Fascia: The Tensional Network of the Human Body

Description:

The role of the fascia in musculoskeletal conditions and as a body-wide communication system is now well established. Fascia: The Tensional Network of the Human Body constitutes the most comprehensive foundational textbook available that also provides the latest research theory and science around fascia and their function.

This book is unique in offering consensus from scientists and clinicians from across the world and brings together the work of the group behind the international Fascia Research Congress. It is ideal for advanced sports physiotherapists /physical therapists, musculoskeletal/orthopaedic medicine practitioners, as well as all professionals with an interest in fascia and human movement.

The comprehensive contents lay the foundations of understanding about fascia, covering current scientific understanding of physiology and anatomy, fascial-related disorders and associated therapies, and recently developed research techniques.

Full colour illustrations clearly show fascia in context

New content based on latest research evidence

Critical evaluation of fascia-oriented therapies by internationally trusted experts

Chapter outlines, key points and summary features to aid navigation

Accompanying digital version include instructional videos created by clinicians

 

Table of Contents:

 

Section I. Scientific Foundations

Part 1. Topographical Anatomy

1.1.  Evolution of fascia-focused anatomy

Introduction

Anatomy

Ancient awareness of fascia

The illumination of fascia

Fascia in the age of science

Combined portrayal of fascia

References

1.2.  General anatomy of the muscle fasciae

Introduction

General structure and composition of muscle fasciae

Functional anatomy of the endomysium

Functional anatomy of the perimysium

Perimysial–endomysial junction zones

Perimysium and intracellular subdomains

Conclusions

References

1.3.  Somatic fascia

Global organization of fascia in the body

Architecture of fascia—the four primary layers

References

1.4.  Fascia superficialis

Introduction

Gross structure and distribution

Components and their relation to function

Aging changes in subcutaneous tissue

References

1.5.  Deep fascia of the limbs

Introduction

The deep fascia of the shoulder

The deep fascia of the arm and forearm

The palmar aponeurosis

Deep fasciae of the lower limbs: Fascia lata and crural fascia

The retinacula

References

1.6.  The thoracolumbar fascia

Introduction

The thoracolumbar fascia

The two-layered model

The three-layered model

Compartmentalization of the paraspinal muscles

Proposed model of the thoracolumbar fascia

The posterior layer of the thoracolumbar fascia

Disposition of the latissimus dorsi

Fiber orientation for the latissimus dorsi

Attachments of the serratus posterior inferior

Unifying theory of the superficial lamina

Deep lamina of the posterior layer of the thoracolumbar fascia

Inferior border of the deep lamina

Superior border deep lamina

Lateral border of the deep lamina

The middle layer of the thoracolumbar fascia

Acknowledgments

References

1.7.  Deep fascia of the neck and deep inner fascia of the anterior wall of the trunk

Introduction

Superficial fascia of the neck

Deep fascia of the neck

Thoracic fasciae

Diaphragm development

Final considerations

References

1.8.  Visceral fascia

Introduction

Development of visceral fascia

Formation of the intraembryonic coelom and surrounding visceral fascia

Formation of the midline mesodermal column and its relationship to the organs of the body

Formation of the spinal nerve and the viscerotome

Summary

Visceral fascia

Regional visceral fascia

References

1.9.  Membranous structures within the cranial bowl and intraspinal space

Embryonic growth dynamics of the dural membrane according to blechschmidt

Intracranial membrane system

Extracranial membrane system

Vascularization of the meningeal membranes

Meningeal nerve supply

Reciprocal tensile membrane and sutherland’s fulcrum

Future tasks and open questions

References

1.10.  Diaphragmatic structures

The diaphragm and its fascia: Anatomical, embryological, and evolutionary development

The muscle fascia of the trunk and neck and its connections with the diaphragm

The visceral fascia of the trunk and its connections with the diaphragm

The fascia of the diaphragm and its connections

The role of the diaphragm in respiratory function and the control of static and dynamic posture

References

1.11.  Molecular aspects of fascia

Introduction

Fascial tissue cells

The extracellular matrix: Fibrous component and aqueous matrix

Cell receptors in fascial tissue

References

1.12.  Fascia of the pelvic floor

Introduction

Body-wide continuity of pelvic fascia

Inner structure of the pelvic cavity

Fascial tonicity and organ function

External anatomy of the pelvis

Fascial tension and chronic pelvic pain

References

1.13.  Embryology of the fascial system

Introduction

Neural (meningeal) fascia

Vascular fascia

Visceral fascia

Deep fascia of the musculoskeletal system

Conclusion

References

Bibliography

1.14.  On the origin of fascia: A phenomenological embryology of fascia as the “fabric” of the body

About so-called germ layers

Where does the fascial tissue come from?

