This document describes the aponeurotic hooking technique using Soft Hooks to relieve fascial restrictions. Soft Hooks are stainless steel tools that allow therapists to more precisely separate fascial planes and remove adhesions. The technique involves the therapist using palpation to guide the placement of the Soft Hook, which is then used to gently separate tissues along fascial planes. This relieves muscular contractures and restrictions. The document provides anatomical details and examples of areas to apply the technique on the thigh to treat issues like patellar hyperpressure, pubalgia, and muscular strains.
1. Aponeurotic hooking technique: The Soft Hooks®
INTRODUCTION
1. Why hooking?
The connective fibrous tissue represents up to 60% of the bodily
mass.
Of different structures, it mainly features a unique fascia1.
This fascial web must remain absolutely free.
Stress at any single point involves the participation of the entire fascia.
Either in case of a muscular contracture, tissue adhesions or fibrous
corpuscles, the release by means of a simple mechanical effect will
bring relief.
Soft hooks allow to painlessly remove those biomechanical troubles
and to re-establish the natural configuration.
2. With what tools?
1
Léopold Busquet, Les chaînes musculaires tome 1,2000.
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2. Aponeurotic hooking technique: The Soft Hooks®
The fingertip approach of underlying skin and tissue structures is
limited by the thickness of the finger.
A simple and precise tool can put that right.
The soft hook: the real lengthening of the finger.
The soft hook is made of a stainless steel wire of a chosen diameter
which ensures the sharpness at tissue level.
First and foremost it is painless.
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3. Aponeurotic hooking technique: The Soft Hooks®
3. How?
A few precisions:
1. The hook does not replace the therapist’s hand but will be its
perfect auxiliary.
2. Any action starts distant from pain and then gets closer to it.
3. The palpating anatomy constantly guides the therapist.
The ideal way to hold the tool is summed up in three points:
- lay the tool in the commissure between thumb and forefinger
-fold the forefinger on the handle
- put the thumb in the opposite side
Simple exercise: go over an uneven surface to feel the vibration2.
2
The flexion of the inox wire is limited by the resistance if the welding and by the handle
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4. Aponeurotic hooking technique: The Soft Hooks®
Look at the picture showing the best way to hold the tool as well as
the typical manoeuvre
Standard movement:
1. The free hand palpates and judges the tissue wave which
defines the curve of the hook to be used.
2. The forefinger will identify the place to hook.
3. The soft hook comes closer to that forefinger and receives
the tissue wave for the patient’s maximum comfort.
Palpating hand and soft hook both make some exploratory motions
over the painful spot.
A brisk pulling of the soft hook will free (the tendon) from
adhesions or separate the fibrositis
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5. Aponeurotic hooking technique: The Soft Hooks®
4. When?
To free the adhesions resulting from shock during a sports practice or
from surgery or to remove inflammatory or neuralgic pains in the
locomotive system.
The obvious relaxation of the muscles due to the transverse
mobilisation of the fibres and the effect of the inhibition of reflex
points already represent a non-negligible treatment.
The main counter-indications are clearly related to the skin and
circulatory condition of the patient.
An excitable patient seems very sensitive to hooking.
Suggested indications for hooking (non restrictive):
Epicondylitis, medial epicondylitis, Achilles tendinitis, pubalgia,
periostitis, muscle contracture, strain, tenosynovitis, keloids,
Dupuytren postoperative, carpal tunnel, ulnar canal syndrome,
occipitalgy, sciatica, lumbago, torticollis, PSH, ganglion cysts,
algodystrophy
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6. Aponeurotic hooking technique: The Soft Hooks®
5. Origin of the method
This technique was developed by Kurt EKMAN, a Swede
kinesiotherapist contributor of CIRIAX in London.
He revealed the deficiencies and limits of palpation and manual
treatment of soft tissues.
The adhesions and small deposits are difficult to palpate on the deep
myo-aponevrotic levels.
He had the idea of creating tools which offered a better access to the
pathogenic structures.
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8. Aponeurotic hooking technique: The Soft Hooks®
A – INFERIOR LIMB
1.- TIGH
ANATOMIC REMINDER
The tigh consists of three areas
• Anterior region
• Posterior region
• Lateral region
Each area is joined by muscle groups with similar actions and is
crossed by a vascular-nervous pedicle.
