The Fascial Manipulation Method is a cycle of articles dedicated to the understanding of themost common dysfunctions we meet during our clinical practice, specifically theirmanifestation and treatment with Fascial Manipulation. FM specialists report clinical cases,accurately describing their symptomatology, the chosen work plan and the resultsobtained, thanks to the treatment. For privacy reasons, the names of the patients have been changed.
Clinician: Amore Domenico
A 24-year-old man, a professional personal trainer and practitioner of various sports (six years of soccer, three years of swimming, four years of kickboxing, and currently engaged in calisthenics), presented with posterior right wrist pain. The onset of pain occurred one and a half years ago during kickboxing training. The patient reported no pain at rest, but specific exercises such as push-ups, handstands, and dips elicited pain intensity rated at 8/10 on the Numerical Rating Scale (NRS). The use of a wrist brace helped reduce the intensity of pain during sports activities.
Medical history revealed no prior traumas, fractures, or surgeries associated with the onset of wrist pain, except for a left ankle sprain that occurred two years ago, approximately six months before the wrist issue began. In June 2024, the patient was involved in a severe motorcycle accident that resulted in multiple fractures. However, this event did not affect the intensity or nature of the wrist pain, which remained unchanged.
After completing the anamnesis, a motor verification of the carpo and humerus segments was conducted. Pain consistent with the patient’s symptoms (NRS 5/10) was elicited during palmar wrist flexion with slight overpressure. Evaluation of the humerus, both in active movement and against resistance, did not yield significant findings. Among global motor verification, the horizontal plane test, performed by compressing the backs of the hands against a table, reproduced the pain. Additionally, the specific movement of the push-up was used as a motor verification test.
The clinical condition was hypothesized to result from functional overload (overuse) due to intensive sports activity. Subsequently, a comparative palpatory examination of the carpo and cubito segments was performed, targeting the CC of the ante, medio, and latero. Palpation of the latero carpo CC evoked radiating pain in the wrist, suggesting treatment on the frontal plane, although densifications were also noted in the CCs of the sagittal and horizontal planes.
During the first treatment session, the CCs of the frontal plane were treated: La-Ca, La-Cu, La-Di, Me-Ca, and Me-Cu. Post-treatment, the most significant motor tests were repeated, showing a moderate reduction in pain (approximately 50%). In subsequent sessions, this improvement was maintained. The patient reported persistent pain during training but noted improved management of the right shoulder during exercises such as dips and pull-ups. The frontal plane treatment was extended during the second session to the following CCs: right La-Di, right La-Hu, bilateral La-Th, bilateral La-Cl, and right Me-Sc.
The third session was conducted one month later due to persistent but improving pain. This session extended the treatment to the CF: An-Me Cu, An-Me Ca 2, An-Me Hu, and An-Me Sc 1.
Several weeks after the final treatment, the patient reported significant improvement, being able to train without the wrist brace. Only mild discomfort remained, specifically during handstand exercises.