# The Diverse Landscape of Fascial Manual Medicine

## TL;DR

This paper explores the role of fascia in manual medicine, highlighting differing views on its definition and function among practitioners.

## Contribution

The paper offers a comparative analysis of fascial perspectives in manual medicine and the FORCE group's viewpoint.

## Key findings

- Manual medicine considers fascia as a continuous structure without segmenting it into layers.
- There is no consensus on the definition and terminology of fascia in clinical practice.
- Manual techniques start at the epidermis and do not penetrate the skin.

## Abstract

Manual medicine is a clinical approach where patients are administered non-invasive, non-pharmacological techniques to address chronic or acute conditions, such as osteopathy, chiropractic, and physiotherapy. The effect is always systemic, even though the chosen manual strategy may focus on a specific area of ​​the body, just as with surgery and pharmacology. Fascia is a subject of intense debate among manual medicine and clinical practitioners, with its definition and terminology still lacking a universal consensus. Manual medicine does not consider fascial continuity as segments or layers, nor does it differentiate fibrous tissue from non-fibrous tissue. While a clinician may target a viscus, muscle, or bone, a manual medicine practitioner's technique begins at the epidermis and never penetrates the skin. This article provides a brief review of the history and various major international currents of thought on the topic of fascia, including its nomenclature and function. It reiterates and compares the view of fascia from the perspectives of manual medicine and our study group, the Foundation of Osteopathic Research and Clinical Endorsement (FORCE).