What is fascia?
- Biological fabric of the body
- All tissues and structures in the body are surrounded by and connected through connective tissue also known as fascia.
- Web system within the body that holds water and forms connective tissue
- Fascia is a three dimensional matrix which surrounds not only every individual cell in the body but also individual muscles, muscle groups, tendons, ligaments, bone, nerves, blood and lymphatic vessels and organs, it can also be found in large sheets or plates
- Communication network
-Where all the water is stored
Where is fascia found?
up to 87% of individual muscle can be fascia
•The fascia extends continuously throughout the body as one organ from the tips of the ears to the hooves of the horse or paws of the dog.
What does fascia do?
•It is the communication system of the body allowing for transportation of information and nutrients between individual cells and different systems within the body.
What is the function of fascia?
- As well as allowing communication through the body the fascia function includes supporting, separating and protecting the cells, which in turn allows for proper cell metabolism and correct function throughout the entire body.
- The fascia acts to reduce friction to minimize the reduction of muscular activities or external forces throughout the body allowing muscles, tendons and ligaments to glide over each other freely during movement of the body.
- Fascia is piezoelectric meaning it has the ability to conduct electricity (ion changes)
What are the three types of fascia?
- There are 3 types of fascia found in the body.
- Superficial – Found just under the skin
- Deep – Surrounding the muscles blood vessels and organs
- Dural – surrounds the brain and spinal cord, sometimes referred to as the craniosacral system
Why is fascia viscoelastic?
•Fascia is viscoelastic meaning it has the ability to change its shape in response to activity and giving it the ability to phase change – change between liquid to plastic, liquid to dense and liquid to dehydrated.
What are the components of fascia?
•Fascia has no blood or nerve supply but does have capillaries running through it and contains nerve endings
•Fascia is made up of 3 different components
•Elastin
•Collagen
•Extra Cellular Matrix ECM (sometimes referred to as ground substance)
- Contains nerve endings so if restricted or trapped, can cause pain
What is elastin?
- Provides the body with flexibility and resiliency
* Responsible for recoiling the soft tissue back to its original state.
What is collagen?
- Configured in a relaxed pattern
- Creates a three dimensional web throughout the body- not strongly bound with elastin
- Handles the multidirectional forces imposed upon fascia
- Consists of microtubules filled with a crystalline saline solution providing shape, support, strength and stability.
What is the extracellular matrix ECM?
- The elasto-collagenous web is embedded in and surrounded by the ECM
- Makes up the bulk of the connective tissue
- Responsible for transporting metabolic material
- It has gelatinous properties composed largely of proteoglycans, glycoproteins and is the medium of water, oxygen and ions
- The consistency is highly variable depending on the type of connective tissue from that of the blood which would be fluid to that associated with bone which would be dense and quite hard.
- The proteoglycans are the primary reservoir of water within the body
What do proteoglycans do in the ECM?
- Proteoglycans are very large macromolecules, consisting of a core protein to which many glycosaminoglycan (GAG) molecules are covalently attached.
- GAGs are long-chained polysaccharides made up of repeating disaccharide units.
- Many of the sugars in GAGs have sulphate and carboxyl groups, which makes them highly negatively charged. The high density of negative charges attracts water, ensuring the fascia has a high water content
- This hydrated fascia permits the rapid diffusion of water-soluble molecules but inhibits the movement of large molecules and bacteria.
- Therefore the proteoglycans play the key role in hydration of the ECM and subsequently the surrounding tissue
What causes injury to the fascia?
- Traumatic injury, a body wound or shock produced by sudden physical injury, as from violence or accident
- Other injuries from external physical causes, such as radiation injury, burn injury or frostbite
- Injury from disease
- Injury from infection
- Injury from toxin or as adverse effect of a pharmaceutical drug or ingested poison
- Metabolic injury such as glycogen storage diseases
- Injury due to autoimmunity
- Injury due to cancer
- Injury secondary to any other disease
- Generic diseases
What can injury to the fascia cause?
- Injury causes effects at a cellular level causing an effect on the ion levels and water content within cells
- These changes will in turn have a major effect on the ECM of fascia and its role in the metabolic communication from cell to cell, within a system and sometimes throughout the entire body.
- One of the body’s responses to cell injury is to use the proteoglycans in the ECM for repair of the damaged cells.
- Without these proteoglycans dehydration of the ECM occurs.
What happens if the fascia becomes dehydrated?
- ECM dehydration will cause dehydration throughout the fascia resulting in an abundance of elastin and collagen and the fascia becomes dense and fibrotic, the crystalline saline in the collagen becomes solidified and the entire fascia’s effectiveness is impaired.
- The fascia is no longer able to function efficiently in all its roles as previously stated to protect and support the cells, allow smooth movement of soft tissues, and to provide a medium for metabolic communication within the body.
- If the fascia becomes impaired it can effectively clamp down or become stuck which will have a major effect on the function of the musculoskeletal system
- The facia binds together at the junctions where the elastin and collagen meet forming bonds called crosslinks.
- Fascia has the ability to tighten with up to 2,000 pound per square inch of force, although most cases are not this sever.
- A restriction of that magnitude will have a considerable effect on the body causing a major restriction in movement and function.
How do scars form on the fascia?
- Fibroblasts are a key cell used in repair and tissue regeneration, these will begin laying down new tissue at the injury site, this forms scar tissue.
- Scar tissue is more fibrous than the original tissue and overdevelopment of scar tissue can cause more problems in the long term.
- If the ECM becomes dehydrated the metabolic communication to the fibroblasts can potentially be lost; fibroblasts may not receive the correct metabolic signal to cease creating new tissue.
- Scar tissue could be laid down in abundance; causing further restrictions in the tissue.
when repairing, collagen and protein is recruited
What are the restrictions of fascia?
- Focal restriction = One area of restriction
- Global restriction = involves multiple systems
- Sematic = restriction affect the whole body and compensations can be seen throughout the body
What is focal restriction?
- Usually occurs just after the acute phase of an injury
- Decreased levels of H2O and O2 can be seen in the fascia
- Change in PH levels and the environment becomes more acidic
- Decreased metabolic communication
- Decreased elasticity
What is global restriction?
- 3D structure of fascia becomes tighter
- Irritation of nerves resulting in the onset of pain
- Functional defects
- Fascia pulls on bony structure which can cause misalignments
What is semantic restriction?
- Restrictions have set into the entire body
- Widespread fascia tightening and solidification
- Compensatory postural changes
- Decreased function
- Persistent pain
What indicates fascial restriction?
- Heat
- Oedema
- lesion
- Pain
- skin puckering and skin tightening
- holes in the fascia can also sometimes be seen on the skin
How can therapists intervene?
Myofascial release
Acupuncture
Acupressure
Mesotherapy
What is Anatomy trains/ Myofascial meridians?
- New concept from Thomas W Myers
- Linking anatomical structures by fascial connection
- Cause and effect of either training or injury can have an effect on all the anatomical structures within that chain
What is fascial mapping?
- In humans this is a very new concept
- Animal research usually follows on from human topics
- Very little research is currently available on fascia in animal generally and even less on fascial mapping of anatomy trains.
