Fascial Distortion Model

The Fascial Distortion Model is an anatomical model in which the underlying etiology of virtually every musculoskeletal injury (and many neurological and medical conditions as well) is based on one or more of six specific pathological alterations of connecting tissues (fascial bands, ligaments, tendons, retinacula, etc.). The model allows for manipulative treatments for afflictions such as pulled muscles, fractures, and frozen shoulders. It was discovered and articulated by American physician Stephen Typaldos, DO.^[1]

Fascial distortion types[edit]

Triggerband (TB): Distorted fascial band — The most common of all, Triggerbands are twisted or wrinkled fascial fibers that cause a burning or pulling pain along fascial structures that are composed primarily of linear fibers (such as fascial bands, ligaments, and tendons). When verbally describing their discomfort, athletes and other patients with Triggerband injuries subconsciously make a sweeping motion with their fingers along the anatomical course of the injured fascial fibers.

Herniated Triggerpoints (HTP): Abnormal protrusion of tissue through the fascial plane — HTPs are tiny pathological herniations of tissue through a fascial plane most commonly found along the top of the shoulder (supraclavicular fossa) and deep in the buttock (bulls-eye). They can also be found along the edge of the scapula, deep in the tissues of the arm and thigh, in the pelvic floor and wherever else the patient indicates. The associated patient body language is a pushing of the tender area with the fingers (subconscious attempt at reduction of the herniation).

Continuum Distortion (CD): Alteration of transition zone between ligament, tendon, or other fascia and bone — Continuum distortions hurt in one spot and patients tend to point with one finger to a specific point of discomfort (but do not push on it or rub the involved area). Continuum distortions can occur alone, or there may be many (commonly seen in plantar fasciitis and sprained ankles).

Folding Distortion (FD): Three-dimensional alteration of fascial plane — Folding injuries commonly occur in tissue around joints, and are similar to what happens to a road map that unfolds and then refolds in a contorted condition. Chief verbal complaint expressed is “aching pain deep in the joint.” These are the joints that tend to swell or ache more when the weather changes.

Cylinder Distortion (CyD): Overlapping of cylindrical coils of fascia — Cylinder distortions cause pain in non-jointed areas (and to a lesser extent in jointed areas) which cannot be reproduced or magnified with palpation. They are also responsible for a wide range of seemingly bizarre symptoms, such as tingling (paresthesia), numbness (diminished sensation), and pain that spontaneously seems to jump from one location to another. Cylinder distortions can also cause weakness or spasm in the trunk or extremities. Because the cylinder fascia is interconnected, cylinders can spread and jump to seemingly unrelated areas of the body.

Tectonic Fixation (TF): Inability of fascial surfaces to glide — When patients complain that a joint is stiff, they are describing a tectonic fixation. Thrusting manipulations (as performed by chiropractic adjustments or osteopathic high velocity manipulation, as well as orthopedic manipulation under general anesthesia) are typical current and widely practiced methods of correcting tectonic fixations.

Treatments[edit]

Because each of the distortions has a signature presentation and consistent cross-cultural body language (hand signals that show both the location and type of distortion present), injuries that have been difficult to treat suddenly become treatable and injuries that may have existed for years can sometimes be resolved in minutes. Diagnosis is made by observing the body language of the patient and collecting information on how the injury occurred (mechanism of injury), then the corresponding treatment can be utilized, often resolving the injury in only a few treatments. The patient is the practitioner’s guide, and therefore the pain is where the patient shows it to be. With a strong understanding of the FDM and the six distortions, new treatments can be designed for specific injuries. Following are the basic treatments for each distortion:

Triggerband Technique – Untwist the twisted or wrinkled fascial fibers that cause a burning or pulling pain along the course of the fascial band by using the thumb to iron out the wrinkles.

Herniated Triggerpoint Treatment – Push the protruding tissue below the fascial plane with the thumb. These may feel either soft and squishy or rather hard and can be of different sizes and shapes.

Continuum Technique – The ligament-bone transition zone is forced to shift with pressure from the thumb on the spot identified by the patient. This is an all or none treatment where only success and failure are possible, no partial success.

Folding Treatments are divided into unfolding technique for traction injuries and refolding technique for compression injuries.

Unfolding injuries – traction is applied to joint to allow folding fascia to unfold and then refold less contorted
Refolding injuries – compress of the joint to overfold folding fascia which then springs back (unfolds) less contorted

Cylinder treatments are done either with the hands (squeegee, Indian burn, double thumb technique and pinching with movement) or with a large range of tools (cups, clamps, kiwi, etc.), all of which are used to untangle the tangled coils of cylinder fascia.

Tectonic Technique utilizes pumping of joints and forceful shearing motions to restore gliding motion to the stuck surfaces in frozen joints.

International presence[edit]

The followers of Stephan Typaldos, DO are on several continents and have created several organizations, all of which work together to advance the Fascial Distortion Model. The first FDM International Meeting was held in Bangor, Maine in 2001 to celebrate the 10 year anniversary of the FDM. The second FDM International Meeting was held in Anchorage, Alaska in June 2005. The third meeting was held in Hawaii in August 2007 and the fourth was in Osaka, Japan in 2009. The 20 year celebration of the FDM was at the FDM World Congress in Vienna, Austria in September 2011. The sixth FDM World Congress was held in San Antonio, Texas in October 2014. Each of these Congresses have been followed by an International Meeting which included team building as well as policy discussions. FDM World Congress meetings are now held every three years and include discussion on an international level establishing standards of practice, teaching and certification.

The FDM Asia Association (FAA) was created in 2002 by Keisuke Tanaka and Kohei Iwata. The European Fascial Distortion Model Association (EFDMA) was created in November 2006 by Georg Harrer, MD and Christoph Rossmy, DO and has the largest membership so far. The American Fascial Distortion Model Association (AFDMA) was created in August 2007 and is a 501c-3 organization. In 2011 the African FDM Society (AFDMS) was established by Harouna Diallo from Burkina Faso, West Africa.

References[edit]

↑ Typaldos, Stephen (2002). FDM: Clinical and Theoretical Application of the Fascial Distortion Model Within the Practice of Medicine and Surgery. p. 9. Search this book on

Research[edit]

External links[edit]

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[1] Typaldos, Stephen (2002). FDM: Clinical and Theoretical Application of the Fascial Distortion Model Within the Practice of Medicine and Surgery. p. 9. Search this book on

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