Fascial Manipulation © - Luigi Stecco

Fascial Manipulation® Workshop

THE MYOFASCIAL (MF) UNIT

a MF unit is composed of :
The Biomechanical Model for 1. A group of motor units, in one or

DIAGONAL AND SPIRAL

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,

Andrea Pasini PT intermedius. Bi fibres: Rectus femoralis

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Lodges and motor units CENTRE OF PERCEPTION

Each mf unit has a Centre of Perception (CP)
● Fascia and septa where movement occurring at the joint is
coordinate sinergic perceived
motor units localized – A vectorial centre,
in different muscle – Resultant of traction of the capsule, tendons, and
ligaments
bellies

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

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Anterior knee joint
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THE MYOFASCIAL UNIT INTERACTION of AGONIST – ANTAGONIST

• Any alteration in the fascia
Elbow flexion: of agonist mf unit can effect
the antagonist mf unit
brachialis - monoarticular
fibres • Some muscle fibres of the
biceps brachii - biarticular agonist mf unit connect to the
fibres fascia of the antagonist mf unit
via the intermuscular septa. lateral
- anterior brachial fascia Brachialis
head Triceps

- elbow joint
- nerve and vascular
components Fascial connections with capsules of mechanoreceptors, muscle spindles and
GTO are also important for spatial, afferent information to Central Nervous
System.
This pattern repeats itself in all mf units

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MYOFASCIAL SEQUENCES of MF UNITS

Myofascial unit
angonist-antagonist • 3D movement and stabilisation
of each segment is guaranteed by
● Every segments is stabilize in synergy and synchrony between
the space thanks three couples proximal and distal, antagonist
of forces (m. angonist and agonist mf units
antagonist)
• MF units that coordinate
movement in the same direction
● Hypertonicity of the agonist are linked by myofascial
myofascial unit creates a insertions and biarticular muscle
fibres to form myofascial
hypertonicity of the antagonist sequences
MFu

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MYOFASCIAL SEQUENCES
er
re la
Each body segment has 6 myofascial units
coordinating its movement

● 78 mf units - trunk
an
me ir and limbs
● 18 subunits - head.
● Total of 14 body
extrarotation
retromotion lateromotion segments that move
in 6 directions on 3
planes

antemotion mediomotion intrarotation

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RE-LA RE-ME

Centres of Fusion
RE

● CC - regulates LA ME

unidirectional muscle
fibres of a single mf unit
WHAT’S NEW?? ● CF - coordinates AN-LA
AN
AN-ME

intermediate muscle la-hu

fibres, activated during er-hu

LA-HU
the passage between mf
units
● Fascia acts as a rheostat, re-la-hu

re-hu

or a regulating device
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arti AN-LA... AN-ME...

limbs
RE-LA... RE-ME...

Names of CF tronco

RE-LA...

● The name of each CF

combines the two planes
AN-LA... AN-ME...
between which it is located (
AN-LA...
I°: sagittal plane, 2°: frontal) tronco
trunk
+ the segment RE-LA...

e.g. an-la-hu, re-me-ca

Trunk diagonals are bilateral and located along lines of muscle
fusion:
● The rotational element is Anterior: lateral to rectus sheath, linea alba.
AN-LA... Posterior : Lateral to spinous processes and erector spinae
always inferred.
So, cf in the trunk are a combination of vectors from one quarter of the
3 body e.g. re-la-lu rt, re-la-lu lt 4

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re-la-po

Diagonals Diagonals
re-la-ca

re-la-cu
re-la-hu
CFs coordinate decreasing activity re-la-sc

of one mf unit and increasing ● A diagonal is a series of re-la-cp

activity of another
CF that coordinate two re-la-cl

adjacent sequences re-la-th

Motor schemes: within the same during movement in an

re-la-lu

AN-LA re-la-pv
segment intermediate direction.
LA
Complex motor patterns: AN ● radial deviation
an-ca + la-ca =an-la-ca
● Diagonals re-la-cx

● Ulnar deviation re-la-ge

Coordinates movement involving re-la-ta

re-ca + me-ca = re-me-ca re-la-pe
two adjacent mf sequences
• Spirals ● Gait : Push off phase
Opposite action between two or more re-ta + me-ta = re-me-ta
segments
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Diagonals An-la diagonal

