FAQ’s Stecco Fascial Manipulation®

How Does It Feel? Understanding Fascia and Pain.

Fascia is a complex connective tissue system that lies just beneath the skin and surrounds muscles, bones, and organs. Its role is essential in movement, proprioception, and coordination. When healthy, fascia glides smoothly, supporting fluid motion and efficient force transmission. When it becomes dysfunctional—due to injury, surgery, inflammation, or immobilization—it can lead to pain, tightness, and impaired function.

Superficial Fascia and Gentle Treatment

Because the superficial fascia lies directly beneath the skin, it responds well to gentle manual techniques. Light, broad friction applied across the subcutaneous tissue helps reorganize focal adhesions and restore its normal, healthy structure. Research by Carla Stecco et al. (2016) found that dysfunctions in the superficial fascia are often associated with:

• Lymphatic issues and swelling

• Impaired superficial venous drainage

• Superficial nerve entrapments

• Disrupted thermoregulation

• Altered coordination, proprioception, and balance

Deep Fascia, Pain, and the Stecco Method®

Deep fascia is denser and envelops muscles, nerves, and bones. It plays a critical role in coordinating movement and transmitting muscular force. Densification or stiffening of deep fascia can lead to myofascial pain, muscle cramps, and restricted mobility. Stecco Fascial Manipulation® addresses these dysfunctions by targeting specific anatomical points:

• Centers of Coordination (CC): related to muscle movement

• Centers of Fusion (CF): related to movement integration between segments

Manual deep friction is applied for 2 to 5 minutes directly to the skin over these points. This restores fascial glide, improves biomechanical alignment, and reduces pain and movement dysfunction.

What Should I Expect During Treatment?

Evaluation

• Ben will assess movement patterns, range of motion, and strength to identify potential specific fascial restrictions.

• Areas of fascial densification (localized thickening or stiffness) are identified through precise palpation. These areas are often more tender and may produce unusual sensations.

Notably, the area of densification is often distant from the site of reported pain—reflecting the fascial system’s interconnected nature.

Treatment and Recovery

• Manual manipulation is performed directly on the skin at identified CC or CF points.

• Most patients experience a reduction in tenderness and improved movement right after treatment.

• Mild to moderate soreness may occur for 24–48 hours as a normal inflammatory response and the treated tissue adapts.

• Follow-up sessions often reveal less tissue density and tenderness, with improvements in strength, flexibility, and pain.

How is Stecco Fascial Manipulation (FM)® different from Traditional Physical Therapy?

The difference between traditional physical therapy and fascial manipulation lies in their approach, focus, and treatment goals. Here’s a breakdown:

Traditional Physical Therapy (PT)

Focus:

• Treats muscles, joints, and nerves directly.

• Aims to restore mobility, strength, and function after injury or surgery.

• Emphasizes local symptom management (e.g., pain in the knee is treated at the knee).

Techniques:

• Stretching, strengthening, joint mobilizations, electrical stimulation, ultrasound, posture correction, and movement retraining.

Approach:

• Often based on biomechanical models.

• Focuses on isolated structures (specific muscles, tendons, or joints).

Fascial Manipulation (FM)

Focus:

• Targets the superficial fascia, deep fascia, and myofascial continuity, treating dysfunctions within the fascial system that may affect multiple areas.

• Based on the principles and clinical studies that restrictions or densifications in fascia can cause pain and altered movement patterns—even far from the source.

Techniques:

• Manual therapy focused on the superficial fascia and/or specific points within the deep fascia (called Centers of Coordination or Centers of Fusion) to restore tissue glide and release tension.

• Often involves treating remote sites from the pain (e.g., treating the thigh to relieve shoulder pain).

Approach:

• Based on a global, integrative model of the body (especially the Stecco method).

• Views fascia as a continuous three-dimensional system that transmits force and influences coordination.

While traditional physical therapy excels at strengthening and restoring range of motion post-injury, Fascial Manipulation is often used when traditional methods fall short—particularly in chronic pain, recurrent injuries (e.g repetitive hamstring strains in football players or repetitive ankle sprains in basketball players), or movement dysfunctions without clear structural causes.

