Triggerband Web Journal

Take a cross section of the upper arm, away from the joints, and what do you have? There is skin, fat, blood vessels, lymph vessels, nerves, muscle, bone, and fascia. If I missed anything, let me know. So an injury to the arm can cause damage to a limited number of structures.

We can see the skin, so we know when it is damaged. Treatment for physical trauma to the skin is also straightforward, involving sutures and grafting. Subcutaneous fat is a deep layer of skin, held in place by fascia. Fat acts as a cushion during injury, protecting nerves and blood vessels that run through it.

Blood vessel damage causes bruising, and typically does not require intervention unless major vessels are severed. This may come as a surprise, but muscles do not have a macro anatomical structure apart from fascia. Every skeletal muscle, bundle and individual fiber is surrounded by fascia. This is not my opinion. It is established – though frequently overlooked – anatomical science. Therefore, the only injury that can occur to muscle, independent of fascia, is at the cellular level.

This leaves bone fractures, nerve damage, and fascial distortions as the primary culprits in upper arm injuries. Fractures are easily diagnosed with x-rays, and more or less complicated to treat, depending on severity of the injury. Fractures do cause pain and loss of motion. However, pain and loss of motion frequently occur in injuries without fractures; and often persist after fractures heal. Logically, these symptoms must have other causes as well.

Nerve damage is a tricky condition to deal with. The nature of nerves, controlling sensory functions and movement, makes their destruction oftentimes difficult to detect and treat. Fortunately, nerves can repair and regrow without treatment. Signs of nerve damage include muscle weakness, pain or loss of sensation, tingling “down-stream” from the injury, and involuntary movements (twitching).

When an upper arm x-ray is negative, bruising and swelling are reduced, strength is present but motion is restricted, and the patient experiences pain when the arm is in certain positions, what do we have? I suggest, by default, that we have fascial distortions.

A Common Sense Approach

The fascial distortion model may seem radical when compared with current schools of thought, notably orthopedics, osteopathy, and chiropractic. However, its anatomical basis is not radical at all. Instead, it is logical common sense.

Lest you doubt the above analysis, the nail in the coffin is that the treatments designed to correct fascial distortions work. Dr. Typaldos demonstrated his confidence in the model and treatments when he gave seminars, by asking doctors to bring him their most difficult patients with musculoskeletal injuries and chronic pain. This risk was calculated, because he knew that the hardest patients would have already been treated for all other possible problems, leaving them with fascial distortions by default. Then he fixed patients on the spot in front of large audiences.

Some doctors who attended his lectures accused Dr. Typaldos of arrogance for these displays. But how else could he break through their faulty way of thinking about musculoskeletal injuries?

Orthopedic analysis illogically removes fascial distortions from the mix of potential contributors to pain and loss of motion, and expands the scope of the other possibilities to encompass 100 percent of all injuries. Orthopedists would be honest if they acknowledged they know the causes of about half of all injuries, while the other half leaves them stumped.

Alexander Typaldos, JD