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FASCIA.LITERATURE REVIEW

FASCIA.LITERATURE REVIEW
By Renata Trister DO

The topic of “fascia” has garnered much attention recently. Previously thought of as a kind of “body sock” wrapping your muscles and organs beneath the skin, it is actually a multi-dimensional and continuous structure that forms the internal framework of your soft tissue architecture. It is actually a system with an appearance similar to that of a spider’s web. Densely woven, fascia covers and penetrates every muscle, bone, nerve, artery and organ. It is not just a group of separate coverings. Fascia is a continuous structure from head to toe. This fact illustrates how every part of the body is connected – like that of the strands in a spider’s web. In fact, fascia is a communicative sensory and proprioceptive tissue.

Dr. Andrew Taylor Still (1828-1917) an American Physician, was the founder of osteopathic medicine. This was a time of uncertainty in medicine, questionable drugs and aggressive techniques were used, such as excessive bleeding and purging. Dr. A.T. Still sought an alternative to these methods. His philosophy of osteopathy was based upon the concepts of body structure and health maintenance rather than disease. He wrote the following comments about this tissue:

“ The soul of man, with all the streams of pure living water, seems to dwell in the fascia of his body”. “ The connecting substance must be free at all parts to receive and discharge all fluids, and then use them in sustaining animal life, and eject all impurities, that health may not be impaired by dead or poisonous fluids”.
“ By its action we live and by its failure we die”.

As the founder of the Osteopathic philosophy Dr. Still made several correlations between anatomy fascia and these were as follows:

That fascia envelops and extends from hand to toe, front to back surrounding every blood vessel, every nerve, every bone and every muscle.
That fascia changes its thickness as it travels from one portion of the body to another. All nerves terminate in this system.

This anatomical concept was ahead of its time and is only now gaining attention.

Fascia is a tensional fluid system. The integrity, mobility and resilience of our body therefore are largely determined by how well hydrated our fascia is. In fact, what we call “stretching a muscle” is actually the fibers of the connective tissue (collagen) gliding along one another on proteins called glycosaminoglycans (GAGs). GAGs, depending on their chemistry, can glue layers together when water is absent, or allow them to skate and slide on one another when hydrated. This is one of the reasons most injuries are fascial. If “dry” we are more brittle and are at much greater risk for erosion, a tear, or a rupture. Microscopic analysis of fascia shows that it is elastic tissue composed of collagen and elastin. These compounds are arranged in a micro tubular fashion that acting like a scaffold for vessels along with other substances such as he ground substance (Hyaluronon) and interstitial fluids. These microtubules transport fluid from one section to another. If fascial layers are traumatized, the healing response fibroses the normal structure thereby twisting and bending the collagen matrix. If this injury pattern can interrupt normal exchange of fluids, compartment syndrome develops. As this tissue is known to have major number of sensory and proprioceptive nerve endings, the pain stimulus of the accumulated fluids in the compartment syndrome is transmitted along the fascial planes. This phenomenon is known as the fascial drag. This has been the basis of myofascial trigger points and the treatment method of myofascial release.

This concept fulfills the osteopathic view that the “ human body is unity of functions”. Osteopathic treatments aim to minimize these fascial strains, restoring fluid continuity to the body.

Tensegrity is a “structural principle based on the use of isolated components in compression inside a net of continuous tension, in such a way that the compressed members (usually bars or struts) do not touch each other and the prestressed tensioned members (usually cables or tendons) delineate the system spatially”. (Gómez-Jáuregui, V (2010). Tensegrity Structures and their Application to Architecture. Servicio de Publicaciones Universidad de Cantabria, p.19.)

The fascia is also an important concept to the architecture of the human body by the tensegrity or the biotensegrity model.
Prof. Donald Ingber was quoted regarding how the cells might sense the microgravity:

Physical forces such as gravity, movement and hemodynamic stresses play a critical role in tissue development and remodeling.
Using tensegrity architecture, cell sense and transduce mechanical signals into chemical responses.
Cytoskeletal filament networks allow immediate cell response to external mechanical stresses- mechanically coupling cell surface receptors (Integrin) to nuclear matrix scaffold, mechanochemical and mechanoelectrical transducing molecules.
Changes in cytoskeletal tension also play a role in signal amplification and adaptation.

This tensegrity model demonstrates the structural and functional continuity between all of the body’s tissues. Fascia is the elastic, gluey component that surrounds, supports and separates, connects and divides, giving the body continuity. Therefore the tendency to think of a local dysfunction to be an isolated just to that region is not correct. Fascia forms a complex, interrelated, three dimentional and symbiotically functioning system that gives the body shape and functional ability.

Since fascia reorganizes itself along the lines of tension this continuous system can cause restrictions that are body wide.