Fascial Manipulation is Particularly helpful when:

• Pain is vague, diffuse, or moves around

• Pain has persisted despite normal imaging (e.g., no tear seen on MRI) or previous traditional physical therapy, chiropractic treatment, acupuncture treatment

• There are restrictions elsewhere in the body (e.g., neck, trunk, or hip) contributing to shoulder dysfunction

• There is a history of injuries or surgeries elsewhere (e.g. past ankle sprain, back injury, abdominal surgery)

• There is a feeling of “tightness” not relieved by stretching.

Why do Patients often Fail Traditional Physical Therapy?

Patients often fail traditional physical therapy for several reasons, many of which relate to how the therapy is structured or what it overlooks. Here are some of the most common factors:

1. Symptom-Based Treatment

   Many traditional approaches focus on the site of pain rather than identifying and addressing the root cause—often located elsewhere in the body due to compensatory movement patterns or fascial restrictions.

2. Lack of Individualization

   One-size-fits-all protocols may not take into account a patient’s unique history, movement habits, or past injuries. Without a personalized plan, progress may stall.

3. Overemphasis on Exercises Alone

   While strengthening and stretching are important, they may not be effective if underlying soft tissue dysfunctions—such as fascial densifications or trigger points—are not addressed manually.

4. Inadequate Time with the Therapist

   Short sessions or limited one-on-one time can prevent thorough assessments and reduce treatment effectiveness, especially for complex or chronic conditions.

5. Ignoring Fascial or Neuro myofascial Contributions

   Traditional therapy often doesn’t consider the role of fascia in movement dysfunction, pain referral patterns, or biomechanical imbalances. Techniques like Stecco Fascial Manipulation® or dry needling target these overlooked contributors.

6. Failure to Reassess and Adapt

   Some programs fail to regularly re-evaluate progress and adjust treatment, resulting in stagnation or frustration for the patient.

7. Double booking in physical therapy refers to the practice of scheduling two (or more) patients during the same appointment time for a single therapist. This often means:

   • The therapist alternates between patients during the session.

   • Support staff, like aides or techs, may oversee exercises while the therapist treats another patient.

   • Hands-on treatment time per patient is reduced.

   Why It Happens:

   • To increase clinic efficiency or revenue.

   • To keep up with high patient volumes.

   • In insurance-based models where reimbursement rates are low.

   Downsides for Patients:

   • Less individual attention and hands-on care.

   • Reduced quality of treatment, especially for complex or chronic conditions. Hands-on therapy only focuses on one body part but does not address other dysfunctional body parts.

   • Traditional models often involve longer total visit times with limited direct benefit—patients may attend therapy three times per week for six weeks, frequently repeating the same exercises with minimal progression.

   AllConnected Physical Therapy provides dedicated one-on-one care, never double-booking patients—ensuring focused treatment, personalized attention, and better outcomes.

What Type of Patients Benefit Most from Fascial Manipulation?

Conditions Treated with Stecco Fascial Manipulation®

Musculoskeletal Pain

• Chronic neck, back, or joint pain

• Shoulder impingement or rotator cuff issues

• Hip pain and tightness

• Knee dysfunction, including patellofemoral pain

• Plantar fasciitis, heel and foot pain

• Achilles tendon issues

• Sciatica or piriformis syndrome

• Carpal tunnel and wrist pain

• Tennis and golfer’s elbow

• TMJ (jaw) pain

• Cervicogenic Dizziness and lightheadedness

• Somatic tinnitus—a type of tinnitus influenced by movement, posture, or muscle tension in the neck, jaw, or upper back

• Post-concussion syndrome or whiplash

• Persistent post-surgical pain and limitations

Myofascial Imbalances

• Myofascial pain syndrome

• Recurrent muscle strains or cramps

• Postural asymmetries

• Decreased flexibility and joint range

• Poor coordination or muscle control

Visceral-Related Dysfunction

• Reflux, bloating, or abdominal tension

• Menstrual discomfort or pelvic pain

• Constipation and urinary incontinence

Neurological & Referred Pain

• Headaches and tension-type migraines

• Nerve entrapment symptoms (numbness, tingling, shooting pain)

• Thoracic outlet syndrome

• Morton’s Syndrome (Morton’s Neuroma)

What Should I Expect at My First Appointment?

Your initial 60-minute session will begin with a thorough review of your medical history, including past injuries, surgeries, and any current limitations in activity or athletic performance.