Mesenchyme, “tissue of innerness”? Fascia, “organ of innerness”?

In fascia it is about two—biotensegrity

References

Part 2. Communication

2.1.  Fascia as an organ of communication

References

2.2.  Proprioception

Proprioception, mechanoreception, and the anatomy of fascia

Connectivity and continuity

Architecture is different from and complementary to anatomy

The substrate of mechanoreception

The functional role of architecture of the connective and muscular tissue in mechanoreception

Dynaments: More than ligaments or muscles

Classification of mechanoreceptors in proprioception

References

2.3.  Interoception: A new correlate for intricate connections between fascial receptors, emotion, and self-awareness

Introduction

What is interoception?

Sensual touch

Interoceptive pathways

Interoception and somatoemotional disorders

Fascia as an interoceptive organ

Manual therapy and interoception

Movement therapies and interoception

References

2.4.  Nociception: The thoracolumbar and crural fascia as sensory organs

Introduction

Part 1: Innervation of the thoracolumbar fascia

Part 2: Electrophysiology

Part 3: Innervation of the crural fascia

Part 4: Effects of an experimental fascia inflammation

References

2.5.  Fascia as a body-wide communication system

Introduction

Communication and information processing

Defining the fascia

The living matrix

Signaling pathways and human performance—the zone: Neurology or biophysics?

Biophysics

Neurology

Conclusion

Dedication

Acknowledgment

References

Part 3. Force Transmission

3.1.  Force transmission and muscle mechanics: General principles

Introduction

Myotendinous force transmission

Myofascial force transmission

Distribution of forces in a multipath system

Intramuscular substrates of myofascial force transmission

References

3.2.  Epimuscular myofascial force transmission: An introduction

Introduction: Epimuscular myofascial force transmission and its substrate

Effects of epimuscular myofascial force transmission

Complexity of myofascial loading of muscle

Additional factors to consider

Effects on functioning of the sensory apparatus

References

3.3.  Myofascial chains: A review of different models

Introduction

Kurt tittel

Godelieve denys-struyf

Joseph schwartz

Serge paoletti

Discussion

References

3.4.  Anatomy trains: Myofascial force transmission in postural patterns

Introduction—fascia as metamembrane

Dividing the indivisible

Isolating a muscle

The anatomy trains

Tensegrity

Conclusion

References

3.5.  Biotensegrity and the mechanics of fascia

Introduction

Biotensegrity

The tensegrity model

The mechanics of fascia

References

3.6.  Human living microanatomy

Introduction

The physical factors

Tissue continuity—no layers, no empty spaces

Dispersed patterns with no regularity

Maintaining tissue continuity during mobility: Movements of fibers, mechanical behavior

Reversing the process of entropy

Irreversibility of time

Quantum physics and chaos theory

Chaos theory is a modern discovery

Fluids

Intercrossing fibers in 3D create irregular polyhedral microvolumes

Turbulence and phase transition

Adaptation and transformation: Megavacuole

Fractalization adds another dimension to the chaotic aspect of living matter

Biotensegrity

Understanding growth and morphogenesis

The structural similarity of life

Conclusion

References

3.7.  The fascial net: Resonance frequency with links to thermodynamics

Introduction

Locomotion theories

Linking the locomotion theories with the thoracolumbar fascia: A novel approach

A simplified lumbar spine finite element model with middle and posterior layers of the thoracolumbar fascia

Methods

Results

Conclusion

References

Part 4. Physiology

4.1.  The physiology of fascia: An introduction

Connective tissue of the locomotor apparatus

Construction and function

Traction or tensile load versus pressure

Physiological stimuli

Wound healing and manual therapy

Conditions for wound healing

References

4.2.  Fascia is alive: How cells modulate the tonicity and architecture of fascial tissues

Cellular populations in fascia

Fascia and immunology

Myofascial tonicity

From myofibroblast contraction to tissue contractures

Modulators of fascial contractility

Interaction with the autonomic nervous system

Indications for rhythmic oscillations of fascial tissues?

References

4.3.  Extracellular matrix

Introduction

The matrisome

Main extracellular matrix players

ECM-associated factors and matricellular proteins

ECM mechanics and fibroblast mechanosensing

Conclusion

Acknowledgments

References

4.4.  The influence of pH and other metabolic factors on fascial properties

pH regulation and influence on fascial tissue

What is the impact of pH on fascial function?

