascial Manipulation technique.
This study evidenced, for the first time, that the time required to modify an apparent fascial density differs in accordance with differences in characteristics of the subjects and of the symptoms. In particular, the mean time to halve the pain was 3.24 min; however, in those subjects with symptoms present from less than 3 months (sub-acute) the mean time was lesser (2.58 min) with respect to the chronic patients (3.29 min). Statistically relevant (p < 0.05) differences were also evidenced between the specific points treated.
