Fascial Distortion Model

The Fascial Distortion Model is an anatomical model in which the underlying cause 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 Connective 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 developed and described by American physician Stephen Typaldos, DO.^[1]

Fascial distortion types

Triggerband (TB): Distorted fascial band — The most common type, Triggerbands are twisted or wrinkled fascial fibers that cause a burning or pulling pain along fascial structures primarily composed of linear fibers (such as fascial bands, ligaments, and tendons). When describing their discomfort, athletes and other patients with Triggerband injuries often subconsciously make a sweeping motion with their fingers along the anatomical path 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 arm and thigh tissues, in the pelvic floor, and wherever else the patient indicates. The associated patient body language usually involves pushing the tender area with the fingers (a subconscious attempt to reduce the herniation).

Continuum Distortion (CD): Alteration of the transition zone between ligament, tendon, or other fascia and bone — Continuum distortions cause pain at a specific point, and patients typically point to this exact point with one finger (without pushing or rubbing the area). Continuum distortions can occur alone or in multiple locations (commonly seen in plantar fasciitis and sprained ankles).

Folding Distortion (FD): Three-dimensional alteration of the fascial plane — Folding injuries commonly occur in tissues around joints, resembling a road map that unfolds and then refolds in a contorted manner. The chief complaint is typically "aching pain deep in the joint." These joints may 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) that cannot be reproduced or magnified by palpation. They can also be responsible for a wide range of seemingly diverse symptoms, such as tingling (paresthesia), numbness (diminished sensation), and pain that spontaneously moves from one location to another. Cylinder distortions can also cause weakness or spasm in the trunk or extremities. Because the cylinder fascia is interconnected, these cylinders can spread and affect seemingly unrelated areas of the body.

Tectonic Fixation (TF): Inability of fascial surfaces to glide — When patients describe a joint as stiff, they are likely experiencing a tectonic fixation. Thrusting manipulations (like those performed by chiropractors, osteopathic physicians, or orthopedic surgeons) are common methods of correcting tectonic fixations.

Treatments

Because each distortion presents with specific body language (hand signals indicating both the location and type of distortion), previously difficult-to-treat injuries can be effectively managed and long-standing injuries can sometimes be resolved within minutes. Diagnosis relies on observing the patient's body language and gathering information about the injury's mechanism, and the appropriate treatment is then applied, often resolving the injury in a few sessions. The patient's pain experience guides the practitioner. A strong understanding of the FDM and its six distortions allows for the development of tailored treatments for specific injuries. Following are the basic treatments for each distortion:

Triggerband Technique – Untwist the twisted or wrinkled fascial fibers that cause burning or pulling pain by using the thumb to smooth out the wrinkles.

Herniated Triggerpoint Treatment – Push the protruding tissue below the fascial plane with the thumb. These may feel soft and squishy or hard, and vary in size and shape.

Continuum Technique – The ligament-bone transition zone is forced to shift with pressure from the thumb on the patient-identified spot. This treatment is binary—either successful or not, with no intermediate outcomes.

Folding Treatments are separated into unfolding and refolding techniques, based on the injury type.

Unfolding injuries – traction is applied to the joint to allow the folded fascia to unfold and refold less contorted
Refolding injuries – compression of the joint to overfold the folded fascia, allowing it to spring back (unfold) less contorted

Cylinder treatments are performed manually (e.g., squeegee, Indian burn, double thumb technique, pinching with movement) or using tools (e.g., cups, clamps, kiwi, etc.) to untangle the tangled coils of cylinder fascia.

Tectonic Technique employs joint pumping and forceful shearing motions to restore gliding motion to the affected joint surfaces.

International presence

Followers of Stephen Typaldos, DO, are present on several continents, and various organizations work together to advance the Fascial Distortion Model. The first FDM International Meeting was held in Bangor, Maine in 2001 to commemorate the 10th anniversary of the FDM. The second FDM International Meeting was held in Anchorage, Alaska in June 2005. The third meeting was in Hawaii in August 2007, and the fourth in Osaka, Japan in 2009. The 20th anniversary celebration of the FDM took place 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 congress was followed by an International Meeting focused on team building and policy discussions. FDM World Congress meetings are now held every three years and include discussions to establish international standards of practice, teaching, and certification.

The FDM Asia Association (FAA) was established in 2002 by Keisuke Tanaka and Kohei Iwata. The European Fascial Distortion Model Association (EFDMA), established in November 2006 by Georg Harrer, MD and Christoph Rossmy, DO, has the largest membership to date. The American Fascial Distortion Model Association (AFDMA) was founded 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

↑ 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

External links

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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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