Effect of metabolic factors and hormones on fascial function

Sex hormones

Relaxin

Corticosteroids

Lactate

References

4.5.  Fluid dynamics in fascial tissues

Introduction

Properties of interstitial water

Morphological quality of interstitial fluids

Interstitial fluids as a medium of communication between the cells

The “breathing” of the tissues

References

Bibliography

Section II. Clinical Application

Part 5. Fascia-Related Disorders

5.1.  Fascia-related disorders: An introduction

5.2.  Dupuytren’s disease and other fibrocontractive disorders

Introduction

Dupuytren’s disease

Who is afflicted by this disease?

The basic problems of dupuytren’s disease

Basic anatomy of dupuytren’s disease

Palmar nodules

Myofibroblasts

Palmar cords

Why are some fingers affected more than others?

Are all myofibroblasts the same?

Inflammatory models

Myofibroblast receptors

What is the origin of the cells that cause the “pits” at the distal palmar crease?

What “instructs” the cells in the aponeurosis to contract?

What “instructs” the cells in the aponeurosis to proliferate?

Current treatments

A strategy for a pharmacological approach

Drugs injected into the cords

A modern development

Peyronie’s disease

Ledderhose’s disease

Conclusion

References

5.3.  Spastic paresis

Introduction

Intramuscular connective tissue changes in spastic paresis and control human muscle

Surgical treatment of the upper extremity in spastic paresis

Observations during surgery

Toward an explanation of spasticity-related joint positions

Conclusion

References

5.4.  Diabetic foot

Introduction

Methodology of testing

Nonenzymatic glycosylation

Plantar fascia

Achilles tendon

Limited joint mobility

Conclusions

References

5.5.  Trigger points as a fascia-related disorder

Trigger points

Fascia and myofascial trigger points

Therapeutic consequences

References

5.6.  Joint hypermobility due to pathologically increased compliance of extra- and intramuscular connective tissues

Introduction

Physical or manual therapy in Ehlers–Danlos syndrome

Neuromuscular involvement of eds

Effects of tnx-deficiency on muscle characteristics in a mouse model of eds

The ultrastructure of muscle extracellular matrix in tnx knockout mice is distorted

Isometric contractions

Intramuscular changes: Increased muscle compliance

Intermuscular changes: Reduced epimuscular myofascial force transmission

Conclusions

References

5.7.  Anatomy of the plantar fascia

Introduction

Macroscopic and microscopic characteristics

Biomechanical implications

Plantar fascia thickness and stiffness

Clinical implications and treatment

References

5.8.  Fascia and low back pain

The epidemic of low back pain

A glimpse into low back pain history

Effect of low back pain on humans and economies

Current treatments of low back pain

Potential sources of low back pain

Fascia: Foe or ally?

Why fascia?

Perspectives on fascia in low back pain

References

5.9.  The role of fascia in oncology

Introduction

Identifying the mystics of cancer biology—a big challenge

Mechano-oncology—cancer mechanobiology

Body-based treatment strategies in the context of cancer

References

Part 6. Diagnostic Procedures for Fascial Elasticity

6.1.  Diagnostic procedures for fascial elasticity: An introduction

References

6.2.  Fascial palpation

Defining palpation

Active vs passive assessment

Palpation tools

Relaxed palpation

Layers

Communicating with the client

Palpating for information

Palpation objectives

Palpate by “feeling,” not thinking

Physiology of touch

Filtering information

An experienced palpation perspective

Practical palpation

Conclusion

References

6.3.  Hypermobility, hypermobility spectrum disorders, and hypermobile Ehlers–Danlos syndrome

Introduction

Clinical presentation

Examination of patients with hypermobility spectrum disorder

Evaluation, diagnosis, and management planning

Management principles

References

6.4.  Mechanical deformation-based assessment methods

Introduction

Terminology

Devices

Static deformation

Bioimpedance

Ultrasonography and elastography

References

Part 7. Fascia-Oriented Therapies

7.1.  Fascia-oriented therapies: Inclusion criteria and overview

7.2.  Trigger point therapy from a contemporary pain science perspective

Introduction

Integrated trigger points hypothesis

Fascia, muscles, and myofascial pain

Some sensory aspects of fascia

Trigger point therapy

References

7.3.  Structural integration

Premises of the work

Characteristics of fascia key to structural integration

Facilitating integrated structure and function

The traditional structural integration 10-series

References

Bibliography

Random trials in normal persons

Studies in specific patient populations

Abstracts of case studies regarding specific conditions

7.4.  Myofascial induction approaches

Introduction

Neurophysiological mechanisms for releasing the restrictions of the fascial system

