Fascial Manipulation® Workshop
Fascial Manipulation © - Luigi Stecco
THE MYOFASCIAL (MF) UNIT
The Biomechanical Model for
DIAGONAL AND SPIRAL
a MF unit is composed of :
1. A group of motor units, in one or
more muscles (monoarticular and
biarticular), that move a body
segment in a specific direction
2. the joint that is moved
3. nerve (efferents, receptors, afferents)
and vascular components
4. the fascia that connects these
elements together
Mono fibres : vastus med, lateralis,
intermedius. Bi fibres: Rectus femoralis
Andrea Pasini PT
Fascial Manipulation © - Luigi Stecco
Lodges and motor units
● Fascia and septa
coordinate sinergic
motor units localized
in different muscle
bellies
Fascial Manipulation © - Luigi Stecco
CENTRE OF PERCEPTION
Each mf unit has a Centre of Perception (CP)
where movement occurring at the joint is
perceived
– A vectorial centre,
– Resultant of traction of the capsule, tendons, and
ligaments
A CP can become painful
• If the unidirectional forces of the mf unit are not
synchronized
• Mechanoreceptors in the capsule, ligaments and
tendons are subjected to non-physiological or excess
traction.
Painful afferents result
4
Anterior knee joint
Fascial Manipulation © - Luigi Stecco
Fascial Manipulation © - Luigi Stecco
THE MYOFASCIAL UNIT
Elbow flexion:
brachialis - monoarticular
fibres
biceps brachii - biarticular
fibres
- anterior brachial fascia
- elbow joint
- nerve and vascular
components
This pattern repeats itself in all mf units
Fascial Manipulation © - Luigi Stecco
Myofascial unit
angonist-antagonist
INTERACTION of AGONIST – ANTAGONIST
• Any alteration in the fascia
of agonist mf unit can effect
the antagonist mf unit
•
Some muscle fibres of the
agonist mf unit connect to the
fascia of the antagonist mf unit
via the intermuscular septa.
Brachialis
Fascial connections with capsules of mechanoreceptors, muscle spindles and
GTO are also important for spatial, afferent information to Central Nervous
System.
Fascial Manipulation © - Luigi Stecco
MYOFASCIAL SEQUENCES of MF UNITS
● Every segments is stabilize in
• 3D movement and stabilisation
of each segment is guaranteed by
synergy and synchrony between
proximal and distal, antagonist
and agonist mf units
● Hypertonicity of the agonist
• MF units that coordinate
movement in the same direction
are linked by myofascial
insertions and biarticular muscle
fibres to form myofascial
sequences
the space thanks three couples
of forces (m. angonist
antagonist)
myofascial unit creates a
hypertonicity of the antagonist
MFu
12
lateral
head Triceps
Fascial Manipulation © - Luigi Stecco
MYOFASCIAL SEQUENCES
la
re
Fascial Manipulation © - Luigi Stecco
er
Each body segment has 6 myofascial units
coordinating its movement
● 78 mf units - trunk
an
ir
me
extrarotation
retromotion
lateromotion
antemotion
mediomotion
and limbs
● 18 subunits - head.
● Total of 14 body
segments that move
in 6 directions on 3
planes
intrarotation
Fascial Manipulation © - Luigi Stecco
Centres of Fusion
● CC - regulates
WHAT’S NEW??
RE-LA
RE-ME
RE
LA
ME
unidirectional muscle
fibres of a single mf unit
● CF - coordinates
intermediate muscle
fibres, activated during
the passage between mf
units
AN-LA
AN-ME
la-hu
er-hu
LA-HU
● Fascia acts as a rheostat,
or a regulating device
AN
re-la-hu
re-hu
2
Fascial Manipulation © - Luigi Stecco
Fascial Manipulation © - Luigi Stecco
arti
limbs
Names of CF
AN-LA...
RE-LA...
AN-ME...
RE-ME...
tronco
RE-LA...
● The name of each CF
combines the two planes
AN-LA...
between which it is located (
I°: sagittal plane, 2°: frontal) tronco
trunk
+ the segment
RE-LA...
AN-ME...
AN-LA...
e.g. an-la-hu, re-me-ca
● The rotational element is
Trunk diagonals are bilateral and located along lines of muscle
fusion:
Anterior: lateral to rectus sheath, linea alba.
Posterior : Lateral to spinous processes and erector spinae
AN-LA...
always inferred.
