Interview with Dennis Jacobs: From the Delbet fascia to the manipulation of the Fascia Cruris

He is involved in competitive sports, has his own practice and has been working as an osteopath and physiotherapist at the Hamburg Therapy Centre for over 10 years: Dennis Jacobs talks to us about the importance of the Delbet fascia, the manipulation of the Fascia Cruris and many other topics.

FIBO: Mr Jacobs, you are involved in competitive sports, you have your own practice and are still working at the Therapy Centre Hamburg. How do you reconcile all this?

Jacobs (laughs): I sometimes ask myself the same question. No, honestly, it's a healthy development. Every project requires space and time and often new networks, projects and fields of activity arise from it. Many athletes come to me in my practices. For special events I take weekends or working days off to look after the athletes in competition. Overall, however, all projects are coordinated and benefit from this network.

FIBO: How does your work in competitive sports differ from that in physiotherapy practice?

Jacobs: I hope only marginally, because I try to give everyone the best possible treatment. In competitive sports, there is often a clear deadline: The competition. Sometimes you have to weigh up whether you are taking an agreed risk at the expense of long-term health development. Nevertheless, who wants to miss a final because of ligament stretching? In such a situation, I advise a non-athlete a little more conservatively. However, an office worker benefits from my techniques just as much as an Olympic participant. It is pleasant to work in a working environment in which the daily interdisciplinary cooperation of doctors, physios and osteopaths, among others, is guaranteed. This means that almost everyone has the opportunity to be cared for at a competitive sports level.

FIBO: Your fascia lecture at Meetingpoint Health deals with the lamina of Delbet, a band-like mesh in the small pelvis. This topic is rarely found in lecture programmes. Yet it is precisely this fascia that is responsible for many symptom complexes and has a high clinical relevance. Is this new territory in physiotherapy?

Jacobs: The Delbet fascia is much older than I am and can be found in many detailed anatomy atlases. I have been a physiotherapist and osteopath for many years, so I think I have a very good overview of the glasses with which the respective profession looks at problems. When I became acquainted with the mechanisms of this structure during my osteopathic studies, many new options and thought patterns in clinical reasoning opened up for me as a therapist in general. From lumbar spinal pain, ISG blockages, pubic inflammation, leg length differences to pelvic floor complaints, cystitis, cycle or digestion problems, I personally would not want to miss this therapeutic arrow in the quiver and I am looking forward to giving the Delbet fascia a stage at FIBO, which I believe it deserves. I will talk about its nature, some mechanisms of action and approaches to treatment and I think I only have half an hour for that. (laughs) It will be a crisp lecture.

FIBO: In your second fascia lecture, you will explain the benefit of manipulating the Fascia Cruris in the treatment of ankle distortions. Is this a pure topic for competitive sports?

Jacobs: Clearly not. Here too, everyone from goldfish to grandmothers benefits from this technique, although it is of course used more frequently in competitive sports due to the increased occurrence of repetitive ankle distortions. As a former performance-oriented footballer, I can look back on my career and count more supination traumas than outer ligaments on my ankle joints. Had I had the knowledge of today then, I might have saved myself the one or other rupture. Fascial manipulations are based on the research of the Italian Stecco family and now have considerable scientific evidence. In the case of recurrent supination traumas, but also in the treatment of a fresh initial injury, the rehabilitative gold standard is often only focused on decongestion, immobilization up to complete scarring of the injured ligament structures with subsequent coordination and strength building for muscular stabilization. So far so good. However, I believe it is always therapeutically worthwhile to include the Fascia Cruris in the treatment.