Method description

Scientific evidence related to the results in the myofascial approach

References

7.5.  Osteopathy and fascia in clinical practice

Introduction

Fascia in the perspective of osteopathic manipulative treatment

Osteopathic contributions to the understanding of fascia

References

7.6.  Connective tissue manipulation

History and background

Applications and contraindications

Principles of connective tissue manipulation

Effects of connective tissue manipulation

Clinical benefits

References

7.7.  Fascial manipulation

Introduction

The biomechanical model for the musculoskeletal system

The biomechanical model for the internal system

Treatment

References

7.8.  Managing dysfunctional scar tissue

Introduction

Connective tissue and the extracellular matrix

Wound healing

Scar tissues

Therapeutic approach

References

7.9.  Acupuncture as a fascia-oriented therapy

Historical background

Acupuncture mechanism

Techniques

Dry needling: A technique approaching muscle and fascia

Evidence

References

7.10.  Gua sha

Introduction

Gua sha terms

Indications

Contraindications

Biomechanism/physiology

References

7.11.  Prolotherapy as a regenerative injection treatment

Introduction

History

Wound healing, repair, and regeneration

Mechanism of action and substances injected

Indications, contraindications, complications, and risks

Techniques

Outcomes and clinical evidence

Fascial neural hydrodissection for entrapment neuropathy

Future challenges

References

7.12.  Neural therapy

Therapy with local anesthetics

Neuroanatomy, neurophysiology

Therapeutic principles

Indications, contraindications, complications

Practical procedure

Research

Acknowledgments

References

7.13.  Instrument-assisted soft tissue mobilization: Emphasizing the fascia

Introduction

Normal muscle function requires normal fascial gliding

Relation of hyaluronan to the gliding of fascia and muscle fibers

Superficial fascia

Deep fascia

Fascial densification/fibrosis

Retinacula

Thicker areas of fascia may be normal tissue

So where do we treat?

Instruments

Important information regarding instrument-assisted soft tissue mobilization

References

7.14.  The fascial distortion model

The patient as expert—the typaldos approach

The fascial distortions

The diagnosis of fascial distortions

Treatment of fascial distortions

References

Bibliography

7.15.  Fascial treatment of axillary web syndrome after breast cancer surgery

Introduction

Etiology

Myofascial techniques

References

7.16.  Temperature effects on fascia

Introduction

Temperature-dependent tissue components

Temperature changes are relevant

Myofascial tonus regulation is temperature dependent

Lack of temperature undulation is detrimental

Therapeutic use of heat

Therapeutic use of cold

References

7.17.  Neurodynamics: Movement for neuropathic pain states

Introduction

Structures of the peripheral nervous system and their functions

Movement for neuropathic pain states

The bigger picture

References

7.18.  Stretching and fascia

Introduction

Definition

Mixed evidence

Stretching: The evidence for tissue change

Mechanical lengthening

Tissue hydration

Proprioceptive stimulation

Direct cellular effects

References

7.19.  Yoga and fascia

What is yoga?

Yoga’s effects on fascia

Fascia research’s effect on yoga

References

7.20.  Pilates and fascia: The art of “working in”

Introduction

The blend of eastern and western philosophies

Fusion and integration of various disciplines

Fascia, bound by lifestyle

Pilates principles and fascia

Core ability, a fascia-related girdling concept

The breath in pilates

Well-connected

Alignment support from within

Specialized equipment: Reformer or transformer

Reformer versus machine

References

7.21.  Nutrition and fascia: An antiinflammatory model

Musculoskeletal conditions and inflammation

Inflammatory response

Fatty acids: Antiinflammatory properties

Fatty acid dietary supplements

Culinary spices and herbs

Fruits and vegetables

Beverages: Green tea and epigallocatechin-3-gallate

Gluten and inflammation

Nutrition: An antiinflammatory model

References

Bibliography

7.22.  Fascial fitness: Suggestions for a fascia-oriented training approach in sports and movement therapies

Introduction

Fascial remodeling

The catapult mechanism: Elastic recoil of fascial tissues

Training principles

Fascial fitness and body image

References

7.23.  Hydrorelease of fascia

Introduction

History of injections with physiological saline

History and definition of hydrorelease

Differences between hydrorelease and hydrodissection

Mechanisms of action of HR and HD

Indications of HR

Contraindications, complications, and risks of HR

Techniques of HR

Myofascia

Nerve (paraneural sheath and fascia around peripheral nerves)