This will be followed by a detailed assessment of your movement quality to identify any dysfunctional patterns. A hands-on manual evaluation will also be performed to locate fascial restrictions—particularly around pain points and areas affected by previous trauma. Based on these findings, we’ll create and discuss a personalized treatment plan. Treatment will begin during this first visit, with the primary goal of addressing the root cause of your symptoms.

What Happens during Follow-up Appointments?

Each follow-up session begins with a discussion about your response to the previous treatment. Your therapist will reassess movement patterns and review the areas treated last time. Based on your progress, treatment will continue with further evaluation and targeted work on any remaining or newly identified fascial restrictions to support continued improvement.

What Does It Feel Like? Will It Hurt?

Fascial Manipulation® typically involves firm, focused pressure that may produce a deep, achy and even a localized sharp sensation—often described as “therapeutic discomfort.” Some areas may be more sensitive than others, especially around old injuries or densified tissue. Some areas treated may reproduce a referred sensation elsewhere. However, open communication between you and your therapist ensures the intensity remains tolerable and adjusted as needed for your comfort.

How Will I Feel After a Session of Fascial Manipulation®?

Individual responses vary, but many patients experience an immediate sense of relief, release, or increased freedom of movement. The treated areas may feel tender for a day or two, though bruising is uncommon. During the first 24 hours, it’s encouraged to stay gently active with your usual routine—such as walking, light jogging, or yoga—but avoid introducing new or intense activities. Full effects of the session typically unfold over 2 to 3 days as your body adapts. During this period, it’s best to avoid anti-inflammatory medications, which can interfere with the natural healing process. For temporary soreness, heat (like a warm shower or heating pad) may help, though gentle movement remains the most beneficial approach.

How Many Sessions Should I Plan For?

Each person and condition is unique, so treatment plans are highly individualized. However, most patients are encouraged to plan for three to four sessions once a week to determine how effective Fascial Manipulation® will be for their specific needs.

FAQ’s Myofascial Trigger Point Dry Needling

What is Dry Needling?

Dry needling is a skilled technique used by physical therapists and other healthcare professionals to treat myofascial pain and movement impairments. It involves the insertion of a thin, sterile, monofilament needle into local trigger points—tight, irritable bands of muscle tissue that can refer pain to other areas. Dry needling can also be effective in treating painful scars and fascial restrictions.

Key Points About Dry Needling:

• Purpose: To reduce pain, improve muscle function, and restore movement by releasing trigger points and stimulating the body’s natural healing response.

• Sensation: Patients may feel a twitch response or mild discomfort when the needle hits the trigger point, followed by a sense of muscle relaxation and improved blood flow.

• Conditions Treated:

  • Muscle tightness or spasms

  • Chronic pain (e.g., neck, back, shoulder, or jaw pain)

  • Sports injuries

  • Tendinopathies (e.g., tennis elbow, plantar fasciitis)

• Difference from Acupuncture: While both use similar needles, dry needling is based on Western medical principles and targets musculoskeletal dysfunction, not traditional Chinese medicine meridians.

Is Dry Needling Uncomfortable?

Dry needling can be briefly uncomfortable, but most patients tolerate it well. Here’s what to expect.

What It Feels Like:

• When the needle hits a trigger point, you may feel a quick muscle twitch, a deep ache, or a cramping sensation—this is normal and indicates the needle is targeting the right spot.

• The actual insertion of the needle is usually felt as a quick pinch or nothing at all, as the needles are very thin.

• Some patients feel soreness in the treated area for 24–48 hours, similar to post-workout muscle soreness.

Pain vs. Relief:

• The discomfort is typically short-lived and followed by a reduction in muscle tightness and pain.

• Communication is key—your therapist will adjust the technique based on your comfort and response.

What Should I Do After Dry Needling to Support Recovery & Maximize Results?

To help your body heal and get the most benefit from your dry needling session, follow these simple post-treatment guidelines:

1. Stay Active, But Easy Does It

   Light activity such as walking or gentle stretching helps improve circulation and prevent stiffness. Avoid intense exercise, heavy lifting, or long-distance running for 24–48 hours after treatment.

2. Expect Some Soreness

   Mild muscle soreness or tenderness in the treated area is normal and usually lasts 1–2 days. This is a natural part of the healing process.

3. Apply Heat, Not Ice

   A warm shower or heating pad can help soothe post-treatment soreness. Avoid using ice unless specifically recommended by your therapist.

