The Fascial Distortion Model: Making the Patient the Expert

Author: Todd Capistrant

Dr. Capistrant: The Fascial Distortion Model can help guide a practitioner towards treatment selection because the model is based on the patient’s input. The patient is the expert. Patients guide us as practitioners by body language or gestures and their verbal description of their pain. They show us exactly the pain they’re feeling, how they’re feeling it, and we guide our treatment based on that description of the pain. It’s a pattern recognition model.

Dr. Booth: The Fascial Distortion Model looks at six different types of patterns of gestures that people do when they have an injury. When they show a certain gesture, we’re going to use a certain manual therapy technique that’s going to match. If they indicate with their finger a single spot on the bone, we’re going to treat differently for that than if they draw a line up and down their arm, or if they dig in with multiple fingers into a soft tissue spot. Each one of those hand gestures is going to lead us to a different treatment. A.T. Still, the founder of osteopathy, said that when you deal with the fascia, you do business with the branch offices of the brain. Our nervous system goes out throughout the body. It is an extension of the brain. And those branch endings of the nerves are in the fascia. They’re right underneath the skin. So, when we touch the skin and touch the fascia it is having an input into the nervous system.

Dr. Capistrant: I’m a family physician by training and I have taught all of the family physicians in my clinic, and they preferentially will use the Fascial Distortion Model to treat pain. The techniques are quick to learn, easy to utilize, usually with the thumb. Some of them can be uncomfortable so we have to have a conversation with the patient that it could be potentially painful and may leave a bruise. Some of the other treatments are completely pain free and so not everything we do hurts. We use the thumb to apply direct pressure on herniated trigger points or a line of pain will be ironing out a wrinkle in the fascia, all of which can be uncomfortable, but intuitively patients understand, because they’ll be pressing on things themselves. We find that practitioners, both MD and DO, who learn the Fascial Distortion Model are re-invigorated to have something new that they can offer patients that doesn’t involve a prescription.


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