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: Nuccelli Matteo
A 35-year-old patient, a semi-professional triathlete, presented to the clinic complaining of pain in the fourth toe of the left foot. This condition had been ongoing for some time, despite undergoing several physical therapy sessions, which had not provided any benefit.
The pain was severe (NRS 8/10) during long-distance running (approximately 20 km) and moderate (NRS 6/10) while cycling. It was disabling, preventing the patient from completing long-distance training sessions or races. The onset of the pain dated back to 10 years before, with significant worsening over the last 4 months. Additionally, two years after the first episode, consecutive pain developed in the left knee and lumbar region, with greater severity on the left side compared to the right.
Motor verification, although not revealing significant pain during daily activities, highlighted a limitation in the sagittal and frontal planes at the level of the PE and LU segments. Palpatory verification of the PE, GE, and LU segments revealed a higher number of densifications in the frontal plane.
First treatment: LA PE, LA TA, LA GE, ME PE, ME TA, ME GE (left side).
After the first session, the pain in the left foot improved by 70%, with intensity reduced to NRS 2-3/10 during running and NRS 2/10 during cycling.
Second treatment: LA CX BI, LA PV SIN.
Following the second treatment, the pain in the left foot, left knee, and lumbar region disappeared both during running and cycling, allowing the patient to cover long distances with an NRS value of 1/10.
Given the significant improvement, it was decided not to proceed with further immediate treatments, and the next session was scheduled 14 days later. During this period, the patient underwent 8 running and cycling sessions and was monitored to assess any potential recurrence of pain and determine the need for future interventions.