Deformations experienced in the human skin, adipose tissue, and fascia in osteopathic manipulative medicine

J Am Osteopath Assoc. 2014 Oct;114(10):780-7. doi: 10.7556/jaoa.2014.152.


Context: Osteopathic manipulative medicine techniques involve compressive and tangential forces to target the fascia. These forces are transmitted to the skin and adipose tissue before the fascia is encountered. Knowing the extent of deformation of these 2 tissue layers relative to the fascia will assist osteopathic physicians in evaluating techniques for manual therapies and adjusting these therapies to reduce patient discomfort and improve results.

Objective: To determine the magnitude of the forces transmitted to the skin, adipose tissue, and fascia, and to determine the magnitude of deformation produced in the skin and adipose tissue relative to the fascia using a mathematical model.

Methods: The large deformation theory of elasticity, valid for 3-dimensional deformations, was used to evaluate the forces that need to be applied such that a specified deformation is produced in any region of the skin, adipose tissue, or fascia layers. Similarly, if the forces are specified, then the deformation produced can be determined.


Conclusion: The forces applied to the surface of the skin were transmitted through this layer and the adipose layer entirely to the fascia. Therefore, the skin and adipose tissue experienced the same magnitude of force as the fascia. However, the skin and adipose tissue experienced more compression and shear than the fascia.

MeSH terms

  • Adipose Tissue / physiology*
  • Biomechanical Phenomena
  • Elasticity
  • Fascia / physiology*
  • Humans
  • Manipulation, Osteopathic*
  • Models, Theoretical*
  • Skin Physiological Phenomena*
  • Stress, Mechanical*