Therapeutic approach
With training, we can regain some of the crimp structure. Since “form follows function, function follows form” is also valid in fascia, we can, with proper training, keep or regain the youthful structure of the fascia.
The collagen fibrils in a healthy body are replaced every 6 months. Therefore, an expected replacement of 30% of collagen fibrils every 6 months and 75% in 2 years is predicted [
12].
However, certain requirements must be met for adequate training. First, we have to ask our patients what they were capable of in the past—which movement patterns can we expect to be reactivated? By drawing the patient’s attention to past movement patterns, they can recall them in their internal model and use them accordingly.
The second question should be: “What are your recent restrictions?” An exact analysis of the musculoskeletal system will provide us with the status quo. The first aim is to increase joint play via manual therapy. Adequate techniques must be chosen with regard to age and frailty. Once this objective has been reached, a training therapy can be started. Nutritional considerations should also be included. Dehoust et al. describe this in their
3 Säulen Therapie (“Three-pillar therapy”) [
6].
A positive side effect is that every touch increases perception in the treated region. A useful and simple technique used in treatment of infants, nonspecific exteroceptive–proprioceptive stimulation, the so-called
Pritschen [
1], can be easily adapted to elderly people. As a result of improved perception, even the “old” brain can do its best to create a successful integration and complex movements.
This leads us to our last question: “What has improved after therapy and how can you continue this effect?” According to subjective demands, age-adapted objectives and exercise are necessary to motivate the patient to improve endurance, coordination, and strength.
All this will help to regain a smooth and elegant way of moving, just like a fetus and a newborn baby do with general movements. All this will help to improve balance and movement and may help to prevent falls.
We assume that continuing movement will keep our musculoskeletal system in good shape and function. “Use it or lose it!” should be kept in mind.