The Magical Network that Connects our body systems

Physiotherapy, June 10, 2017

I want to unpack some concepts about fascia. This incredible network helps store energy and allows us to move more efficiently.

There is a connective tissue that envelops around the many layers of muscle, tendons, and even the bones are encased in the connective tissue (CT). All of this CT forms an extensive network, framework or as I like to imagine - "dynamic scaffolding". These layers of CT between, around, and inside the muscle are called fascia. Epimysium (fascia around the muscle), and the perimysium (inside the muscle). The two main functions of the fascia are separate and allow "gliding" between structures, and to connect and transfer force.

 

When I was at university in the mid 1990's I was taught that the fascia was like "gladwrap" and was simply a wrapping. I envisioned a flimsy material. It is described in the recent literature as a network that can resist and transfer forces. It is a very functional tissue with interconnecting throughout the ENTIRE BODY -  from the plantar fascia (thick connective tissue)  at the bottom of the foot, morphing into the achilles tendon,  growing up into the gastroc, linking up with the hamstring, connecting with the ischial tuberosity, blending into ligaments that travel upwards to the thoracolumbar fascia linking the glut max with the powerful latissimus dorsi, continuing up enveloping the spinal stabilisers at either side of the spine, up to the neck over the scalp to the top of the brow! Our knowledge is still evolving of this very intricate system. Recent research has highlighted it's role in both overall health and movement support. Fascia has been shown to contain sensory organs suggesting it could detect and transmit information back to the CNS about body position and movement (Chaitow et al. 2012). The presence of myofibrils (contractile elements) gives the fascia the ability to dampen or redirect forces of tension by muscular pull by dampening, or redirecting the stress along different facial trains (Paoletti, 2002).  Specific lines of fascia connect skeletal muscles creating continuous myofascial linkages throughout the body. Many of these have been described in Anatomy Trains (Myers, 2011), Myofascial slings (Lee, 2011), and Myofascial chains (Paoletti, 2002). These links are responsible for posture maintenance, and for smooth and efficient movement.

In Christopher McDougall's latest book "Natural Born Hero's" Chris talks about are true strength and functional potential is not about our muscle bulk but our "fascia" - the fibrous tissue that surrounds our muscle and bones. This full body network gives us elastic recoil.  This elastic potential is the secret to runners covering incredible distances with mind-boggling speed. Bruce Lee's famous one- inch punch (check it out on Youtube) is thought to be due to his ability to harness the power of his fascia.
Connective tissue and fascia are slow to adapt to load. Injuries incorporating the fascia have much longer time frames for recovery compared to muscle. Muscle is elastic while the fascia is more plastic and fibrous resulting in longer healing times.

 

Proposed Mechanism of Low Back Pain (LBP)

Inflammation of the lumbar fascia leads to pain related protected movement patterns. This loss of normalised movement creates CT fibrosis (thickening of the fascial sheaths so the sliding mechanism is inhibited), so basically tissues that should move are become adhered and stuck leading to deeper levels of movement impairment. A great study by Jarvinen et al. (2002) showed that immobilisation in bedridden hospital patients induces multi- directional collagen arrangement (so it's not ordered) and "crimp" reduction. Crimp is the connective tissues ability to stretch a little and return back to its original shape. Training and loading the tissues helps with overall function. Research has demonstrated that the deep segmental muscles that make up the deep myofascial systems (trans abdominus, multifidi, pelvis floor, and diaphragm) function in a "feed forward manner" (Richardson et al., 2004) meaning they contract milliseconds before movement providing joint stabilisation. This feed forward system in the DMS creates a solid base platform to create efficiency within the entire kinetic chain. Injury, immobolisation, and pain decompensate the entire stability-movement system. A study by Langevin et al. (2011)* found on average there was 20% less movement in people with lower back pain compared to people with no back pain. The sliding capacity of the thoracolumbar fascia in women is higher than men. In my experience generally, men need to do more yoga, and women more core strength work. Unfortunately, this is often not the case. To improve force transmission from the upper body to the lower and help with elastic potential (imperative for energy efficiency in long distance running or any repetitive endurance task) Vleeming et al. Spine (1995), and Cusi et al European Spine Journal (2013) showed that torsional training that mimics function is important. Exercises must look at increasing "fascial stiffness" which is to do with pelvic stability - this then allows force to be transmitted effectively through the fascia.

 

"Motion is INDEED Lotion for the ENTIRE body."