Structural osteopathy

Fascia is a connective tissue that envelops, supports and connects muscles, joints and other structures in the body.

It is present throughout the body and plays a part in the organisation of tissues and the transmission of forces during movement.

That is why it plays an important role in my assessment and in the techniques I use.

Through palpation, I assess the mobility, tension and response of the tissues, both in the area causing you discomfort and in other areas that may need to be examined.

Fasciotherapy, or manual fascial therapy, forms part of this approach.

I use gentle touch, sustained pressure and progressive techniques, adapting the intensity and pace to suit each individual’s needs.

This approach is combined with joint and muscle techniques where the assessment requires it.

Perhaps you’ve overexerted yourself, spent too many hours in one position, or woken up feeling particularly stiff in one area.

You may find it difficult to turn your neck, bend over, walk comfortably or perform a movement that you used to do without thinking.

We begin by assessing which movements cause you discomfort and how the area responds to touch.

Depending on what we find, we can work on:

• Muscles and fascia. Areas of tension, strain and tissues involved in movement.
• Joints and spine. Mobility of the neck, upper back and lumbar spine, and the ribs.
• Pelvis and limbs. Hips, sacrum and other joints involved in the movements you find difficult.

The aim is to reduce discomfort wherever possible and restore comfort and freedom of movement.

Some people describe a rather familiar story.

They treat a specific area, you feel better, but after a few days or weeks, the same discomfort returns.

In these cases, I’m keen to understand what’s happening during your everyday movements and which other areas might be involved.

For example, strain in the lower back may be accompanied by stiffness in the pelvis, limited hip mobility or a ribcage that barely moves when breathing.

Muscle and fascial tension can also be found in neighbouring areas.

During the assessment, we explore these relationships and determine which ones are relevant to your case.

The anatomical continuity of the fascia forms part of this integrative approach, although tension found in one area does not automatically explain pain in another.

The spine is a structure designed to move, bear weight and adapt to many different activities.

During the assessment, I’d like to know:

• How you move. Which movements you find comfortable and which you find difficult.
• What symptoms do you experience? Where do you feel them, when do they worsen, and which activities are you finding difficult to do?
• How you respond. What changes during the examination, through manual contact and after treatment.

I also take into account any reports or imaging results you may bring with you.

A protrusion, a hernia or certain degenerative changes may be significant, but we must interpret them in conjunction with how you feel, your medical history and the physical examination.

See disc protrusion and herniated disc →

My treatment is primarily manual and, in most cases, I use gentle, progressive techniques.

Palpation guides much of the process. It allows me to explore how the tissues respond and to adjust my touch as we go along.

I can combine fascial work, joint mobilisation, muscular techniques and other osteopathic approaches.

Fasciotherapy plays a particularly important role because it allows me to work manually on the tissues using subtle touch, whilst focusing on their mobility and the response we observe.

We also value your feedback.

You may notice that a particular area starts to move more comfortably, that tension is easing, or that you can now perform a movement that used to cause you discomfort.

I’d like us to discuss this during the session. What I feel with my hands and what you notice helps us to tailor the treatment.

A more intense technique or joint manipulation is not necessarily better simply because it produces a more noticeable sensation.

The choice depends on the assessment and how your body responds.

Sometimes, following manual treatment, it is advisable to incorporate an active phase.

This may be the case if you need to regain certain movements, improve control of a joint or gradually return to an activity you have been avoiding for some time.

Perhaps you practise yoga and there are poses you can no longer do comfortably, or you go running and notice that one leg always takes the strain, or you spend long hours on your feet at work and your back ends up suffering as a result.

Where appropriate, we select specific exercises, practise them together and adjust their difficulty.

Active exercises complement the work we’ve done on the treatment table and allow you to continue working on your mobility outside the practice.

See postural re-education →

It depends on how you arrive at the practice, the issue we’re addressing and your response to the treatment.

Some people notice changes in mobility or in their sense of tension during the session itself.

Others begin to notice the benefits when they resume their usual activities over the following days.

I’d like to know how you’ve been getting on, whether you’re able to move more comfortably, how long any improvement has lasted, and what symptoms remain.

This information enables us to assess your progress and decide whether it is best to continue with the current approach, introduce an active component or review the treatment plan.

The aim is to reduce discomfort and stiffness where they occur, improve your mobility and help you get back to the activities you need or enjoy.

To achieve this, I combine structural assessment with work on the fascia, muscles and joints, using the techniques best suited to your individual case.

I want you to understand what we’ve found, what we’re working on and how your body is responding.

Sometimes it’s just bodywork and paintwork. Other times, you need to look at what’s holding the bodywork together.