Laurie's Blogs.


Sep 2023

Working with Fascia

Laurie Edge-Hughes, BScPT, MAnimSt, CAFCI, CCRT, Cert. Sm. Anim. Acup / Dry Needling

You might be living under a rock if you’ve not heard that the fascial system provides a new way to access various structures further removed from just the tissues below the surface of the skin.  


I came across an interesting randomized clinical trial that looked at using fascial stretching techniques on hamstring flexibility. 


Ruiz JJB,  Perez-Cruzado D,| Llanes RP.  Immediate effects of lumbar fascia stretching on hamstring flexibility: A randomized clinical trial.  Journal of Back and Musculoskeletal Rehabilitation, vol. 36, no. 3, pp. 619-627, 2023.


Here’s the abstract:


Background: The hamstring muscles have a great tendency to decrease their extensibility, a phenomenon that presents a distinct clinical entity called short hamstring syndrome (SHS), in addition to problems with adjacent structures.


Objective: The objective of this study was to evaluate the immediate effect of lumbar fascia stretching on the flexibility of the hamstring musculature.


Methods: A randomized controlled trial was carried out. Forty-one women between 18 and 39 years old were divided into two groups: the experimental group received a technique of fascial stretching in the lumbar area while the control group participated in a magnetotherapy machine that was turned off. Hamstring flexibility in both lower limbs was measured by the straight leg raising test (SLR) and the passive knee extension test (PKE).


Results: The results showed statistically significant improvements (p< 0.05) in the SLR and the PKE for both groups. There was a large effect size (Cohen's d) for both tests. There was a statistically significant correlation between the International Physical Activity Questionnaire (IPAQ) and the SLR.


Conclusion: The inclusion of lumbar fascia stretching might be an effective part of a treatment protocol to increase the flexibility of the hamstring muscle observing an immediate result in healthy participants.


So, there are a few things to discuss in this paper.  One, we often think that are treatments, whatever they may be, need to be directed to the tissues where we are finding issues.  However, this paper teaches us that we can think outside the box to perhaps accomplish the same thing!  So, I think we need to look at the fascial chains.  What connects to what?  


As well, the findings of the study also highlight the need to do a full body assessment and that there is more than one way to treat a problem.  The latter comment is something that many of the veterinarians that came to do their canine rehab placements at my clinic found out.  They would tell me about what they saw one of the other therapists do with a patient and ask me if it was ‘correct’.  I’d say, I trust my therapists, their decision making, and their skills and that there is more than one way to approach a problem.  Therein lies the “ART” of Physical Medicine!


So, on that note, enjoy some ‘thinking outside the box’ this week!

Until next time… Cheers!