Hybrid Fascial Manipulation®/Stecco®, Level 4 b (FM4)

Course Summary

In the Hybrid Fascial Manipulation®/Stecco®, Level 4 b (FM4) course, participants expand on their understanding of the biomechanical fascial model to treat patients with complex dysfunctions more efficiently. Fascial Manipulation Level 4 (FM4) course brings together the final piece of the fascial puzzle. The course is focused on the superficial fascia (external) and paravertebral and prevertebral ganglia (internal) systemic dysfunctions.

The Fascial Manipulation®/Stecco® Courses are aimed at healthcare professionals who have already completed Hybrid Fascial Manipulation®/Stecco®, Level 3 b (FM3). The course includes practical exercises and in-depth analysis of clinical cases demonstrated by the instructors.

Hybrid Fascial Manipulation®/Stecco®, Level 4 b (FM4) helps to treat the patient in a global way focusing on the superficial fascia and its connected systems.

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Hybrid Fascial Manipulation®/Stecco®, Level 4 b (FM4) Course Prerequisites:

As part of the learning process, Level 4 students will be required to present:

  • Certification in Fascial Manipulation®/Stecco®, Level 3 (FM3).
  • Assessment Charts of cases treated after their Level 1, Level 2 and Level 3 certification for discussion.

How the course is presented

The course is presented in a Hybrid format that has an online learning portion that is to be completed prior to coming to the in-person workshop. A detailed description of individual sections is provided below.

The Hybrid Course Format

The Hybrid Format is divided into two parts called FM-4a and FM-4b. The first part (FM-4a) is an online lecture with coursework and exams that is taken at least 6 weeks before taking the second part. The second part is an in-person workshop with lectures, demonstrations and lab practicals. You must attend all scheduled workshop days.

The Online Section
  • Must be completed prior to attendance to in-person lab section.
  • Exams must be completed and reviewed by instructors prior to attending the live in-person section.
  • Lectures are approximately 10 hours.
  • After purchase, course participants will get enrolled on the Stecco education Platform to review and complete the online portion.
The In-person Section
  • Participants must attend all workshop days.
  • Practical labs applying techniques learned.
  • Instructor review of case studies on previous treatments performed by the participant.

FM4 course description

Practitioners expand their current fascial understanding to the highest level. The course starts with learning the anatomical divisions of the superficial fascia known as quadrants. These divisions, both in horizontal and longitudinal directions, are due to thickenings of the retinacula cutis that are adhesive to the deep fascia. The area of a quadrant typically corresponds to the distribution of the cutaneous nerves and angiosomes. Within each quadrant, there are all the three superficial components of the systems: receptors, lymphatic vessels and adipose cells.

Lessons focus on inspecting the quadrants of the superficial fascia with new manual skills to find the alterations of dermatomas, adipotomas and angiosomas localized in the external systems. They will learn to assess the internal systems, researching the autonomic fibers that are sufferings for the thermoregulatory system; the fibrosis of the adipotomas for the metabolic system and the densifications of the peri-lymphonodal connective tissue for the immune system.

Practical exercises, clinical demonstrations and instructor led treatments are included along with current clinical theory and science.

Topics covered

Anatomy of the superficial fascia
Anatomy and physiology of the adipose tissue: the adipotomere
Anatomy and physiology of the lymphatic system: the lymphatomere
Fascia entrapment neuropathy
Discussion and evaluation of the superficial fascia quadrants.
Adipose Metabolic System (SAM) evaluation and treatment including the adipotomere
Lymphatic Immune System (SLI) evaluation and treatment including the lymphatomere
Evaluation and treatment of the dermatomere
Cutaneous and thermoregulatory systems (SCT) evaluation and treatment
Cutaneous and thermoregulatory systems and central nervous system interactions
The vegetative system: prevertebral and paravertebral ganglia
The immunitary system
The metabolic system
Treating the Psychogenic System
Discussion of the systems and interaction between them including pain pathology
Discussion, application and evaluation of using the assessment chart for advanced treatments
Discussion on patient treatments with demonstration of the manual techniques
Presentation and discussion of case studies
Review and discussion of student assessment charts from previous fascia manipulation treatments

At the completion of the course

Identify and differentiate the key anatomical structures of the superficial fascia — including the adipotomere, lymphatomere, and dermatomere — and explain their physiological roles within the body’s interconnected systems.
Evaluate and apply manual techniques for the assessment and treatment of the Adipose Metabolic System (SAM), the Lymphatic Immune System (SLI), and the cutaneous and thermoregulatory systems (SCT) in a clinical setting.
Analyze the interactions between the superficial fascia systems — including the vegetative, immunitary, metabolic, and psychogenic systems — and their relationship to pain pathology in order to formulate comprehensive treatment strategies.
Accurately complete and interpret a structured assessment chart to guide advanced fascial manipulation treatments, incorporating clinical findings from multiple superficial fascia quadrants.
Critically discuss and evaluate real patient case studies and peer assessment charts, demonstrating clinical reasoning in the selection and application of appropriate fascia manipulation techniques.

What does a course day look like?

Each day will begin at 8:30 am and finishes around 6:00 pm.

At the conclusion of the complete course there will be an examination to appraise the level of understanding and skill level of the practitioner.

Hybrid Fascial Manipulation®/Stecco®, Level 4 b (FM4)

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  • Learn Fascial Manipulation Level Four (FM-4) in Phoenix, AZ on Jan 29th, 2027

    Stretch 2 Win 580 N. 54th St. Suite 1, Chandler, AZ, United States

    In Phoenix, AZ on January 29-31, 2027; Learn Fascial Manipulation Level 4®. This course continues your education in Fascial Manipulation® Method. The Fascial Manipulation® curriculum takes a unique approach by looking at the body as a whole, not just “where it hurts” or where the problems appear to be. Fascial Manipulation® Level 4 helps healthcare professionals to treat the patient in a global way by expanding on their understanding of the biomechanical model to treat patients with multi-segmental dysfunctions more efficiently. This course allow the practitioner to treat musculoskeletal and internal problem simultaneously in complex patients who has visceral-somatic or somato-visceral compensations.

    Get Tickets $1,300.00

About Stecco

Fascial Manipulation® is a manual therapy that has been developed by Luigi Stecco PT, in collaboration with his children Carla Stecco and Antonio Stecco (both MDs, PhDs), over the last 40 years. 

About Structure & Function Education

Structure & Function Education (SFE) provides world class education services to healthcare and sport performance professionals, so they in turn can elevate the lives of their patients. To do this, we empower our team members to combine the latest research and their clinical expertise to help create best practices in healthcare and sport performance. Structure & Function Education was founded with a rebellious spirit and lofty objective: to change the way medicine and sport performance interacts with each other throughout the world, for the betterment of our patients and clients.

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