Alternative to the FAST Technique

Danielle Steilen, MMS, PA-CDanielle Steilen, MMS, PA-C

There is a “new” technique spreading across orthopedic offices in the U.S. It is called the FAST Technique, short for fasciotomy and surgical tenotomy, aimed at tendon injuries such as plantar fasciitis, tennis elbow, and other tendon issues. It is minimally invasive in that an ultrasound is used to identify the area of pain and an instrument the size of a toothpick is inserted into the scar tissue to break up and remove this tissue. The claim is that removing the scar tissue removes the source of pain. Unfortunately that’s not the case in tendon injuries.

While it is being labeled as innovative, it sadly produces the same results as any tendon surgery: removal of scar tissue and other tissue that will ultimately weaken the tendon. Let’s break down the name of the technique: fasciotomy is cutting away at the fascia and tenotomy is transection or division of the tendon. In other words the surgeon cuts away at the tissue surrounding the tendon (fascia) and cuts the tendon. This cutting and dividing is just a bad idea. Dividing the tendon makes it smaller than it already is. Most tendons are just a few millimeters in diameter, so do you want your tendon to do from 10 mm to 5 mm?

Alternative to the FAST technique

Instead of taking away parts of the tendon, it is best to have the tendon repaired with Prolotherapy. Wouldn’t you rather have it grow from 10 mm to 12 mm because Prolotherapy made it stronger and thicker? Your tendon is obviously going to be stronger when it is 12mm, not 5mm as a result of the FAST technique.

As for the claim that the FAST technique removes the source of pain? What causes tendon pain? Most of the time it is joint instability. The tendon is under maximum tension and when the joint is unstable, the tendon works overtime to keep the bones aligned and stabilized. Stabilization should come from the ligaments, which need to be strengthened to relieve the tendon. So will The FAST Technique, fasciotomy and surgical tenotomy help with the joint instability? Of course not. The better approach is to strengthen the joint and tendon with Prolotherapy.

The FAST Technique is surgery. Prolotherapy is a regenerative injection therapy. Prolotherapy’s technique has not changed basically since the 1950′s. Why? Because it works.


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