The Fascial Distortion Model (FDM) is an anatomical perspective, originated by US physician Stephen Typaldos, D.O., in which “the underlying etiology of virtually every musculoskeletal injury (and many neurological and medical conditions) is considered to be comprised of one or more of six specific pathological alterations of the body’s connective tissues (fascial bands, ligaments, tendons, retinacula, etc.). As a model, the FDM is an abbreviated interpretation of the pathology of fascial injuries and contemplates the structural consequences of orthopedic, medical, surgical, and manipulative interventions.”
There are six principal types of fascial distortions, each with its own body language, signature presentation and likely outcome with and without Fascial Distortion Model treatments. Some common injuries that are easily resolved with FDM manual treatments include: pulled muscles and muscle tears, sprained ankles, shin splints, Osgood-Schlatter Disease, whiplash, headaches, shoulder pain, frozen joints, kidney stones, plantar fasciitis, sprains, strains and tendonitis, and low back pain. Chronic pain can also be successfully treated using the FDM, but results typically take longer than for acute injuries. Sciatica, carpal tunnel syndrome and many other injuries can also be successfully treated in this model.In the FDM approach, treatment is directed into the specific anatomical distortions of the capsule, ligaments and surrounding fascia, physically reversing them. When the fascial distortions are corrected, the anatomical injury no longer exists; the patient can resume normal function and is pain free. Both successes and failures are immediately obvious to the patient and the practitioner, which, in the case of success, is very rewarding for both. Many a doctor, having discovered the FDM, has said “this makes medicine fun again!” Because the FDM treatment is based on patient body language and mechanism of injury, which help determine the FDM diagnosis, results are objective, measureable, and often amazing.
- Triggerband (TB): Distorted fascial band
— The most common of all, triggerbands are twisted or wrinkled fascial fibers that cause a burning or pulling pain along fascial structures that are comprised primarily of linear fibers (such as fascial bands, ligaments, and tendons). When verbally describing their discomfort, athletes and other patients with triggerband injuries subconsciously make a sweeping motion with their fingers along the anatomical course of the injured fascial fibers. - Herniated Triggerpoints (HTP): Abnormal protrusion of tissue through the fascial plane
—HTP’s are tiny pathological herniations of tissue through a fascial plane most commonly found along the top of the shoulder (supraclavicular fossa) and deep in the buttock (bulls-eye). They can also be found along the edge of the scapula, deep in the tissues of the arm and thigh, and in the pelvic floor. The associated patient body language is a pushing of the tender area with the fingers (subconscious attempt at reduction of the herniation). - Continuum Distortion (CD): Alteration of transition zone between ligament, tendon, or other fascia and bone
— Continuum distortions hurt in one spot and patients tend to point with one finger to a specific point of discomfort (but do not push on it or rub the involved area). Continuum distortions can occur alone, or there may be many (commonly seen in plantar fasciitis and sprained ankles). - Folding Distortion (FD): Three-dimensional alteration of fascial plane
Folding injuries commonly occur in tissue around joints, and are similar to what happens to a road map that unfolds and then refolds in a contorted condition. Chief verbal complaint expressed is “aching pain deep in the joint.” These are the joints that tend to swell or ache more when the weather changes. - Cylinder Distortion (CyD): Overlapping of cylindric coils of fascia
— Cylinder distortions cause pain in non-jointed areas (and to a lesser extent in jointed areas) which cannot be reproduced or magnified with palpation. They are also responsible for a wide range of seemingly bizarre symptoms, such as tingling (paresthesia), numbness (diminished sensation), and pain that spontaneously seems to jump from one location to another. Cylinder distortions can also cause weakness or spasm in the trunk or extremities. Because the cylinder fascia is interconnected, cylinders can spread and jump to seemingly unrelated areas of the body. - Tectonic Fixation (TF): Inability of fascial surfaces to glide
— When patients complain that a joint is stiff, they are describing a tectonic fixation. Thrusting manipulations (as performed by chiropractic adjustments or osteopathic high velocity manipulation, as well as orthopedic manipulation under general anesthesia) are typical current and widely practiced methods of correcting tectonic fixations. However, in the FDM other manipulative, non-manipulative, medical and surgical approaches are being designed and applied so that even the most stubborn frozen shoulders or stiff backs can be quickly and adequately treated.
Summary
In its most narrow application, the Fascial Distortion Model is a competitive and effective method of envisioning and treating a wide range of musculoskeletal injuries. However, the broader implications of the FDM are that it offers anatomical insight (and thus predictability) into other current treatment methods and hopefully in the future, will stimulate the development of even more effective medications, surgical procedures, and manipulative therapies.