The whole member is covered by skin, a superficial and a deep fascia.
It surrounds the muscles forming the intramuscular septa.
Anterior region of the tigh
• Quadriceps femoris muscle
• Sartorius muscle
Femoris vessels
• Artery
• Vein
• Nerve
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9. Aponeurotic hooking technique: The Soft Hooks®
Medial region of the tigh
(from inside to outside)
• Sartorius muscle
• Iliopsoas
• Pectineus muscle
• Adductor longus muscle
• Gracilis muscle
Deeper
• Adductor brevis muscle (between ALM and GM)
Buttocks area
• Gluteus maximus
• Gluteus medius
• Gluteus minimus
• Tensor fasciæ latæ
Deeper
• Piriformis muscle
• Sacrospinous ligament
Posterior region of the tigh
Long rear muscles
• Semimembranosus muscle
• Semitendinosus muscle
• Biceps femoris muscle
Nerves
• Sciatic nerve
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10. Aponeurotic hooking technique: The Soft Hooks®
• Posterior cutaneous nerve
Popliteal fossa (Knee pit)
Boundaries
Inside
• Semimembranosus muscle
• Semitendinosus muscle
Outside
• Biceps femoris muscle
Inferior (with the plantaris muscle)
• Medial and lateral heads of the gastrocnemius muscle
Contents
• Popliteal vein and artery
• Tibial nerve
Floor
• Popliteal muscle
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11. Aponeurotic hooking technique: The Soft Hooks®
HOOKING
Separation of the anterior gracilis muscle
Internal: the Sartorius muscle
External: to the fasciæ latæ
Separation of the Sartorius muscle
Vastus medialis muscle (teardrop muscle)
Area of concentration
Sartorius muscle – vastus medialis muscle – anterior gracilis
muscle
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12. Aponeurotic hooking technique: The Soft Hooks®
Edge of the vastus lateralis muscle in contact with the anterior gracilis
muscle
Reminder
The vastus lateralis (side and rear) is covered by the FLT
Separation of the vastus lateralis
from the short head of the biceps femoris muscle down the tigh
Separation if the vastus lateralis
from the long head of the biceps femoris muscle to the upper area
of the tigh
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13. Aponeurotic hooking technique: The Soft Hooks®
Key point
Vastus lateralis – biceps femoris – gluteus maximus
Gluteus maximus, linked up with
• long head of the biceps femoris muscle
• semitendinous muscle
Afterwards, separation of semitendinous / semimembranous muscles
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14. Aponeurotic hooking technique: The Soft Hooks®
Separation of the gracilis muscle with
• Semimembranous muscle (popliteal area)
• Sartorius muscle (just ahead it)
Separation of the adductor magnus muscle (posterior side)
• semitendinous, semimembranous
• gracilis muscle (just ahead it)
Key point
Adductor longus – semimembranous – gracilis muscle
Adductor longus
• gracilis muscle
• adductor brevis
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15. Aponeurotic hooking technique: The Soft Hooks®
PATHOLOGIES
STRUCTURES TO BE TREATED
Patellar hyperpressure
• Buttocks
• Tensor
• Adductor
• Patte d’Oie
Pubalgia
• Adductor longus
• Adductor magnus
• Gracilis
• Gluteus maximus
• Abdominal muscles (periosteum)
• Hamstring
• Piriformis
• Psoas
• Quadratus lumborum muscle
Muscular strain
Hooking the periphery of the injure relaxes the contracture
emphasizing this way the drainage with this defibrosing effect.
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16. Aponeurotic hooking technique: The Soft Hooks®
PATHOLOGIES
STRUCTURES TO BE TREATED
Patellar hyperpressure
• Buttocks
• Tensor
• Adductor
• Patte d’Oie
Pubalgia
• Adductor longus
• Adductor magnus
• Gracilis
• Gluteus maximus
• Abdominal muscles (periosteum)
• Hamstring
• Piriformis
• Psoas
• Quadratus lumborum muscle
Muscular strain
Hooking the periphery of the injure relaxes the contracture
emphasizing this way the drainage with this defibrosing effect.
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