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: Ferrara Francesco
A 28-year-old male professional boxer presented to the clinic complaining of bilateral neck pain, recurring for the past four years. The pain, assessed using the NRS scale, ranged from a minimum of 4/10 to a maximum of 7/10. Although no specific movement exacerbated the pain, the patient reported limited range of motion and mild discomfort during neck movements, with the highest intensity noted during neck extension.
During the medical history intake, additional issues were identified, including a constant sensation of tension in the left biceps, with a pain/discomfort rated 4/10 on the NRS scale, and bilateral wrist and hand pain, likely related to his sports career. The patient began boxing in 2017, and symptoms in the wrists had appeared early on, culminating in 2022 with a 10-month suspension from competitive activity due to a bone edema in the left scaphoid.
The patient also reported having played professional rugby for over ten years prior to starting his boxing career. Notable previous injuries included an acromioclavicular joint dislocation of the right shoulder in 2015 and a distal tibial fracture with subsequent surgery in 2012.
When questioned about internal dysfunctions or regular medication use, the patient stated that he was in generally good health. Motor verification was then performed on the neck and both upper limbs, including the shoulder, elbow, and wrist. During testing, the patient reported discomfort in both the sagittal and frontal planes but did not reach the level of acute neck pain (7/10).
Subsequently, palpatory verification was carried out, focusing on both the scapulae and carpi. Palpation of the scapula revealed thickening in the anterior scapular region (AN SC), with the patient reporting intense pain in that area. Palpation of the medial scapular region (ME SC) revealed moderate tenderness, while the intra scapular region (IR SC) was the least painful. The palpation then proceeded to the CF of AN ME SC 1-2 and AN LA SC 1-2. Palpation of AN ME SC 1 elicited burning pain, which radiated down to the left wrist.
Moving to the right and left carpo, palpation revealed similar tension, with the left carpo particularly tender in AN CA. Longitudinal palpation was performed along the entire left upper limb, followed by the right upper limb. Treatment was applied to AN ME CA 1 and AN ME SC 1 on the left side. The latter was initially difficult to approach, but after treating AN ME CA 1, it became more tolerable. On the right side, AN ME CU and AN ME SC 1 were treated, as these points were particularly painful. At the end of the session, during motor verification, the patient reported a general feeling of lightness.
Three days later, the patient contacted the clinic, reporting a significant improvement in neck pain, confirming the progress made following the first treatment.