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Osteopathic Manipulative Treatment of the Deep Fascia for the Treatment of Chronic Trauma-induced Somatic Dysfunction

Journal: The AAO Journal Date: 2022/06, 32(2):Pages: 21. doi: Subito , type of study: case report

Free full text   (https://meridian.allenpress.com/aaoj/article/32/2/15/482674/LBORC-NUFA-Poster-Abstracts-2022-Students)

Keywords:

case report [514]
deep fascia [2]
OMT [2951]
osteopathic manipulative treatment [2973]
trauma-induced somatic dysfunction [1]

Abstract:

Introduction/Background: Fascia is a connective tissue that envelops the human body from organs, muscles, and bones, to nerves and blood vessels, enabling the systems of the body to operate as a unit. Case: A 22-year-old male involved in a motor vehicle collision sustained multiple injuries including: carotid artery dissection, traumatic brain injury with subdural hematomas and subarachnoid hemorrhage, exploratory laparotomy with splenectomy, and clavicle fracture needing open reduction internal fixation. Even after two years he continued to experience recurrent somatic dysfunctions (SD), most notable being rib pain limiting respiration, and thoracic cage, cervical, and shoulder restrictions. He received osteopathic manipulative treatment (OMT) for these SD with Still’s, Strain-Counterstrain, and high-velocity low-amplitude techniques, however they would recur within a month. While an osteopathic medical student, he volunteered to serve as an educational demonstration for OMT pre-doctoral teaching fellows. Results: The student underwent a series of demonstrations focusing on manipulation of the transversus thoracis, diaphragm, mediastinal ligaments, parietal and visceral pleura, and periosteum of the ribs, sternum, and clavicles. Following each demonstration, he felt complete relief of posterior rib pains with improved breathing capacity and increased compliance of the thoracic cage and shoulder girdle. The duration of his relief expanded after each session, progressing from one to several months with no recurrence of SD. Discussion: This case shows enhanced treatment effects on chronic trauma-induced SD when the deep fascia is addressed compared to superficial anatomy treated with classic techniques, providing evidence that deep fascia could serve as a mechanism for chronic SD. More research is needed to investigate deep fascia manipulation and its role in SD.


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