4. Skip Anti-Inflammatories (If You Can)

   A little inflammation is a good thing—it’s part of the body’s healing response. Try to avoid NSAIDs (like ibuprofen) for 24–48 hours. If you need something for pain, Tylenol is a better option.

5. Stay in Touch with Your Therapist

   Keep Ben informed about how you responded to treatment during your next visit—your feedback helps him adjust future sessions to better meet your body’s needs. You’re also welcome to reach out anytime via text or email with questions or concerns.

Contraindications to Dry Needling?

Dry needling is a powerful treatment technique, but certain situations require caution or complete avoidance. Below are the main contraindications divided into absolute and relative categories:

Absolute Contraindications

• Local infection at or near the needling site

• Compromised immune system (e.g., due to chemotherapy or immunosuppressants)

• Open wounds or skin lesions (e.g., severe eczema, psoriasis)

• Over major blood vessels or nerve bundles

• Lymphedema in the area (especially post-mastectomy) is a local contraindication 

• Lack of informed consent or strong needle phobia

Relative Contraindications

• Pregnancy (especially 1st trimester and near abdomen/lumbar/pelvic regions)

• Controlled bleeding disorders, depending on the treatment site

• Recent surgical procedures near the intended treatment area

• Severe vascular disease or circulatory impairment

Is Trigger Point Dry Needling a Good Adjunct to Stecco Fascial Manipulation®?

Yes, trigger point dry needling (TDN) can be a very effective adjunct to Stecco Fascial Manipulation® when used appropriately.

Here’s why they complement each other well:

1. Different Mechanisms, Synergistic Effects

   • Stecco Fascial Manipulation® targets fascial densifications that disrupt movement patterns and biomechanical force transmission.

   • Dry needling addresses neuromuscular trigger points—hyperirritable spots in muscle tissue that can cause referred pain and motor dysfunction.

   By combining both:

   • You address both fascial and muscular contributors to dysfunction.

   • It helps restore gliding in fascia and reduce neuromuscular tension, improving outcomes more quickly and comprehensively.

2. Broader Therapeutic Reach

   • Patients with chronic pain, overuse injuries, or post-surgical dysfunction may benefit from the broader diagnostic and treatment approach.

   • If one technique reaches a plateau in progress, the other often provides an added therapeutic push.

3. Clinical Application

   • Ben often begins the treatment with Stecco mapping and treatment to resolve fascial restrictions using non-invasive manual techniques.

   • In addition, he may then use TDN selectively on stubborn muscle trigger points that remain tense or painful even after fascial correction.

Frequently Asked Questions About AllConnected Physical Therapy

Where is AllConnected Physical Therapy located?

We are located at 1733 Park Street, Suite 200C, Naperville, IL 60563. Free parking is available on site.

How do I book an appointment?

You can call us directly at 847-732-2336 or visit our website to request an appointment. We recommend booking early, as availability is limited.

Ready to Schedule?

You can book your appointment directly online by visiting: https://allconnectedphysicaltherapy.janeapp.com/

Who will I be working with?

You’ll be working one-on-one with Ben Grotenhuis, PT, CMTPT, FAAOMPT, a licensed physical therapist with over 35 years of clinical experience and extensive advanced training. Ben is one of the few clinicians in Illinois certified in Levels I-IV of the Stecco Method® of Fascial Manipulation. He has been certified in trigger point dry needling through Myopain Seminars since 2011 and serves as an assistant instructor with the organization. Ben also holds a fellowship in orthopedic manual therapy (FAAOMPT)—the highest level of clinical training in the field.

What should I expect at my first visit?

Your first visit includes a 60-minute comprehensive evaluation of your movement, injury history, and fascial restrictions. You will also receive hands-on treatment during this session.

What types of treatment are offered?

Ben specializes in Stecco Fascial Manipulation®, Trigger Point Dry Needling, and individualized Manual Therapy aimed at treating the root cause of pain and dysfunction.

Ben will provide personalized instruction in both home and gym-based exercise programs to support your functional goals. While exercise is an important component of recovery, the primary focus of treatment will be hands-on, manual therapy.

Do you take insurance?

We are out-of-network with insurance providers but can provide a Superbill for you to submit for potential reimbursement if you have out-of-network benefits.

What Should I Wear to My Therapy Session?

