Diacutaneous fibrolysis: what it is, uses and benefits

In diacutaneous fibrolysis, hooks are used to put pressure on the skin. And although at first glance it seems somewhat drastic, it is a safe procedure.

Last update: November 10, 2021

Diacutaneous fibrolysis is a technique, typical of physiotherapy, that applied to help release tension in the fasciae and in the different muscle layers. This practice, which emerged in Sweden in the 1950s, is currently widely used.

In addition to improving mobility and muscle tone, circulation and reflex function are favored. In particular, a hook-like instrument is used in diacutaneous fibrolysis. Although it is not to worry, since it does not penetrate the skin. Keep reading and we will explain how it works.

What is diacutaneous fibrolysis?

In the body there are different types of tissues: skin, muscles, tendons, nerves, joints, bones. These are related to each other thanks to the fibrous envelopes of another tissue called conjunctive. It has several functions, such as structural support, a medium for the exchange of nutrients, oxygen and waste.

At the same time, the connective tissue facilitates the gliding between the components of the musculoskeletal system. In particular, this is possible due to the fact that the internal structures of the body (muscles, organs) are covered by membranes known as fascias, which reduce friction.

For different reasons, the connective tissue can harden or thicken, forming what is known as fibrosis. In the case of muscles, when the mentioned membranes are affected, what is known as Compartment syndrome.

In this and in other cases, the diacutaneous fibrolysis technique can be applied. It is also called myofascial instrumental fibrolysis or hook technique.

According to its etymology, it has to do with fibrosis (abnormal growth of tissues), -lysis (release), day- (through) and -cutaneous (related to the skin). And while the term is a bit conceptually overloaded, the technique itself is not too complex.

Its purpose is to help break fibrosis and adhesions. Therefore, it contributes to the treatment of various pathologies, injuries, inflammatory or degenerative processes, whether muscular or joint, as well as neuralgic and even trophic.

How is it the procedure?

As in the various forms of manual therapy, the person should lie down on a flat, comfortable surface, preferably on a stretcher. If it is on your back or face down and with or without clothing, it will depend on the area to be treated.

In turn, three phases or moments can be distinguished during the diacutaneous fibrolysis application procedure. Let’s see what they are.

Some muscle pain comes from an irritation of the fasciae that prevents the proper sliding of the structures.

1. Digital or manual palpation

The anatomical area to be treated is evaluated and delimited, according to what the patient has expressed in terms of pain and discomfort. This is done by the physiotherapist with his free hand, that is, the one in which he does not have the hook.

2. Instrumental palpation

Once the restricted area has been delimited, instrumental palpation is the one that allows the hook to be positioned correctly, accurately identifying and locating fibrosis. These two previous steps will not only increase the effectiveness of the technique, but will also reduce the risks of inappropriate application.

3. Fibrolysis

Diacutaneous fibrolysis itself occurs when tools (hooks) are used to penetrate places where hands could not reach. Between the muscle fascicles, as well as the areas of attachment of ligaments and tendons.

In this way, the aim is to break the adhesions and fibrous corpuscles. It is considered that the destruction of these fibroses could help to release the tissues, restoring the mobility of the muscle groups and reducing pain and inflammation.

As a general rule, the process is done from distal to proximal. This means that work begins at a certain distance from the affected region to reduce tension and improve mobility. Then, as the treatment progresses, the hook is brought closer to the epicenter of the lesion.

Techniques and Instruments

Within diacutaneous fibrolysis there are several techniques, in relation to the application of the hooks, to achieve the desired effects. In this regard, the following are mentioned:

  • Hooked: it is done with the concave part of the curvature, placing the hook perpendicular to the muscle.
  • Fascial stretch: This technique is performed with the convex part of the hook curvature, placing it upside down. In this way, a stretching and relaxation effect of the fascia is sought.
  • Scratching: it is done with the tip of a small hook. The goal, as the word itself says, is to scratch in various directions to increase circulation when there is inflammation.

Hooks for diacutaneous fibrolysis

Initially, it was tested with different materials: wood, bone, plastic. Currently, the hooks are made of stainless steel.

But since there are muscles more voluminous than others, each hook has a slightly different size and curvature, which allows to work dissimilar anatomical reliefs. However, in all hooks the design is similar: a convex outer surface, a flat inner surface, a beveled angle, a rounded edge, and it ends in a spatula shape.

On the other hand, the general configuration of the tool allows access to the intermuscular septa, selectively stimulating the connective fibers, corpuscles and adhesions.

Effects and benefits of diacutaneous fibrolysis

The effects sought with diacutaneous fibrolysis point in three ways:

  • Mechanics: related to the mobility of the affected area.
  • Circulatory: with diacutaneous fibrolysis, circulation is stimulated, both blood and lymphatic system.
  • Reflex action: inhibits reflex points.

In addition to the aforementioned effects, diacutaneous fibrolysis also produces derived benefits. These include the following:

  • It favors the release of histamine.
  • Helps to eliminate lactic acid.
  • Regulates muscle tone.
  • Promotes elasticity.
  • It positively impacts the range of the joints. For example, in the ankle, according to the studies carried out.

For whom is diacutaneous fibrolysis recommended?

Diacutaneous fibrolysis is a technique widely used in physiotherapy. Hooks can be used for almost any muscle or tendon structure, and even joint.

Its use includes adhesions due to trauma, postsurgical scar fibrosis, muscle fibrosis, contractures, tendon injuries, pubalgia, plantar fasciitis, entrapment of peripheral nerve trunks, occipital or Arnold’s neuralgia.

It is also frequently used in compartment syndromes, epicondylitis and epicondylalgia, scapulohumeral periarthritis, torticollis, carpal tunnel syndrome, tenosynovitis of the foot, and rotator cuff tendinopathies.

To treat carpal tunnel syndrome, this technique might be a suitable option.


Despite this wide range of possibilities for diacutaneous fibrolysis, it should not be thought of as a therapy for any type of condition. In particular, it is not recommended in the following cases:

  • Fractures
  • Osteoporosis.
  • Venous thrombosis.
  • Varicose veins.
  • Skin with burns or open wounds,
  • People who take anticoagulants.

Finally, there is no evidence that diacutaneous fibrolysis is effective in treating inflammatory conditions like arthritis. Therefore, in the case of this disease, it is preferable to continue with the traditional approach.

Hooks are not for playing

When you look at the hooks used for diacutaneous fibrolysis, they appear to be shiny kitchen tools. However, they are not for playing.

And if well diacutaneous fibrolysis is a low-risk procedure In most cases, it will be safer as we put ourselves in the hands of real physiotherapists.

So, before going to any appointment, you must request information about the health professional who is going to treat us. It is recommended that he not only know about physiotherapy, but that he has been trained in the management of the technique.

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