• What is Functional Anatomic Palpation Systems™?
• Why was Functional Anatomic Palpation Systems™ developed?
• Why are anatomy palpation skills so important to manual practitioners?
• History of F.A.P.™

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What is Functional Anatomic Palpation Systems™?

Functional Anatomic Palpation Systems™ (F.A.P.™) is an advanced, systematic approach to soft tissue palpation whereby the practitioner is able to delineate, feel, and therefore assess specific anatomic structures.

Through F.A.P.™ training, the individual can learn the skills necessary to specifically isolate structures involved in clinical conditions, which then translates into more specific treatment regimens.

Why was Functional Anatomic Palpation Systems™ developed?

The world of manual therapies continues to grow and progress. In accordance, a strong knowledge in functional and applied anatomy is in many ways the cornerstone of a practitioner's ability to both diagnose, and treat musculoskeletal conditions effectively. Although there have been developments in improving imaging methods, their high costs and limited access have proved problematic in determining a quick and timely diagnosis.

As well, many musculoskeletal conditions 'fly under their radar' so to speak as many microtissue injuries (sprains, strains, fascial adhesions, fibrosis and scar tissue, etc.) are not perceivable by imaging methods. Therefore the manual practitioner is often left with their hands, and knowledge of anatomical structure, to determine the cause of patient's symptoms.

While many educational institutions offer training in human anatomy, training is limited to textbook memorization and on occasion, cadaver dissection. Further, although many 'technique' seminars claim to be specific with their treatment and assessment procedures, few if any offer instruction to back these claims.

F.A.P.™ seminars were created to offer advanced instruction in palpation and assessment of actual soft tissue structure. Participants learn to efficiently, and specifically locate soft tissue structures which immediately enhances their diagnostic and treatment abilities.

Why are anatomy palpation skills so important to manual practitioners?

With recent advances in manual medicine, treatment options for practitioners are growing in number. Various new techniques have emerged both in the literature and in the everyday practice of chiropractors, physiotherapists, massage therapists, osteopaths, and athletic therapists. Each of these particular techniques including Active Release Techniques ART®, Trigenics®, Graston®), electro-acupuncture, Kinesiotaping©, myofascial release, muscle energy techniques, laser therapy, etc. offers a particular approach to dealing with specific tissue pathology, and/or mechanical dysfunction. For example, ART® acts to remove soft tissue fibrosis or scarring, whereas electroacupuncture is utilized for neuro-modulation and reduction of pain and inflammation.

As with other more established forms of therapy, such as spinal manipulation, mobilization, and stretching, even the best management techniques will fall short if the evaluation is not thorough enough to delineate the exact deficits. But are our methods of tissue evaluation and examination specific enough to correctly select the right technique to accomplish its intended purpose?

Most manual practitioners have limited access to diagnostic advances in imaging methods. In terms of orthopedic examination, most procedures are designed to determine the extent of 'macro' injuries to tissues (ruptures, fractures, tears, etc.); however, a large majority of conditions seen in a manual practitioner's office are 'micro' tissue injuries such as repetitive strain disorders or fascial adhesions which are often not detected with these tests. Even in situations where an orthopedic test elicits a patient's symptoms, little information is forthcoming to assist in the selection of appropriate treatment.

As an example, positive shoulder impingement signs do not delineate the exact structures that are causing the pain. These signs simply indicate that the location of the painful structure is the subacromial region, which can represent various diagnoses, including:

• Supraspinatus insertional tendonopathy
• Long head of biceps tendonopathy
• Long head of biceps tenosynovitis
• Subacromial bursitis
• Glenohumeral joint capsular tear or capsulitis
• Internal impingement (posterior-superior glenohumeral impingement)
• Subscapularis tendonopathy/ impingement

Many of the above possibilities differ in terms of histological causes (inflammation, collagen degeneration, angiogenesis, ligamentous tear, etc.) and symptomatology (pain, swelling, stiffness, etc). Most importantly perhaps, they also differ from a treatment perspective, in terms of structural location. Considering the many current treatment possiblilities in manual care, a diagnosis of subacromial impingement is insufficient for selecting from the most suitable modalities. Such a diagnosis lacks the specificity to determine exactly where the practitioner inserts the acupuncture needle and to what depth, or where a myofascial release technique is performed, or which joints need to be mobilized and in which direction.

Thus the manual practitioner is often left with just their hands and their knowledge of anatomical structure and soft tissue palpation to determine the cause of a patient's symptoms. Further, treatments of said problems are often solely guided by the same skill?? anatomy palpation.

Contrary to popular belief, anatomic palpation is a skill that is mastered through practice and proper instruction. Textbook knowledge of anatomy and anatomic structure is insufficient when dealing with live tissues and hence, soft tissue palpation courses are necessary in order to perfect this skill. Functional Anatomic Palpation Systems™ anatomy seminars offer the most advanced soft tissue palpation training for all manual disciplines.

History of F.A.P.™

Functional Anatomic Palpation Systems_TM was created and developed by Sports Specialist Chiropractor, Medical Acupuncturist, and Certified Personal Trainer Specialist Dr. Andreo A. Spina.

After graduation from McMaster University with a degree in Kinesiology, Dr. Spina attended and graduated with summa cum laude honors from the Canadian Memorial Chiropractic College, and later completed a two year post doctor fellowship in Sports Sciences.

During his studies, Dr. Spina received various academic awards including the 'John W.A. Duckworth Award' for the highest standing in Human Anatomy and Histology. With a strong background and interest in human anatomy, he became a tudor in the human anatomy lab at his educational institution. While teaching cadaver dissection, Dr. Spina soon realized that the methods used to teach manual practitioners human anatomy was flawed for several reasons.

While the curriculum strongly focused on textbook anatomy and memorization, it failed to translate that knowledge into palpatory skills needed for assessing and treating real patients. Dr. Spina then set out to discover if other manual discipline human anatomy courses (Physiotherapy, Massage Therapy, Athletic Therapy, Medical School, etc.) were also lacking in this regard and to his surprise, they absolutely were!

Dr. Spina also attended numerous seminars, lectures, and conferences on soft tissue assessment and manual treatment techniques. There he also noticed the lack of consistency surrounding anatomic palpation, both between seminars, as well as between various instructors teaching at the same seminar! Many system and techniques emphasized the importance of anatomic specificity, however none provided the necessary instruction on how to achieve it.

The ability to differentiate between anatomic structure using palpation needs to be learned, practiced and then practiced some more! It is not enough to memorize the colorful 'cartoonish' picture recreations of human anatomy found in textbooks, nor is it sufficient to assume that you know how to locate a tissue because you have memorized its insertion points.

Human anatomy is extremely variable from person to person, thus to specifically, and confidently differentiate between structures you must employ a sound system. Using a combination of textbook knowledge, knowledge gained from hundreds of hours in the anatomy lab teaching and dissecting human tissue, and from experience utilizing various treatment and assessment techniques, such a system was developed. Functional Anatomic Palpation Systems© Anatomy Seminars provide the skills necessary to rely on palpatory findings, specifically locate and diagnose soft tissue dysfunction, and enhance application specificity of any and all manual treatment techniques.