Is FM Something New?

This post is a continuation in a series on Fascial Manipulation (FM)

Well, new to some! But it dates back to the late 1970’s, and began in Italy with Luigi Stecco, an Italian physiotherapist (in the US we’re known as physical therapists, same thing). He was dissatisfied with the poor outcomes typically accomplished in physical therapy as well as health care in general, and felt something was being missed. He studied anatomy and movement intensely, and proposed new constructs for approaching movement and dysfunction in the body. For a whirlwind explanation of it all you can watch this video.

He published his first book in 1987 exploring how muscles that move a body part in a certain direction relate to each other through their insertions onto the fascia. Here he related his concepts on movement, neuro-myo-fascial sequences and acupuncture meridians in his book that became very popular in China. His next book in 1990 further expanded his hypotheses of fascial involvement in proprioception (position sense), the physiology of fascia, and its relationship with pain.  He began collaborating with Julie Ann Day, an Australian trained physiotherapist, who was instrumental in translating his books into English. Taught by Luigi, Julie went on to train many other teachers including Larry Steinbeck, my main FM instructor and mentor.

It’s amazing that years before it was ever proven with high-powered microscopic magnification and staining that Luigi was proposing the fascia is innervated, plays a major role in governing movement, and could be a source of pain. This was the very same tissue that we were getting out of the way in our anatomy dissection labs so we could see the “important stuff.” It’s interesting to me how little our appreciation of the fascia has changed since then, even with all the science pointing us toward it. While change is slow, fortunately it is coming.

In 1997 Luigi began collaborating with his daughter, Carla, an MD, who joined him in researching his theories with much work done at the University of Padova in Padova, Italy. She became one of the first to identify and publish on the innervation of the fascia. His son Antonio, also an MD, PhD, later teamed up with them to contribute much to the literature expanding our understanding of the fascia. Over the years they have published an astounding compilation of books, research articles, and literature reviews. Luigi, Carla, and Antonio continue to present their work at events all over the world to practitioners from all disciplines, and have done much to catapult the discussion on fascia.

In 2008 they founded the Fascial Manipulation Association (FMA) with the intent of promoting fascial research, investigating diagnostic tools and interventions for working with fascia, and expanding knowledge of the FM method. Since then courses have expanded and are currently taught all over the world by an elite group of teachers of which I am honored to be one. (A comprehensive listing of courses can be found on the FMA website under the education tab.) In 2017 the FMA introduced the specialist certification for recognizing clinicians who completed training in FM levels 1, 2, and 3 and also passed a written, oral, and practical examination. Practitioners from all over the world travel to Italy for this certification which is offered yearly. (A listing of these practitioners can be found on the FMA website, with other non-certified clinicians found in my Find a Provider section.)

To say FM has changed my life would be an understatement. I happened upon it at a time when I was, maybe like Luigi, getting a bit burnt out on physical therapy. I would work hard with patients, doing everything everyone told me was best practice, but it still fell short. I felt like we were never really getting to the root cause of problems, but just rehabilitating them after they had done their damage. Conversely for myself as a patient with lots of musculoskeletal and internal organ function issues, I was also getting discouraged at ever getting better.

Then mostly out of obligation to a colleague (thanks Brent!) I attended a weekend FM introductory course taught by Larry Steinbeck, and I began using the method. Even with my minimal understanding of it I was still getting results! Impressed and excited, I signed up for the full course. Later Brent and Larry were sorry to inform me that out of that introductory group I was the only one who signed up, so there would be no course. At that time (2014) there were very few courses offered in the US, and going to Italy was not an option for me. So we did the next best thing and held our own private course for the therapists in all our clinics! Since then we have continued to develop our skill in using this amazing method in the treatment of an incredible variety of diagnoses. It’s not easy to learn and apply correctly, perhaps owing to why there are not more clinicians utilizing it. But based on the changes I have seen it make for my patients as well as what I have felt it do for me, I could never go back to practicing without it.

I will be forever indebted to Larry for all I have learned from him. He was one of the very few physical therapists who recognized the potential of this method years ago and acted on it. He has worked diligently to promote FM and a much needed change in our perspective as health care providers. He patiently mentored me as I moved through this whole process from student to teacher. He continues to provide wisdom, insight, and direction as we work to promote FM – sometimes like salmons swimming upstream! Many patients and clinicians are much better today because of his diligence and passion, which never seem to diminish.