The Fascial Manipulation Method is a publication featuring actual case reports. This publication is dedicated to the deepening our understanding of the common dysfunctions we encounter in our clinical practice, how they present and how they can be treated with Fascial Manipulation. Professionals tell us their cases, accurately describing the patients symptomatology, the working plan they have chosen and the results obtained due to the treatment. The names of the patients have been modified for privacy reasons
Clinician: De Salvo Fabio
Patient:
Francesca, 28 years old, researcher, former athlete (volleyball player for 20 years). She stopped sports about two years ago due to conflict with work commitments.
SI-PA:
The patient reports a sensation of heaviness in the lower limbs, bilateral and symmetrical, extending from the proximal segment (GE – TA) down to the feet. The symptom is more pronounced in the evening hours, worsens toward end of day, and does not fully regress with rest.
She also reports the presence of the so-called “sock sign” (clinically observed) and frequent episodes of cold feet.
PA-CONC:
- Irritable Bowel Syndrome
- Gastritis
- Subjective left-sided hearing loss (described as “occluded ear”); uses a hearing aid for about two years
PA-PREV:
- Recurrent episodes (2 per year) of cervical stiffness
- History of recurrent cystitis (4 episodes reported)
Significant event:
At age 24, she had a severe tonsillitis episode with prolonged recovery (1 month).
Hypothesis:
Given the involvement of multiple systems, the decision was made to begin with a palpatory verification of lymph nodes and a targeted treatment of the lymphatic and immune systems.
The working hypothesis is based on the reported evening lower-limb heaviness and the presence of the “sock sign,” which suggest a possible slowdown in lymphatic drainage. The previous prolonged tonsillitis and recurrent cystitis episodes further support the possibility of immune system involvement.
Palpatory Verification:
I conducted palpatory verification of CX lymph nodes, then of the anterior quadrants corresponding to the PV and CX segments. I also tested the trunk catenaries in preparation for a second treatment focused on the immune system via deep points or catenary manipulation.
Treatment:
I manipulated the perinodal zones of the dysfunctional lymph nodes (nodes were not enlarged, were mobile relative to underlying planes, but were congested by surrounding stiff connective tissue). After those maneuvers, I proceeded to the lower limb quadrant treatment via lymphatic drainage in q- AN ME CX.
Outcome:
On a telephone check four days after the session, the patient reports subjective improvement, with a reduced sensation of heaviness in the lower limbs and less fatigue. However, the “sock sign” persists. In the second session, the plan is to deepen evaluation of the posterior compartment, the trunk lymphatic chains, and to reassess the quadrants already treated in the first session.