3
Fascial Manipulation © - Luigi Stecco
So, cf in the trunk are a combination of vectors from one quarter of the
body e.g. re-la-lu rt, re-la-lu lt
4
Fascial Manipulation © - Luigi Stecco
re-la-po
Diagonals
Diagonals
re-la-cu
re-la-hu
CFs coordinate decreasing activity
of one mf unit and increasing
activity of another
● A diagonal is a series of
Motor schemes: within the same
segment
Complex motor patterns:
● Diagonals
re-la-ca
CF that coordinate two
adjacent sequences
during movement in an
intermediate direction.
AN-LA
LA
● radial deviation
an-ca + la-ca =an-la-ca
● Ulnar deviation
AN
Coordinates movement involving
two adjacent mf sequences
re-ca + me-ca = re-me-ca
re-la-sc
re-la-cp
re-la-cl
re-la-th
re-la-lu
re-la-pv
re-la-cx
re-la-ge
re-la-ta
re-la-pe
● Gait : Push off phase
• Spirals
Opposite action between two or more
segments
re-ta + me-ta = re-me-ta
5
6
Fascial Manipulation © - Luigi Stecco
Fascial Manipulation © - Luigi Stecco
Diagonals
Diagonals
An-la
diagonal
Diagonale
di an-la
super.
ofdell’arto
the upper
limb
Diagonals unite unidirectional
CF.
● If the two sequences are activated with
Via the longitudinal collagen
fibres, diagonals can
intervene in :
IR
an-la-ir
1. regulation of upright
position
AN
LA
2. posture maintenance
the same force (50% + 50%) the motor
resultant would be on a line between
the two. Should one sequence prevail,
then the limb would move more
towards ante or more towards latero.
3. fixation of segments during
unidirectional, forceful
movements
7
Fascial Manipulation © - Luigi Stecco
Fascial Manipulation © - Luigi Stecco
MYOFASCIAL DIAGONALS
an-la-sc
an-la-cp
an-la-cl
an-la-th
an-la-lu
an-la-pv
an-la-hu
an-me-sc
an-la-cu
an-me-hu
an-la-ca
an-me-cl
an-me-cu
an-la-di
an-me-th
an-me-ca
an-me-lu
an-me-po
an-me-pv
Antagonist Diagonals
In the limbs:
- AN-LA / RE-ME
- RE-LA / AN-ME
an-la-cx
an-la-ge
an-la-ta
an-me-cx
an-la-pe
an-me-ge
In the trunk:
- AN-LA lt /RE-LA rt
an-me-ta
an-me-pe
4 diagonals connect centres of fusion
AN-ME and RE-ME in the
trunk have a motion
importance but they don’t
have a precise movement
Fascial Manipulation © - Luigi Stecco
Synergic Diagonals
AN-LA & AN-ME: forward
RE-ME & RE-LA: backward
Fascial Manipulation © - Luigi Stecco
MF SPIRALS
The MF Spiral is the structure
that coordinates contiguous
segments of the limbs or trunk
that move in opposite directions
AN-ME- & RE-ME: medially
AN-LA & RE-LA: laterally
Fascial Manipulation © - Luigi Stecco
It coordinate the action of CF’s
that are implicated in complex
gestures
Fascial Manipulation © - Luigi Stecco
MF SPIRALS
• The mf spiral synchronize two
adjacent segments that move in the
opposite direction
(in the limbs)
• In the trunk they synchronize the
crusade movement
AN-ME
AN-LA
RE-LA
RE-ME
Fascial Manipulation © - Luigi Stecco
Fascial Manipulation © - Luigi Stecco
The spirals in the limbs
Trunk: the “short spirals”
They trace the shortest path that connects the shoulder girdle
with the controlateral pelvic girdle
Fascial Manipulation © - Luigi Stecco
Trunk: the long Spirals
Fascial Manipulation © - Luigi Stecco
● As already mentioned, the sequences coordinate the
forces of the unidirectional mf units whereas the
spirals coordinate dynamic movements
These links
exclude the
inferior limbs
Thus favoring the
coordination
between the CP,
Trunk and upper
limbs
Fascial Manipulation © - Luigi Stecco
CF combine several functions
• They are the converging points for the
vectors of different mf units whose resultant
is part of a segmentary motor scheme
• They are the converging points for vectors
of the mf units of fusion, or intermediate
muscular fibres of two different directions.
• They are the converging points of vectors
coming from proximal segments and of
vectors that go towards the antagonist mf
unit of the distal segment.
Fascial Manipulation © - Luigi Stecco
THE ANATOMY OF THE MYOFASCIAL
SPIRAL
mf spirals considered to be the sum of the
helicoidal tensions that the CCs of
fusion exert on the fascia. These
components intervene in the regulation
of complex motor activities or gestures.
