success in the fascial paradigm

8/3/2019 Success in the Fascial Paradigm

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The Science of Physical Rehabilitation

Success in the Fascial

ParadigmCase Study

Gavin Broomes B.Sc.

09/02/2012


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May 2010 January 2012

Despite the obvious remaining muscular tension and asymmetric neutral position, there is a remarkableimprovement in many key areas: There is a generalized reduction in overall muscular tension which is a

direct reflection of the increased compression strength of the trunk. This reduction promotes a more

comfortable neutral position and permits positional transfers with less difficulty and discomfort. The

abdomen exhibits an increase in volume and tone which contributes to the overall improvement of the

pelvis (as seen in the next comparative photos). Upon close inspection, there is also a positive reduction

in the valgus distortion of the leg in conjunction with encouraging gains in muscular bulk of the legs.


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The improvement and development of the muscular bulk of the posterior pelvis (Gluteals) is quite

dramatic. It is important to note that this significant improvement has been achieved with relatively

little direct application to the hip itself, rather a careful and concentrated focus on the primary

developmental fundamentals of early motor development---compressional strength (can also be

considered as postural strength). The improvements that are seen at the pelvis, hip, and legs areattributed to the development of the hydrostatic strength and integrity of the abdomen. In addition,

this sets obvious precedent as to whether passive non-invasive approaches work. Although this leg is

not able to be exposed to load bearing activities, it is orders of magnitude in better condition and sets a

standard for potential future rate of progress.


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The general overhead view clearly illustrates the reduction of global muscular tension. In most children

with CP, the prone position is extremely uncomfortable (if not impossible) due to the lack of thoracic

strength and volume (proper support of body weight), profound muscular imbalances (difficult to find

neutral position), and a significant proprioceptive deficiency (difficulty in establishing comfortable,confident contact with the bench due to disruptive proprioceptive feedback). Although the time period

may seem long (to the non-ABR person), the result is quite evident and effectively confirms that even

with natural growth and development (which typically produces more distortion and challenges) there is

an obvious improvement in his condition that contributes to comfort, general health, and well-being.


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A closer inspection of the posterior trunk reveals that the reduction in muscular tension, in conjunction

with the improved strength and tone of the thorax and abdomen, has resulted in a reduction in the

extent of the asymmetric curve of the spine. Again, this reduction has been achieved without ANY

invasive intervention or direct focus on skeletal muscle.

Although this specific case was chosen to be presented, it is not an exception to the rulerather it is the

rule itself. By definition, the term developmental delay DICTATES that the primary rehabilitative focus

(and therefore the primary evaluative standards) be the promotion of the healthy developmental

process. The unfortunate reality is that many parents (and professionals) get drawn to chronological

age and therefore implement age-appropriate protocols that are: a) based entirely in the

musculoskeletal paradigm; b) derived and extrapolated from protocols that are used on healthy

individuals. The relevance of fascia in the early developmental process is undeniableand therefore

should be given considerably more focus and attention.

success in the fascial paradigm

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