Wear comfortable, flexible clothing that allows for easy movement and access to the skin for manual treatment. Athletic wear—such as shorts and a loose-fitting top—is ideal. Please avoid jeans or restrictive clothing. Also, refrain from applying lotions before your session, as they can make manual treatment more difficult.

What if I’ve already seen other providers?

Many patients come to see Ben after other therapies have fallen short. He focuses on a systems-based, whole-body approach to uncover the of your symptoms—not just the site of pain.

How Much Does an Appointment Cost?

The initial evaluation and treatment session (60 minutes) is $174.12 for new patients and $145 for returning patients seen within the past four years. Follow-up appointments are $145 for a full hour of one-on-one care.

Rates may be adjusted annually by approximately 5% to account for inflation.

Preferred payment methods include cash, checks, Zelle, debit cards, HSA, HRA, and FSA, all free of additional fees. Credit cards are accepted.

Will I Need to Fill Out Paperwork?

Yes. Before your first visit, you will have to complete an online intake form that covers your reason for seeking care, prior injuries, medical history, treatment history, and clinic policies. Please fill it out as thoroughly as possible—this information helps guide your individualized treatment plan.

What Can I Do To Keep My Fascia Healthy?

Healthy fascia is essential for pain-free movement, flexibility, and overall physical well- being. Here are some effective ways to keep your fascia in good condition:

1. Move Regularly

“Motion is Lotion. Muscle Contraction is Medicine.”

Regular movement is one of the most effective ways to nourish and stimulate your fascia. Daily dynamic activities—such as walking, gentle mobility exercises, yoga, Pilates, aerobics, or weight lifting—help keep your fascia hydrated, elastic, and free of adhesions.

Exercises that engage multiple planes of motion and promote fascial glide and elasticity are especially important for maintaining healthy, resilient tissue. The key is variety, consistency, and intentionality.

Prolonged sitting can lead to stiffness and discomfort. Aim to interrupt sedentary periods every 30 to 45 minutes with brief “exercise snacks”—such as standing squats, knee raises, stair climbing, or a brisk 2–3 minute walk—to keep your tissues active and responsive.

Movement is medicine for your fascia. Staying active with regular, varied movement helps preserve its structure, hydration, and function—supporting your overall health and mobility.

What Are “Exercise Snacks”?

Exercise snacks are short bursts of movement lasting just a few minutes. These mini-movements—like squats, jumping jacks, or brisk walking—don’t require a full workout session but can still provide meaningful benefits. They’re a simple, accessible way to reduce sedentary behavior and support your fascia and overall well-being, especially when time is limited.

2. Stay Hydrated

While there’s no direct research linking increased fluid intake to specific changes in fascia, hydration is essential for overall tissue health. Connective tissue is water-binding, and fascia depends on adequate hydration to stay supple, elastic, and resilient.

Dehydrated fascia can become sticky and stiff, reducing its ability to glide smoothly—contributing to discomfort and limited mobility. Drinking water throughout the day supports the body’s natural processes and promotes healthy connective tissue.

3. Eat to Support Your Fascia

A balanced diet—such as the Mediterranean diet—can help maintain strong, healthy connective tissue, including fascia. This way of eating is rich in:

• Omega-3 fatty acids from fish, flaxseeds, and walnuts

• Olive oil, nuts, and seeds for healthy fats

• Lean proteins such as fish, legumes, and poultry

• Antioxidant-rich fruits and vegetables

• Collagen-supporting nutrients, like vitamin C and amino acids

While collagen supplements are popular, current research does not show that they are directly absorbed by fascia tissue. However, providing your body with the right building blocks through nutrient-dense whole foods supports the repair and resilience of all connective tissues.

4. Prioritize Recovery

Fascial health isn’t just about movement—rest and recovery are just as important. Adequate sleep, proper nutrition, and strategies to reduce stress all play a role in tissue repair and inflammation control. Without proper recovery, fascia can become more prone to tension, tightness, and dysfunction.

5. Address Pain or Dysfunction Early

If you’re dealing with chronic pain, stiffness, or recurring injuries, fascial dysfunction may be a contributing factor. Ben can assess your movement patterns, identify fascial restrictions, and provide targeted treatment—including Stecco Fascial Manipulation®, Dry Needling, and prescribe specific therapeutic exercises—to restore mobility and prevent the issue from becoming more limiting.