The mf unit utilises the deep collagen
fibres,
the sequence utilises the longitudinal
fibres of the fascia,
the mf spirals utilise the oblique fibres
(retinacula)
Fascial Manipulation © - Luigi Stecco
The continuity of the spirals could
provide the explanation...
● The orthogonal mf units are
synchronised by the
endofascial collagen fibres of
the longitudinal sequences.
● The mf units of the motor
scheme are synchronised by
the endofascial collagen fibres
of the spirals.
Fascial Manipulation © - Luigi Stecco
The Ankle Retinacula: Morphological Evidence of the Proprioceptive Role of the
Fascial System Carla Stecco et al , Cell Tissues Organs, 2010.
Dissection, histological and
immunohistochemical analysis
of 27 legs. MRI on 7 healthy
volunteers,17 patients with
outcomes of ankle sprain, and 3
amputated legs.
Conclusion: Retinacula are not
static structures for joint
stabilisation, like ligaments, but
a specialization of fascia for
local spatial proprioception of
foot and ankle movements. …
integrative role of the fascial
system in peripheral control of
articular motility.
18
Fascial Manipulation © - Luigi Stecco
This complexity of fibres would not be necessary
if the only role of the retinacula were to bind the
tendons close to the bones
• Around the knee the patellar
retinaculum and the popliteal
retinaculum do not maintain
any tendons close to the bone.
• At the wrist the transverse
carpal ligament restrains the
flexor tendons whilst the
flexor retinaculum is
effectively independent.
Fascial Manipulation © - Luigi Stecco
physiology
● The CF is located over the muscular fibres of the mf
unit of fusion and between the tendons of the two
segmentary mf units.
● Just like the director of an orchestra it directs the
crescendo of one mf unit and the diminuendo of the
other.
● This coordination is effectuated by tendons
tensioning the retinacula together with the
consequential activation of the Golgi tendon organs.
Fascial Manipulation © - Luigi Stecco
All of these fibres must be able to glide
independently from one another within the ground
substance.
This independence has become so reinforced in the
transversal fibres that in some parts they have formed
retinacula.
A retinaculum is formed by a network of fibres that cross
over each other and at the same time slide
independently from one another.
The collagen fibres of the retinacula do not stop at joints
but continue, in a helicoidal pattern, along the various
fasciae
Fascial Manipulation © - Luigi Stecco
Differences between segmentary
CCs and CFs
● - Segmentary CCs are located over the muscle belly and
they coordinate mf units via the epimysium, the
perimysium and the endomysium.
● - The CFs are located over tendons and they coordinate
motor schemes via the retinacula and the fascial spirals.
● - Segmentary CCs are located in parts of the body that are
in line with the three spatial planes.
● - The CFs are located near articulations and in
intermediate zones between two planes (diagonals).
Fascial Manipulation © - Luigi Stecco
Fascial Manipulation © - Luigi Stecco
Differences between segmentary
CCs and CFs
● Segmentary CC are recruited by effort, or force, and
when muscular insertions on the fascia are tensioned
(sequence).
● The CF are recruited by tensioning of the retinacula
either directly (via tendons) or indirectly (via
movements of bones onto which they are inserted).
● In order to coordinate motor schemes both segmentary and
fusion cc's tension the muscle spindles and Golgi tendon
organs which belong to the muscle fibres of their mf units. The motor schemes organised by
diagonals
spirals
● involves simultaneous
● involves the movement
activation of all segments of two adjacent
of a limb, or of the trunk,
segments in opposite
on a given diagonal
directions.
between two planes;
● In anatomy it can be
● In anatomy it can be
noted that some muscles
noted that some
are arranged in a
muscles are arranged in
longitudinal direction
spiral configuration
● Gray H, 1993
Fascial Manipulation © - Luigi Stecco
FASCIAL MANIPULATION - BIOMECHANICAL MODEL
Simplification of a complexity
Centre of Coordination =
point on deep fascia where
unidirectional muscular
forces converge
14 body segments.
Each segment served
by six myofascial units
(mf units).
an-ge
Mf unit = monoarticular
and biarticular
unidirectional muscle
fibres, their deep fascia
and the joint they move
in one direction on one
plane.
Me-ge
Ir-ge
An-me-ge
CP
CP = Centre of perception , where pain is felt
Centre of fusion = points
where vectors from 2
adjacent mf units converge.
Cf can combine along
myofascial diagonals or
spirals.
●thanks