The heart of healing lies in our ability to listen, to perceive, more than in our application of technique.

1. CURRENT TRENDS IN MANAGEMENT OF
MUSCULOSKELETAL PAIN
A WORKSHOP WITH APPLICATION
OF FASCIA APPROACH
Dr kannabiran Bhojan, PhD(P.T)
Orthopedic Manipulative Sports Physiotherapist
Professor RVS college of physiotherapy
Certified Spinal,Cranial,Visceral,Fascial,MOVE Kinetictaping,Dry needling Practioner
Coimbatore

2. WHY????????????????
• While everyone learns something about bones and muscles, the
origin and disposition of the fascinating fascial net that unites them is
less widely understood
Because its less widely understood

3. The heart of healing lies in our ability to listen,
to perceive, more than in our application of
technique.

4. Holistic networks
• The neural net
• The fluid net
• The fibrous net

5. All three convey informationAll three convey informationAll three convey informationAll three convey information
Each of the major body communicating networks is
made up of tubular subunits. The nerves are
unicellular tubes, the capillaries are multicellular
tubes, and the tubes of the collagen
fibers are cell products, woven by the fibroblasts.

6. The formation of the fascial net

7. The fibrous net
connective tissue net extends
into the dorsal and ventral
cavities as well, to surround
and invest the organs.

8. FASCIAL DYSFUNCTION AND DISEASE
• ADAPTATION TO OVERUSE ,DISUSE ,MISUSE & TRAUMA

9. DENSIFICATION AND LOSS OF FASCIAL SLIDING FUNCTIONDENSIFICATION AND LOSS OF FASCIAL SLIDING FUNCTIONDENSIFICATION AND LOSS OF FASCIAL SLIDING FUNCTIONDENSIFICATION AND LOSS OF FASCIAL SLIDING FUNCTION
Fascial restrictions can apply excessive pressure to
tissues causing a variety of symptoms ; pain, headaches
or restriction of motion.
This restrictions affect our flexibility and joint stability,
and sporting/ballistic movements of the human body.
How far we can hurl a stone, how high we can jump,
and how long we can run depend not only on the
contraction of our muscle fibers, but also to a large
degree on how well the elastic recoil properties of our
fascial network are supporting these often complex
movements

10. GLOBAL POSTURE ASSESSMENT OVERVIEWGLOBAL POSTURE ASSESSMENT OVERVIEWGLOBAL POSTURE ASSESSMENT OVERVIEWGLOBAL POSTURE ASSESSMENT OVERVIEW

11. FASCIA A HOLISTIC COMMUNICATING SYSTEMFASCIA A HOLISTIC COMMUNICATING SYSTEMFASCIA A HOLISTIC COMMUNICATING SYSTEMFASCIA A HOLISTIC COMMUNICATING SYSTEM

12. ANATOMY TRAINS AND FASCIAL BASCISANATOMY TRAINS AND FASCIAL BASCISANATOMY TRAINS AND FASCIAL BASCISANATOMY TRAINS AND FASCIAL BASCIS

13. The Superficial Back LineThe Superficial Back LineThe Superficial Back LineThe Superficial Back Line

14. SUPERFICIAL FRONT LINESUPERFICIAL FRONT LINESUPERFICIAL FRONT LINESUPERFICIAL FRONT LINE

15. The Deep Front LineThe Deep Front LineThe Deep Front LineThe Deep Front Line

16. The Lateral LineThe Lateral LineThe Lateral LineThe Lateral Line

17. The Spiral LineThe Spiral LineThe Spiral LineThe Spiral Line

18. The Arm Lines
two Front Arm Lines.
two Back Arm Lines.

19. The Functional LinesThe Functional LinesThe Functional LinesThe Functional Lines

20. How do fascial problems start
• Densification and disturbed fascial sliding system

21. According to fascia
When body segments are pulled out of
place and muscles are required to maintain
static positions – either
stretched/contracted ('locked long') or
shortened/contracted (locked short') –
then we see increased fascial bonding and
thixotropy of the surrounding intercellular
matrix (ECM),

22. Essentially, these muscles or parts of muscles
are being asked to act like straps
(A) The ECM is designed to allow the relatively free flow of metabolites from blood to cell and back again in the
flow of interstitial fluid and lymph. (B) Chronic mechanical stress through an area results in increased laying down
of collagen fiber and decreased hydration of the ECM's ground substance, both of which result in decreased
nourishment to certain cells in the 'back eddies‘ caused by the increased matrix.