Retinaculum

Tendon and tendon sheath

Joint capsule and surrounding tissues

Fascia in fat pads

Ligamentum flavum/dura complex

Acknowledgments

References

7.24.  Fascia and traditional chinese medicine

Introduction

The basic elements of acupuncture and fascia

Acupuncture and moxibustion techniques with fascia

Acupuncture research and fascia

Conclusion: The contribution of fascia to acupuncture and moxibustion

References

7.25.  Extracorporeal shockwave therapy applied to myofascial tissue

Introduction

Shockwave basics

Mechanisms of action of extracorporeal shockwave therapy on tissue

Effects of ESWT on tendons and myofascial tissue

Antiinflammatory effects and pain reduction of ESWT

Antifibrotic effects of ESWT on myofascial tissue

Promotion of healing processes and effects of ESWT on myofascial tissue

Therapeutic approach

Clinical example of ESW application for myofascial pain in a musculoskeletal disease

Perspectives

References

7.26.  Bowen therapy

What is bowen therapy?

How prevalent is bowen therapy?

Foundations

Bowen practice: The classic move

Bowen practice: The pause

Hypothesized mechanism of action

Clinical research

References

7.27.  Fascia and mental imagery: Can the two walk together?

Introduction

Mental imagery: Definitions and roles

Similarities between fascia and mental imagery

Suggested associations between fascia and mental imagery

Fascial dynamic neurocognitive imagery: A brief history

Fascial dynamic neurocognitive imagery exercises for mental imagery and fascia

Exercise 1: Fascial concentration and awareness

Exercise 2: Fascial concentration and awareness

Exercise 3: Fascial sliding integrated touch and mental imagery

Exercise 4: Lungs’ fascial sliding

Acknowledgments

References

7.28.  Foam rolling

Introduction

Possible mechanisms of foam rolling

Research contexts

Variations and implementation

Conclusion

References

7.29.  The functional aspects of fascia during human performance and sports

Wheel of history

No human is limited

What to train?

Release the restrictions

Strengthen the weak part

Fine-tune the network

The art and science of training

References

Section III. Research Directions

Part 8. Fascia Research: Methodological Challenges and New Directions

8.1.  Fascia—clinical and fundamental scientific research: Considering the scientific process and its potential for creating clinical applications

Introduction

The need for ongoing fundamental scientific work

Retrospective research analyzing what is needed to attain potential new clinical applications in the future

Conclusions

References

8.2.  Imaging: Ultrasound

A short history

Form and function of muscle–tendon–fascial structures revealed by ultrasonography

Hypertrophic muscles

Ultrasound elastography

Structures around skeletal muscles visualized and tested by ultrasonography

New techniques applied to analysis of ultrasound images

References

8.3.  On the problems of oversimplification in experiments and modeling of the body as a multilevel organizational unit

Introduction

A serious example of the effects of oversimplification

Different levels of organization within the body distinguished

A model and experiments dealing with more than one level of organization

Limitations of experiments on myofascial force transmission

Does epimuscular myofascial force transmission play a role in vivo for healthy subjects?

Advantages and limitations of the applied MRI techniques

Advantages and limitations of studying myofascial force transmission by measuring moments

References

8.4.  Myofascial force transmission and molecular pathways involved in adaptation of muscle size

Introduction

Mechanical loading induces muscle adaptation in vivo

Training

Muscle strain

Molecular mechanisms of adaptation of muscle size

Machinery for protein synthesis

Translation of mRNA

Completion of the protein synthesis

Machinery for protein degradation

Mechanochemical signaling and mechanotransduction for protein synthesis and degradation in muscle

The roles of fascia in the regulation of myofiber size

Ex-vivo culture of mature, single myofibers

References

8.5.  Myofascial effect on muscle stem cell function and muscle regeneration

Introduction

Mechanical linkage of muscle stem cells to their niche components in the extracellular matrix

Force transmission from myofiber to muscle stem cell

Potential effect of physical cues on muscle stem cell function

References

Glossary

Index

 

 

An aparitie	28 Dec. 2021
Autor	Robert Schleip, Carla Stecco, Mark Driscoll, Peter Huijing
Editura	Elsevier
Format	Paperback
ISBN	9780702071836
Limba	Engleza
Nr pag	744
Versiune digitala	DA