We are constantly reminded how exercise benefits our bone and muscle health or reduces fat. However, we are also seeing growing interest in an often overlooked element of our anatomy: our fascia.
Fascia is a thin covering of connective tissue, primarily made of collagen – a rope-like structure that provides strength and protection to many areas of the body. It surrounds and holds in place every organ, blood vessel, bone, nerve fiber and muscle. And scientists are increasingly recognizing its importance for muscle and bone health.
It’s hard to see fascia in the body, but you can get an idea of what it looks like if you look at a steak. These are fine white streaks on the surface or between layers of meat.
Fascia performs general and special functions in the body and is arranged in several ways. The superficial fascia closest to the surface lies under the skin, between the layers of fat. Next we have the deep fascia which covers the muscles, bones and blood vessels.
The link between the health and function of fascia, muscles and bones is strengthened by recent studies that show the important role fascia plays in the working of muscles, helping muscle cells contract to generate force and affecting muscle stiffness.
Each muscle is wrapped in fascia. These layers are important because they allow adjacent or overlapping muscles to move freely without affecting each other’s functions.
Fascia also helps with the transition of force through the musculoskeletal system. An example of this is our ankle, where the Achilles tendon transfers force to the plantar fascia. This sees forces travel vertically downward through the Achilles tendon, then being transferred horizontally to the sole of the foot – the plantar fascia – during movement.
A similar force transition is seen from the chest muscles to the forearm muscle groups. There are similar fascia connection chains in other areas of the body.
When the fascia is damaged
When fascia is not functioning properly, such as after an injury, the layers become less able to facilitate movement over each other or facilitate the transfer of force. Damage to the fascia takes a long time to repair, probably because it has cells similar to tendons (fibroblasts) and has a limited blood supply.
Recently, fascia, particularly the layers near the surface, has been shown to have the second largest number of nerves after the skin.
Muscle fascial linings have also been associated with pain related to surgery, musculoskeletal injuries related to sports, exercise, and aging. Up to 30% of people with musculoskeletal pain may have fascial damage or fascia may be the cause.
A type of massage called fascial manipulation, developed by Italian physiotherapist Luigi Stecco in the 1980s, has been shown to improve pain caused by patellar tendinopathy (pain in the tendon below the kneecap), short and long. long-term.
Fascial manipulation has also shown positive results in the treatment of chronic shoulder pain.
One of the growing trends in musculoskeletal injury treatment is Kinesio tape, often used in professional sports. It is also used to supplement fascia function and is used to treat chronic lower back pain where fascia involvement is a factor.
Fascia in disease
In addition to being damaged, fascia can also provide pathways through which infections can spread, within the muscles.
The spaces between the fascial layers are usually closed (think folded cling film), but when an infection occurs, germs can spread between these layers. This is a particular problem in the neck, where there are several layers of fascia allowing infections to spread.
In severe cases, surgery is often necessary to remove dead tissue and preserve the remaining healthy tissue.
One of the prime examples of how healthy fascia functions and the challenges its dysfunction can cause is plantar fasciitis, a common complaint, which causes pain around the heel and arch of the foot.
This incredibly common disease affects 5 to 7% of people and reaches 22% among athletes. It is recognized as an overuse injury, causing thickening of the fascial bands on the soles of the feet that help support the arch of the foot.
Fascia can also be involved in more serious health conditions, such as necrotizing fasciitis. It is a rare but serious bacterial disease that can spread quickly through the body and cause death.
The disease is almost always caused by bacteria, especially group A. Streptococcus Or Staphylococcus aureus. The initial infection comes from a cut or scratch, then the bacteria travel along the fascia to other areas away from the initial access site and multiply in the ideal environment provided by the warm recesses of the fascia. body.
We can see it better now
One of the reasons fascia has been neglected in health and disease is that it was difficult to see with current imaging technology. More recently, however, MRI and ultrasound have been shown to be beneficial for visualizing fascia, particularly in musculoskeletal conditions such as plantar fasciitis and pathological changes in the fascia of the shoulder and neck.
With the growing interest in fascia and the growing understanding of its contribution to musculoskeletal health, it is wise to suggest that we care for it in the same way as we do the rest of the musculoskeletal system: by using them.
Simple techniques like foam rolling and stretching are beneficial for increasing mobility, but there is still much to learn about our fascia and the role it plays in our daily health.
Adam Taylor, Professor and Director of the Clinical Anatomy Learning Centre, Lancaster University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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