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: Bettinsoli Andrea
A 35-year-old male patient presented to the clinic. He has been practicing athletics for approximately 15 years and works as a lawyer.
He reports the onset of pain and stiffness in the right hip, predominantly localized in the anterolateral region. The symptoms first appeared around two years ago but have exacerbated over the past two weeks. The pain primarily occurs at the end of the day, in an upright position, and during ambulation, worsening with running. Conversely, he reports symptom relief in the morning, while lying supine or at rest.
During the anamnesis, additional information emerged concerning previous injuries. Specifically, nine years ago, the patient sustained a fracture of the right lateral malleolus during a recreational soccer match, which required surgical intervention. The postoperative recovery period was longer than expected. He currently reports mild stiffness in the right ankle joint (tibiotalar joint), although it does not significantly affect his daily activities.
Based on this information, a hypothesis is formulated regarding potential biomechanical compensations that may have developed in the right hip as a consequence of the previous ankle fracture and the associated immobilization period.
Motor Verification
Motor verification was performed. Hip mobility tests revealed a marked limitation in ante coxa (AN CX), followed by a restriction in retro coxa (RE CX). Ankle mobility was also evaluated, showing a slight limitation in flexion-extension movements (AN-RE TA).
Palpatory Verification
The evaluation continued with palpatory verification. Palpation of the right gluteal region and talo (TA) revealed increased densifications, predominantly in the sagittal plane.
Once the main plane was identified, longitudinal palpation was conducted over the involved segments (PV-PE) to locate the most densified points.
Treatment
After identifying the densified CC, treatment was administered to the following points: RE-PE (right), AN-TA (right), RE-TA (right), AN-PV (bilateral), RE-CX (right), AN-CX (right)
At the end of the session, the patient reported a significant improvement in both pain symptoms and range of motion of the right hip. Post-treatment motor evaluation confirmed the reported improvements.
A follow-up appointment was scheduled one week later to continue the treatment plan.