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: Marengo Michele

Marco, a 68-year-old retired person, has come to my office for a problem localised to his neck and right shoulder of about 1 year and a half duration. He reports a sensation of tension from the right mandibular angle to the right shoulder during flexion, abduction and external rotation of the shoulder. This tension limits the aforementioned movements and causes pain (VAS 6/10).

It all started on July 2019, when he underwent a complex neck surgery (specifically a bilateral supraomohyoid laterocervical clean-up associated with transoral glossipelvectomy for cancer of the anterior floor the oral cavity). I note a large scar that extends from one corner of the mandibular to the other. In the months following the surgery, he underwent several cycles of physiotherapy aimed at the functional recovery of the shoulder with satisfactory results. He is now able to carry out the activities of daily life without problems, but the feeling of tension and related pain remain.

He also reports that, following the surgery, he developed gradual anaesthesia at the level of the tongue. This has led to have difficulty eating , including the biting of the tongue.
It is a very disabling disorder for him, and for this problem he is following a cycle of speech therapy rehabilitation.
There are no further traumas, fractures and systemic pathologies. Not having further data available, I hypothesise Marco’s problems derive from the complex intervention carried out in July 2019.

The motor verification elicits pain on all 3 planes, mostly on the frontal one, while the palpatory verification allows me to identify the frontal plane as the most involved. During the first treatment, I treat a point on the neck (la-cl right), which triggers a painful radiation towards the right shoulder. At the end of radiation and the reduction of pain during the treatment of this point, I treat the CC of the same sequence on the shoulder (la-hu right), which appears very densified.

I then re-evaluate the motor verification. The sensation of tension is reduced, as well as the pain (VAS 2/10). I finish the treatment by balancing: I treat me-cu right and me-sc left and, on the antagonist sequence, the left-cl on the trunk.
Finally, I check motor verification for the last time: Marco appears enthusiastic! He reports a marked reduction in the sensation of tension and also notices a slight increase in the sensitivity of the tongue. So I decide to leave some shoulder exercises waiting for the second treatment, set at a distance of one week.

The following week Marco reports that he has maintained the benefits of the first session: the tension is now much reduced, as well as the pain (VAS 2/10). The increased sensitivity on the tongue has also been maintained, which allows him to eat more easily.
I continue the treatment on the residual CCs: I decide to treat the right-sc, the right cp3, the left-sc.
At the end, I re-evaluate the motor verifications one final time: the feeling of tension has disappeared as well as the pain. Marco appears even more enthusiastic than the previous session: the sensitivity of the tongue has been increased again, albeit leaving part of the tongue still with anaesthesia.

The Fascial Manipulation treatment not only eliminated for Marco a problem resistant to numerous physiotherapy cycles, in just two sessions, but also allowed him to recover a partial sensitivity of the tongue, a disorder for which he seemed very concerned.

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