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J Bodyw Mov Ther. 2014 Jul;18(3):462-8. doi: 10.1016/j.jbmt.2013.11.020. Epub 2013 Dec 3.

Case study: could ultrasound and elastography visualized densified areas inside the deep fascia?

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Fysioterapia Tuulia Luomala, Terätie 10, 14200 Turenki, Finland. Electronic address:
Manuaalinen Fysioterapia Mika Pihlman, Myllytontunkatu 3, 20540 Turku, Finland.
Metropolia University of Applied Sciences, Faculty of Welfare and Human Functioning, Helsinki, Finland.
University of Padova, Department of Human Anatomy and Physiology, Italy.


Many manual techniques describe palpable changes in the subcutaneous tissue. Many manual therapists have perceived palpable tissue stiffness and how it changes after treatment. No clear demonstration exists of the presence of specific alterations in the subcutaneous tissue and even less a visualization of their changes following manual therapy. This case study visualizes by ultrasound and elastography an alteration of the deep fascia in a 40-year-old male with subacute pain in the calf area. Ultrasound and elastography permits visualization of gliding, echogenicity and elasticity of deep fascia and their changes, after manual therapy (Fascial Manipulation(©)). This study suggests the possible use of the ultrasound and elastography to furnish a more objective picture of the "sensations" that are commonly reported by manual therapists, and which supports clinicians in the diagnosis of the myofascial pain.


Densification; Fascia; Fascial manipulation; Gliding; Manual therapy; Myofascial pain; Sliding system

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