Diagonale
ofdell’arto
the upper
di an-la
super.
limb
Diagonals
Diagonals unite unidirectional
CF. ● If the two sequences are activated with
Via the longitudinal collagen the same force (50% + 50%) the motor
fibres, diagonals can IR resultant would be on a line between
intervene in : the two. Should one sequence prevail,
an-la-ir
1. regulation of upright
then the limb would move more
position AN LA towards ante or more towards latero.
2. posture maintenance
3. fixation of segments during
unidirectional, forceful
movements

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Fascial Manipulation © - Luigi Stecco
MYOFASCIAL DIAGONALS

an-la-sc
an-la-hu an-me-sc Antagonist Diagonals
an-la-cu an-me-hu
an-la-cp
an-la-ca an-me-cl an-me-cu
an-la-cl
an-la-di an-me-th an-me-ca
an-la-th
an-me-lu an-me-po
an-la-lu In the limbs:

an-me-pv
an-la-pv - AN-LA / RE-ME

- RE-LA / AN-ME
an-la-cx
an-la-ge In the trunk:

an-la-ta an-me-cx - AN-LA lt /RE-LA rt
an-la-pe an-me-ge

an-me-ta
an-me-pe AN-ME and RE-ME in the
trunk have a motion
importance but they don’t
have a precise movement
4 diagonals connect centres of fusion
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Synergic Diagonals MF SPIRALS

AN-LA & AN-ME: forward The MF Spiral is the structure

RE-ME & RE-LA: backward
AN-ME- & RE-ME: medially
AN-LA & RE-LA: laterally
that coordinates contiguous
segments of the limbs or trunk
that move in opposite directions
It coordinate the action of CF’s
that are implicated in complex
gestures

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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
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The spirals in the limbs Trunk: the “short spirals”

They trace the shortest path that connects the shoulder girdle
with the controlateral pelvic girdle

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Trunk: the long Spirals

● 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.
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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)
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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.
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This complexity of fibres would not be necessary All of these fibres must be able to glide
if the only role of the retinacula were to bind the independently from one another within the ground
tendons close to the bones substance.

• Around the knee the patellar

retinaculum and the popliteal This independence has become so reinforced in the
retinaculum do not maintain transversal fibres that in some parts they have formed
any tendons close to the bone. retinacula.
• At the wrist the transverse A retinaculum is formed by a network of fibres that cross
carpal ligament restrains the over each other and at the same time slide
flexor tendons whilst the
independently from one another.
flexor retinaculum is
effectively independent. The collagen fibres of the retinacula do not stop at joints
but continue, in a helicoidal pattern, along the various
fasciae

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physiology Differences between segmentary

● 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.
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).
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Differences between segmentary

The motor schemes organised by
CCs and CFs
diagonals spirals
● Segmentary CC are recruited by effort, or force, and
● involves simultaneous ● involves the movement
when muscular insertions on the fascia are tensioned
activation of all segments of two adjacent
(sequence). of a limb, or of the trunk,
● The CF are recruited by tensioning of the retinacula
segments in opposite
on a given diagonal
either directly (via tendons) or indirectly (via between two planes; directions.
movements of bones onto which they are inserted). ● In anatomy it can be ● In anatomy it can be
● In order to coordinate motor schemes both segmentary and noted that some muscles noted that some
fusion cc's tension the muscle spindles and Golgi tendon are arranged in a muscles are arranged in
longitudinal direction
organs which belong to the muscle fibres of their mf units.  spiral configuration
● Gray H, 1993

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FASCIAL MANIPULATION - BIOMECHANICAL MODEL

Simplification of a complexity

14 body segments. Centre of Coordination =

Each segment served point on deep fascia where
by six myofascial units unidirectional muscular
(mf units). forces converge
an-ge

Centre of fusion = points

Mf unit = monoarticular
where vectors from 2
and biarticular
adjacent mf units converge.
unidirectional muscle
Cf can combine along
fibres, their deep fascia Me-ge myofascial diagonals or
and the joint they move
Ir-ge spirals.
in one direction on one
plane.

●thanks
An-me-ge

CP

CP = Centre of perception , where pain is felt