北欧神话和希腊神话>metroLUIGI STECCO CARLA STECCO FASCIAL MANIPULATION PRACTICAL PART
English Edition by
JULIE ANN DAY
world cupForeword by
ROBERT SCHLEIP PhD
Director, Fascia Rearch Project
Ulm University, Germany情人节快乐英语
吸血鬼日记衍生剧Welcome to an exciting new field in muscu-loskeletal therapy: the fascinating world of fascia. Fascia forms a continuous tensional network throughout the human body, covering and connect-ing every single organ, every muscle, and even every nerve or tiny muscle fiber. After veral decades of vere neglect, this ubiquitous tissue has transformed from the “Cinderella of orthopaedic science” into an almost super star position within medical rearch. Starting with the first few years of this 21st century, the number of rearch papers on fascia in peer-reviewed journals experienced an alm
ost exponential increa. The 1st International Fascia Rearch Congress, held at the Harvard Medical School in October 2007, was celebrated with worldwide acknowledgement. Similar to the rapidly growing field of glia rearch in neurology, there is now a global recognition that this underesti-mated contextual tissue plays a much more impor-tant role in health and pathology than was estimated during previous decades.
As every medical student knows and every doc-tor still remembers, up to now, fascia has been in-troduced in anatomy disction cours as the white packing stuff that one first needs to clean off, in or-der “to e something”. Similarly, anatomy books have been competing with each other, in how clean and orderly they prent the locomotor system, by cutting away the whitish or mi-translucent fascia as completely and skilfully as possible. While stu-dents appreciate the appealing graphic simplifica-tions, with shiny red muscles, each attaching to spe-cific skeletal points, frustration is certain when the simplified maps have almost nothing to do with how the real body feels and behaves, be it in medical surgery or during therapeutic palpation.
To give an example: in real bodies, muscles hardly ever transmit their full force directly via ten-dons into the skeleton, as is usually suggested by our textbook drawings. They rather distribute a large portion of their contractile or tensional forces onto fascial sheets. The sheets transmit the forces
to synergistic as well as antagonistic mus-cles. Thereby they stiffen not only the respective joint, but may even affect regions veral joints fur-ther away. If we look cloly at the two powerful muscles gluteus maximus and tensor fascia lata, both inrt into the den fascial sheet along the lat-eral thigh, called the iliotibial tract. This tissue is part of the fascial envelope of the thigh, called fas-cia lata, who tension influences not only the stiff-ness of the lateral hamstrings and quadriceps, but also verely effects the behaviour of the knee joint and the whole lower leg.
The simple questions discusd in musculoskele-tal textbooks “which muscles” are participating in a particular movement thus become almost obsolete. Muscles are not functional units, no matter how common this misconception may be. Rather, most muscular movements are generated by many indi-vidual motor units, which are distributed over some portions of one muscle, plus other portions of other muscles. The tensional forces of the motor units are then transmitted to a complex network of fascial sheets, bags, and strings that convert them into the final body movement. Into how many ‘muscles’each of them has been divided by our historical text-book authorities, depended more or less on their manual skills with the disction knife. Their dis-tinctions have little to do with the question about which movements the structures can perform.
Similarly, it has been shown that fascial stiffness and elasticity play a significant role in many ballis-ti
c movements of the human body. First discovered by studies of the calf tissues of kangaroos, an-telopes, and later by hors, modern ultrasound studies have revealed that fascial recoil plays in fact a similarly impressive role in many of our human movements. How far you can throw a stone, how high you can jump, how long you can run, depends not only on the contraction of your muscle fibers; it also depends to a large degree on how well the elas-tic recoil properties of your fascial network are sup-porting the movements.
If the architecture of our fascial network is in-deed such an important factor in musculoskeletal behaviour, one is prompted to ask why this tissue been overlooked for such a long time has. There are veral answers to this question. One aspect has to do with the development of new imaging and re-arch tools, which now allow us to study this tissue in vivo. Another reason is the degree to which this
在线中英文转换器FOREWORD
FOREWORD VI
预科班是什么意思 tissue resists the classical method of anatomical re-arch: that of splitting something into parate parts that can be counted and named. You can rea-sonably estimate the number of bones or muscle
s; yet any attempt to count the number of fasciae in the body will be futile. The fascial body is one large networking organ, with many bags and hundreds of rope-like local densifications, and thousands of pockets within pockets, all interconnected by sturdy pta as well as by loor connective tissue layers.
This ‘non graspability’of fascia is also reflected in the u of many different terminologies through-out literature, describing which exact tissue types are included under the term “fascia”. Whether the thin intramuscular endomysium or the superficial fascia can be regarded as fascia (or rather as loo connec-tive tissue), or whether only den irregular connec-tive tissue sheets should be included, ems to de-pend on the individual perspective of each author. Let me therefore introduce you to the newly pro-pod definition of fascia propod at the first Fascia Rearch Congress. The term ‘fascia’here describes the soft tissue component of the connective tissue system that permeates the human body. This in-cludes not only den planar tissue sheets (like pta, joint capsules, aponeuros, organ capsules, or reti-nacula), which may be also called “proper fascia”, but it also encompass local densifications of this network in the form of ligaments and tendons. Addi-tionally it includes softer collagenous connective tis-sues like the superficial fascia or the innermost intra-muscular layer of the endomysium.