23. Fascial dysfunction might involveFascial dysfunction might involveFascial dysfunction might involveFascial dysfunction might involve
• Modified local and general ROM
• Reduced local tissue resilience /viscoelasticity
• Loss of sliding potential between tissue surfaces
• Impaired coordination /motor control
• Postural deviation/mal alignment
• Soft tissue pain on movement
• Myofascial pain
• Decreased proprioception & decreased equilibrium
• Autonomic imbalance

24. ZINK SEQUENCE

25. STAR

26. Fascial dysfunction and adaptation
• Fascia focused therapy and adaptation
• Restoring sliding function
• Fascia and ageing ,Retarding fascial ageing
• Fascial inflammation ,wound scars ,fibrosis
and adhesion
• Hypermobility syndromes

27. The Front Functional Line in a
tennis serve. The stronger and
more vertical the serve, the more
the Superficial Front Line will also
participate in driving the ball.

28. A tennis forehand connects
the Superficial Front Arm
Line to its partner directly
on the opposite side - one
of several angles that the
arms can transmit force to
the front of the torso.

29. Backhand shot could similarly
join the Superficial Back Arm Line
to its opposite partner as well as
down the torso to the pelvis and
beyond

30. The forces going through the hurdler's bodyhurdler's bodyhurdler's bodyhurdler's body
cross the Front Functional Line only at onecross the Front Functional Line only at onecross the Front Functional Line only at onecross the Front Functional Line only at one
moment during the leap,moment during the leap,moment during the leap,moment during the leap, but a connection
between the forward leg and the opposite
shoulder is maintained throughout the
movement.

31. The cricket bowler uses the
Front Functional LineFront Functional LineFront Functional LineFront Functional Line to add
impetus to the power of the
arm.

32. The kayaker uses the opposite hip to stabilize his
paddling - the lowered pulling arm via the BFLlowered pulling arm via the BFLlowered pulling arm via the BFLlowered pulling arm via the BFL, and
the lifted pushing arm via the FFLlifted pushing arm via the FFLlifted pushing arm via the FFLlifted pushing arm via the FFL.

33. Structural analysis

34. The winding and
unwinding of the torso in walking
involves the Functional LinesFunctional LinesFunctional LinesFunctional Lines
(pictured) in alternating
contraction, and the Spiral Lines andSpiral Lines andSpiral Lines andSpiral Lines and
Lateral LinesLateral LinesLateral LinesLateral Lines as well

35. Begin by lying comfortably on your back and letting
your knees go to the right.

36. When you reach side-lying, you can continue by taking
your knees and elbows away from each other

37. After you reach the belly-lying position, you can
continue on around the roll by taking your knees to
the left and letting the rest of your body follow.

38. The right Spiral Line is the primary rotator of the trunk,
assisted in this movement by the left Front Functional
Line bringing the left arm toward the right hip.

39. Structural analysis

40. Structural analysis

41. The pre-classical Kouroi series
of sculptures
shows close to ideal
'coordinated fascial tensegrity' -
balance and
proper placement for the
Anatomy Trains lines.

42. Most martial or
sportive actions
involve connecting
the arm to the
opposite leg to
increase leverage.

43. The great athletes involve
all the lines,
distributing the strain
evenly across the body.

44. Superficial Front Line stretchesSuperficial Front Line stretchesSuperficial Front Line stretchesSuperficial Front Line stretches. In each of t he following
illustrations, each pose may stretch or challenge multiple
muscles or lines, or have other intentions than mere
stretch. For a simplified understanding of how the
continual fascia within a line continuity may be stretched,
as well as the individual structures.

45. Primary
SuperficialSuperficialSuperficialSuperficial BackLineBackLineBackLineBackLine
stretches.

46. A Lateral LineA Lateral LineA Lateral LineA Lateral Line stretch, and a Lateral Line
strengthening exercise.

47. Spiral LineSpiral LineSpiral LineSpiral Line stretches.

48. Arm LineArm LineArm LineArm Line stretches.