People suffering from subacute whiplash-associated disorders experienced a significant improvement in neck flexion following three sessions of a myofascial technique, according to recent research.

The study, “Effects of myofascial technique in patients with subacute whiplash associated disorders: a pilot study,” featured 18 subjects with a mean age of about 40 years. Seven were male, while the remaining 11 were female. All participants presented with whiplash-associated disorders resulting from a car accident.

“Whiplash associated disorders include a wide variety of clinical manifestations, such as neck pain, neck stiffness, arm pain and paresthesias, headache, dizziness, problems with memory and concentration, visual disturbances, and psychological distress,” state the study’s authors.

Those subjects included in the study were diagnosed with grade I or II whiplash injury, as defined by a set of criteria called the Quebec Task Force classification for whiplash-associated disorders. According to this classification system, grade I whiplash-associated disorders involve complaints of neck pain, stiffness or tenderness without physical signs, whereas grade II whiplash-associated disorders also include musculoskeletal signs, such as decreased range of motion and point tenderness.

Research participants were randomly assigned to receive either three 30-minute sessions of Fascial Manipulation© or 10 30-minute sessions of neck exercises and mobilization. The Fascial Manipulation© sessions took place every five days for two weeks. The neck exercise and mobilization sessions took place five days a week for two weeks.

“According to the Fascial Manipulation© model, musculoskeletal dysfunction is considered to occur when muscular fascia no longer slides, stretches or adapts correctly, resulting in local fibrosis at these specific points of tension,” state the study’s authors. “The manual technique of Fascial Manipulation© consists of creating localized heat by friction, using the elbow, knuckle or fingertips on the above-mentioned points.

“This would produce both stress effects (mechanical and chemical) on connective tissue,” the researchers report, “and cause a local rise in temperature at the ground substance of the deep fascia in order to restore its function.”

The primary outcome measure in this study was cervical active range of motion, including flexion, extension, right lateral-flexion, left lateral-flexion, right rotation and left rotation. Cervical active range of motion was assessed before the intervention period, immediately after the two-week intervention period and again two weeks later.

Results of the research revealed that immediately after the two-week intervention period, those subjects who received three sessions of the myofascial technique displayed greater improvement in neck flexion than those who performed 10 sessions of conventional rehabilitation.


Authors: A. Picelli, G. Ledro, A. Turrina, C. Stecco, V. Santilli and N. Smania.

Sources: University of Verona, Italy; University of Rome, Italy; Madrid School of Osteopathy, Italian Section, Verona, Italy; University of Padua, Italy; La Sapienza University, Rome, Italy; Neurological Rehabilitation Unit, Azienda Ospedaliera-Universitaria Integrata, Verona, Italy. Originally published in 2011 in the European Journal of Physical and Rehabilitation Medicine, 47(4), 561-568.