While not everybody will be happy with this new terminology, it offers many important advantages for the field. Rather than having to draw most often arbi-trary demarcation lines between joint capsules and their intimately involved ligaments and tendons (as well as interconnected aponeuros, retinacula and intramuscular fasciae), fascial tissues are en as one interconnected tensional network that adapts its fiber arrangement and density according to local tensional demands. This terminology fits nicely to the Latin root of the term ‘fascia’(bundle, bandage, strap, uni-fication, binding together) and is synonymous with the non-professional’s understanding of the term “connective tissue” (in contrast to medical and bio-logical scientists, which include cartilage, bone and even blood as connective tissue).
The dynamic field of fascia rearch, to which the authors of this book contribute significantly, has shown in veral ways that fascia is much more ‘alive’than was previously assumed. Aliveness has at least two aspects here. One is its capacity to ac-tively contract, as laboratory work with rat and hu-man fascia by our group (Fascia Rearch Project, Ulm University, Germany) and the group working with Ian Naylor (Bradford University, U.K.) has shown. The other aspect is its quality as a nsory organ. It has been shown that fascia is denly in-nervated with many nsory nerve endings includ-ing mechanoreceptors and nociceptors, which can become the source for acute myofascial pain syn-
在线汉英词典dromes. Fascia, if understood in the wider defini-tion of the term described above, is one of our rich-est nsory organs. It is for sure our most important organ for proprioception and for our “n of em-bodiment”.
The Stecco family, two of which are authors of this book, have become a driving force in this new field. Their first book “Fascial Manipulation for Musculoskeletal Pain” (Piccin, 2004) already attract-ed worldwide attention, and was quickly pasd around from one myofascial therapist and bodywork instructor to another. It was therefore not a large sur-pri that their prentation at the Harvard Fascia Congress in 2007 was honoured with a special award for its scientific quality and depth of implications. I have no doubt that this new book, which not only deepens the theory and anatomical details of the first book but also prents a preci description of their therapeutic technique, will have a major impact upon the whole field of manual therapy.
The authors prent a novel model concerning the contribution of fascia to neuromuscular coordi-nation through a specific topography of centers within the fascial network (centers of coordination, centers of perception, and centers of fusion). While this is a completely new model, it is prented in a very convincing manner. The evidence given in this book in support for this intriguing model, covers not only corroborating phylogenetic and neuro-physiological details, but includes thousands o
f hours of anatomical cadaver rearch, performed by the original founder of this approach, Luigi Stecco, as well as his daughter Carla Stecco MD and son Antonio Stecco MD. Their diligent cadaver studies have resulted in veral new anatomical discoveries and descriptions, published in peer-reviewed scien-tific anatomical journals. Anybody who has fol-lowed the emerging new publications on fascia in the scientific literature in the last few years will have noticed the important contributions. This family team has studied fascial morphology and to-pography in detail, which is not only impressive but also resulted in the novel descriptions and findings that support the new model for neurofascial coordi-nation prented in this book.
While the findings add great credibility to their work, further rearch will be needed to convince the scientific community of the full validity of this new concept. Whatever the coming years will bring up, whether in support of or in extension to the specific predictions made in this historical book, the will be exciting years. The contribu-
FOREWORD VII
tions given to the world wide community by the Stecco family, as well as by veral other fascia in-spired groups, have already motivated some of the world’s leading experts in musculoskeletal medi-
cine to enter the field of fascia rearch themlves. For example, Prof. Siegfried Men, muscle pain expert from Heidelberg University, recently started to include the lumbar fascia in his innervation and nociception studies and already found some ‘very interesting details’which he will soon publish. Sim-ilarly, Helene Langevin MD, renowned acupunc-ture rearcher in Vermont, is currently using ultra-sound to compare fascial morphology between chronic back pain and healthy people.
One of the treasures of this book is the large num-ber of cadaveric photos showing topographical anatomy details of fascia. The are extremely well done and display some local properties that have never been described in such detail. Nevertheless, let me remind you, that the pictures, as beautiful as they are, show a much drier body than the one you are living in and the one you are touching in your clients. Plea keep the fluid dynamics of the living body in mind and in your touch, when you turn from this book to the properties of fascia in a real living person. Fascia in living bodies is much more slip-pery and moist than you may tend to imagine.
大洋洲英语If you are a beginner within the field of physio-therapy (or orthopaedics, rehabilitation, movement therapy, etc), be prepared that this is not a book to skim over lightly while watching TV. It is a gold mine of condend information. If you mistakenly skip over a ntence, it may easily occur that you
will miss this information later, when trying to un-derstand the logic of the following pages, as there is not much redundancy in this book. Yet I give you my word that even most experts in this field will look at and read this book with immen excitement and a state of joyful discovery. While other books have been written on fascia from veral different angles, this one clearly ts a new standard. My congratulations to the authors for completing the most valuable and richest book that has ever been published on fascial manipulation; and also to you, dear reader, for having chon this very book in or-der to learn more about a truly fascinating tissue and its manipulation.
R OBERT S CHLEIP PhD
给某人打电话英文
Director, Fascia Rearch Project
Ulm University, Germany
