A New Approach to Common Injury

Fascial Distortion Model Puts a New Lens Over Basic Problems
Written by Michael Richardson

Looking through a different lens can be the key to finding new answers, and practitioners of a new way to look at common pain and injury, called the fascial distortion model (FDM), would be the first to agree.

Created in 1991 by Dr. Stephen Typaldos, the FDM is a revolutionary approach to common injuries. It focuses on the fascia, which can be described as shiny saran wrap covering basically every part of the body. It is the main connective tissue of the body, making up things like tendons, ligaments and other tissues that surround muscles, nerves, bones and organs.

Practitioners work to find what are called “fascial distortions” in the fascial tissue. These distortions are often misdiagnosed as muscle tears, pulled muscles, sprains, tendonitis and more, according to those educated in FDM.

FDM therapists work out these distortions, often resulting in faster, more accurate and better therapy than traditional methods, practitioners say.

There are six types of distortion in the FDM:

  1. Triggerband: Twisted or wrinkled fascial fibers.
  2. Herniated triggerpoints: Abnormal protrusion of tissue through fascial plane.
  3. Continuum distortion: the areas where ligament, tendon, other fascia and bone transition from one to the another is damaged.
  4. Folding distortion: Folded tissue.
  5. Cylinder: Overlapping fascia.
  6. Tectonic fixation: Inability of fascial surfaces to glide

Matt Booth, a therapist practicing FDM in Idaho, says that a lot of pain perception comes from the fascia. Because of this, when patients describe the pain they are having, their hand motions often indicate the specific problem with the fascia itself.

“It blows me away how accurate people are,” he says.

The advantage is that the patient is able to show the doctor the path to follow, Booth says, who is only the third physical therapist in the United States to practice FDM. It is more common in Europe and Japan.

Better accuracy in diagnosing the problem means less need for imaging and lab work, which means less overall cost.

The FDM puts its focus away on patients’ complaints that traditional treatment might not. For example, Booth says, approaching a normal ankle sprain is different. An FDM therapist might manipulate the tissue of the ankle, rather than simply recommending icing and taping.

In the FDM model, a sprain is a tiny alteration in the bone-fascia junction. Booth compares it to a rope tied to a dock, where the pressure on the rope pulls up a part of cleat up off the dock. So pushing that cleat back down would make sense. Booth says he remembers not fully understanding why some techniques worked, until he learned the FDM.

Seven years ago, Todd Capistrant, DO, was treated by a physician practicing the FDM, and got his tennis elbow resolved. He decided to start using FDM, which is now a central part of treatment for his patients in Alaska.

Capistrant, who is a member of the American FDM Association, says that there are some tough barriers to climb before FDM becomes widely accepted. There are multiple international organizations, but Capistrant says physicians are hesitant to latch onto new techniques, especially a completely new model. The AFDMA is working to make FDM part of medicine in general, rather than just something therapists use.

The AFDMA members work to train physicians, and also work to get research done to give the FDM the credibility it needs to gain momentum. They currently have connections with Pacific Northwest University and Des Moines University.

But understanding of the fascia is already progressing, according to Capistrant, who recently published a case study at the Fascia Research Congress, a hub for fascia research. Before fascia was thought to be just a support tissue, but research now shows that it is much more. Its proper movement is vital to the functioning of the body.