Archive for August, 2014

Fascia, fascia, fascia

August 17, 2014


As we read more research articles and bury our heads in fascia specific books, our fascination for all of its implications for whole body health just keeps expanding. You have to understand that all of this information is adapted from human medicine at this point. There are however some amazing equine anatomists whether in Australia or Europe doing equine fascia dissection and we are anxiously waiting for the published studies.

Traditionally, fascia has, for centuries, been essentially relegated to be just the “white packing stuff” around the muscles. However, over the past few years, the huge paradigm shift in how we look at fascia and what it means for movement and health, helps us better understand how dysfunction takes place. Currently, fascia is being recognized as the “Cinderella” tissue of medical research. The latest studies have yielded astounding insights regarding the importance of this body wide tensional network. Especially important are the implications for musculoskeletal medicine.

Fascia As A Sensory Organ

Let’s review some of the intrinsic properties of fascia. Based on these new developments, it is now recognized that fascial network is one of our richest sensory organs. “The surface area of this network is endowed with millions of endomysial sacs and other membranous pockets with a total surface area that, by far, surpasses that of the skin or any other body tissues. Interestingly, compared with muscular tissue’s innervation with muscle spindles, the fascial element of it, is innervated by approximately six times as many sensory nerves than its red muscular counterpart” (Robert Schleip, 2013)

Stecco et al, in their 2008 research, had already recognized that the superficial layers of the body are in fact, more densely populated with mechanoreceptors than tissues situated more internally.


Fascia is Arguably The Most Energy Efficient

Material In The Body

This form of connective tissue possesses an incredible intrinsic “rubber band like action.” Using the example of biceps muscle contraction, the Triceps muscle group fascia is also stretched. After the contraction, the Triceps fascia will literally and instantaneously, spring back to its previous position. Kram and Dawson, 1998 described the “catapult mechanism” and observed that the tendons and fascia of the legs, for instance are tensioned like rubber bands.

The Amazing Adaptability Of Fascia

Fascia, for better or worse, possesses the ability to contract independently of the muscles it surrounds. It responds to stress without any conscious command from our brain. In the case of injury, it is a big deal, because of lack of activity or inappropriate postural positioning, it will thicken the once-supple fibers. Chronic stress will fuse the connective tissues together in an attempt to protect the underlying muscle. Poor posture, lack of flexibility and repetitive movements will pull the fascia into unconsciously ingrained patterns, in order to stabilize the body.

Fascial adaptability is readily demonstrated. If you palpate the legs of an able-bodied person, it will be observed that, from our normal everyday walking, the fascia on the lateral (outside) of the thigh has developed a palpable firmness. However, when assessing the legs of a wheel chair patient, there is no palpable difference in development, or firmness between the inner and outer sides of the thighs. On the other hand, if you evaluate a professional horse rider’s legs, you would immediately note, that the fascia on the inner side of the legs is more developed and stronger. El-Labban et al., actually conducted an in-depth study on that subject in 1993. Many riders are very aware of this and could have told them so!

Excessive repetitive actions, chronic stress or trauma will increase the density of the fascia and drastically impair movement, circulation and lymphatic flow. It will often result in accumulation of dense fascia, and/or scar tissue. This is usually followed by an area or areas of chronic pain. It certainly makes you understand the power of adaptability. We all need to realize how much fascia is dramatically impacting our movements – for better or for worse. But this is not all bad news! Due to the intrinsic and versatile nature of fascia, and its remodeling capacities, it allows that even major damage is reversible.

Fascial Rehabilitation

There are multiple modalities available to rehabilitate fascia. These range from “Rolfing,” to milder forms of manipulative “Myofascial Release,” “Trigger Point Therapy”, to the use of Acupuncture or Acupressure. The latter two has led us to our goal of developing a specific myofascial system of acupuncture.

Fascia And The Mechanism Of Acupuncture

Langevin and Yandow, in their 2002 research project, hypothesized that a “Qi blockage” can be viewed as an alteration in the composition of fascia. Needling or acupressure may bring about cellular change in the fascia. The Vermont researchers have also shown that connective tissue is a sophisticated communication system. We are just scratching the surface of its potential.

“Loose connective tissue forms a network extending throughout the body, including subcutaneous and interstitial connective tissues. The existence of a cellular network of fibroblasts within loose connective tissue may have considerable significance, as it may support yet unknown body-wide cellular signaling systems. Our findings indicate that soft tissue fibroblasts form an extensively interconnected cellular network, suggesting they may have important, and so far unsuspected integrative functions at the level of the whole body.” (Langevin et. al. 2004)

Thus, the hypothesis that the acupuncture meridian system corresponds to a significant degree to connective tissue planes (Langevin and Yandow 2002) has merit. Acupuncture needle stimulation sends a mechanical signal through this tissue network (Langevin et al. 2001, 2002). Connective tissue consists both of a delicate web with fine branches penetrating all tissues, and major “trunks” forming connective tissue planes that link all parts of the body with each other.  Documented efficacy of acupuncture relies, at least, to a major extent, on interaction with fascia. Dr. Langevin demonstrated this effect on certain acupuncture points via her special ultrasound elastography techniques.

Tom Myers, a noted myofascial therapist, also feels that there is considerable evidence for a link between meridians and fascial pathways or “chains.” In his book “Anatomy Trains,” he juxtaposed the “Superficial Fascial Back Line” with the Bladder Meridian or Channel. It seems like the other six “anatomy trains” described by Myers, show interesting correlations with other meridians; for instance, the “Superficial Front Line” with the “Stomach Meridian/Channel” and the “Lateral Fascial Line” with the ‘Gallbladder Meridian/Channel.”

More studies, with greater number of subjects, and working on different areas of the body, certainly need to be done, before we can “prove” the anatomical correspondence of acupuncture channels with the fascial planes.

However, the provocative evidence in Dr Langevin’s study, contains the promise of discovering not only more about human physiology and health, but also the possibility of understanding the scientific mechanisms of acupuncture and being able to explain it biomedical terms.