Fascial Manipulation in a nutshell…a very large nutshell…

What is Fascial Manipulation and how can it help you move, live and feel better?
 

shutterstock_254159596I am a physiotherapist with over 25 years of experience. I treat the usual work related ergonomic injuries and the back and neck pains that often result from working in an office at a computer most of the day. I am able to provide ergonomic and postural advice and exercises. I can assess joint and muscles injuries both acute and chronic. My special interest is in running injuries, problems that persist or areas of multiple regions of pain or tightness etc. The injuries that don’t seem to want to go away but nothing specific has ever been diagnosed. I now use a whole body technique called Fascial Manipulation to help assess multi region issues and see if they are connected.

 

Fascial Manipulation is a holistic manual therapy technique devised and refined by Luigi Stecco an Italian physiotherapist over the past 40 years and being further refined and researched by his children who are both medical practitioners and researchers. It is a developing field and technique that is growing around the world but is very new to Australia.

 

But what is fascia? Fascia is the soft tissue that covers every cell, muscle, muscle group and organ etc in our bodies. (It is the white bit around meat!) Until recently it has been ignored by anatomists, even though it covers everything and most of our neural receptors are within it. There is the superficial fascia (the skin and neural receptors) and the deep fascia (more muscle related). The iliotibial band (ITB) and the plantar fascia in the foot, are the best known parts of the fascial system, because they are some of the densest fascial places within the body. Fascia is usually a lot thinner in other areas – but just as important!

 

Whereas muscles attach bone to bone, fascia through its spiraling interconnected, multi directional layers, connects our feet to our heads to our hearts, lungs and hands etc. Many muscles also attach into fascia as well as onto bone and so fascia has the ability to transfer forces throughout many areas of the body. It has the ability to cause muscle dysfunction and timing issues, for example have you had a muscle that you have tried to strengthen but nothing changed? It could be a fascial system block.

 

As well as affecting the tension of the fascia around muscles the fascial tension around organs can be altered, which can cause symptoms like constipation, bloating, recurrent throat or voice issues, reflux, cysitis, and palpitations to name only a few.

 

Fascial or soft tissue tension over time and years and/ after suffering a number of injuries and/or illnesses etc, can result in various areas of the fascia tightening up and exerting force at a point of compensation, often away from the site of breakdown or pain or dysfunction. The body has an amazing ability for compensation, so part of the Fascial Manipulation treatment, especially for internal dysfunctions where the organs are involved, aims to restore some ‘give’ and flexibility to the body’s fascial system by releasing areas where adhesions have formed and prevented normal movement. The body can operate very well even without perfect fascial flexibility but if it reaches a point where the compensations are no longer possible then injuries/pain/internal dysfunctions can begin to have an affect on our lives.

 

Fascial Manipulation technique has a number of points throughout each part of the body, very similar to acupuncture points. In the initial assessment, your present, as well as your past injuries, illnesses, surgery, trauma etc are taken into account and the whole body is assessed to locate the most efficient points to release for your condition.

 

If the right points have been found then 50% improvement or more should occur with the first treatment or with internal dysfunctions improvement over the following week should occur. Some purely musculo-skeletal conditions can be resolved in 1-3 sessions, whereas depending on the internal dysfunctions or complicated cases with multiple conditions/injuries etc may take longer. Generally the treatments are spaced out one week apart to give the body time to adjust to its new tensioning and after about 3 sessions at least one month is recommended between treatments, if required, to allow the cells of the fascia to regenerate.

 

The treatment can be quite tender and often remains sore for about 2-3 days after the treatment session. This is normal and part of the healing process, as the treatment involves causing friction to the points that are found to be densified. The friction heats up the ‘stuck’ densified hyaluronic acid layer until it becomes fluid once more and thus small areas of inflammation are created. The points may stay sore but usually the condition being treated is improved, immediately for musculo-skeletal issues and over one week for internal dysfunctions.

 

Fascial Manipulation works well on any sports injuries, back and neck injuries, overuse injuries, chronic injuries and for people who have developed multiple areas of pain or issues in their bodies.

 

Within 1-3 sessions you will know if it will work for you! Once treated, the areas that were previously ‘blocked’ are now able to move as they are supposed to making exercises more likely to work and help strengthen the targeted areas. With internal dysfunctions, by removing the fascial tension the organs are more free to move in the rhythm they need to work, (all organs have small amounts of movement.), thus minimising unusual symptoms. Fascial Manipulation cannot change pathologies but may be able to help pre-pathological states with the internal organs. The treatment points do not involve manipulating the internal organs, instead the points are located at sites where tension has been found to concentrate for example along the abdominal muscle sheath or feet.

 

Jo Hadley

Phyisotherapist

Quay Health

jo-hadley_profile

Nerissa D'Mello​​

Clinical Lead Physiotherapist
Nerissa’s interest in physiotherapy began after experiencing multiple injuries growing up. Being in and out of clinics sparked her curiosity about how the body heals and inspired her to help others return to what they love. Early hands-on experience with a Scottish rugby club during her masters strengthened her passion for musculoskeletal and orthopaedic rehabilitation.
 
Now the Clinical Lead Physiotherapist at Quay Health, she has a strong interest in helping patients recover without surgical intervention when possible. Her treatment style combines hands-on techniques with exercise prescription, grounded in the latest research to promote lasting recovery.
 
Some of the techniques Nerissa uses are dry needling, VALD ForceDecks and Dynamo for data-driven rehab, taping, and shockwave therapy for stubborn tendon injuries.
 
She enjoys treating a broad range of patients, regardless of age, fitness, or background, and is currently expanding her expertise in women’s health.
 
Patients can expect a thorough, personalised approach focused on understanding their goals, hands-on treatment, and education in a supportive environment.
 
Outside work, you can find Nerissa training for her first full marathon, playing tennis, smiling at your dog, and trying to keep up with all her downloaded podcasts.
 
Clinical interests include:
 
  • Shoulder injuries, including rotator cuff and instability
  • Ankle sprains
  • Tennis and racquet sports injuries
  • Neck and upper back pain
  • Rehab from postoperative hip and knee replacements
  • Women’s health 
 
Languages spoken other than English: Conversational Hindi
 
Nerissa is available at Quay Health. Call 1300 782 943 to make an appointment or book online.

Jamie Belesky

Senior Physiotherapist

Jamie discovered his passion for physiotherapy through his own rehabilitation journey after tearing his ACL as a teenager playing football. Going through that process sparked his appreciation for how effective rehab can restore confidence and performance. He now has over 10 years’ experience working across musculoskeletal and sports physiotherapy in clinics in Wellington, Auckland, and London, including high-performance gym and sporting environments.

His treatment style is evidence-based, hands-on, and exercise-focused. Jamie combines manual therapy with structured rehabilitation programs to achieve long-term results and believes treatment should always be individualised to the person and their goals.

Jamie uses a range of techniques including dry needling, joint mobilisation, sports massage, taping, shockwave therapy, and VALD ForceDecks testing.

Outside the clinic, you’ll find Jamie running, surfing, playing golf, or watching football.

Clinical interests include:

  • Knee and ankle rehabilitation
  • Low back pain
  • Running-related injuries
  • Shoulder pain and instability
  • Tendon injuries

 

Jamie is available at Quay Health. Call 1300 782 943 to make an appointment or book online.