Mathematical analysis of the flow of hyaluronic acid around fascia during manual therapy motions

Max Roman, Hans Chaudhry, Bruce Bukiet, Antonio Stecco, Thomas W. Findley

Research output: Contribution to journalArticlepeer-review

30 Scopus citations


Context: More research is needed to understand the flow characteristics of hyaluronic acid (HA) during motions used in osteopathic manipulative treatment and other manual therapies. Objective: To apply a 3-dimensional mathematical model to explore the relationship between the 3 manual therapy motions (constant sliding, perpendicular vibration, and tangential oscillation) and the flow characteristics of HA below the fascial layer. Methods: The Squeeze Film Lubrication theory of fluid mechanics for flow between 2 plates was used, as well as the Navier-Stokes equations. Results: The fluid pressure of HA increased substantially as fascia was deformed during manual therapies. There was a higher rate of pressure during tangential oscillation and perpendicular vibration than during constant sliding. This variation of pressure caused HA to flow near the edges of the fascial area under manipulation, and this flow resulted in greater lubrication. The pressure generated in the fluid between the muscle and the fascia during osteopathic manipulative treatment causes the fluid gap to increase. Consequently, the thickness between 2 fascial layers increases as well. Thus, the presence of a thicker fluid gap can improve the sliding system and permit the muscles to work more efficiently. Conclusion: The mathematical model employed by the authors suggests that inclusion of perpendicular vibration and tangential oscillation may increase the action of the treatment in the extracellular matrix, providing additional benefits in manual therapies that currently use only constant sliding motions.

Original languageEnglish (US)
Pages (from-to)600-610
Number of pages11
JournalJournal of the American Osteopathic Association
Issue number8
StatePublished - Aug 2013

All Science Journal Classification (ASJC) codes

  • Complementary and alternative medicine


Dive into the research topics of 'Mathematical analysis of the flow of hyaluronic acid around fascia during manual therapy motions'. Together they form a unique fingerprint.

Cite this