Fascia has been a topic of great scientific interest and discussion, especially in more recent years.
There have been differing definitions of fascia, but fundamentally it is a continuous sheet-like structure made of connective tissue which surrounds and penetrates all organs, muscles, bones, and nerves (1). It is similar to the pith of an orange: the orange skin is like our skin, and the segments are like our muscles and organs, and the pith which is on the inside of the skin and continues down between the sections is like the fascia.
The intertwining fascial environment is able to constantly transmit and receive information, which increases the integration of bodily systems (2,3). This integration of systems does not only just concern physical wellbeing, but it has also been found that fascia has an association with emotional health too (4) (the phrase 'weight off my shoulders' is connected to a worried, anxious state having an affect on the fascia which can cause physical tightness and pain in the shoulder, neck and upper back in humans).
Fascia can be classified in several different ways, according to its location and function:
· Superficial fascia is located directly under the skin and superficial fat layers. It is thicker around the trunk and gradually becomes thinner the further down the limbs;
· Deep fascia is found around bones, muscles, nerves, and blood vessels;
· Visceral fascia surrounds organs including areas such as the lungs, abdomen, and heart;
· Parietal fascia is found among the tissues that encapsulate body cavities (5).
Fascia is an active tissue which has a role in supporting the tissues and organs it surrounds (5). It also allows normal movement to occur, as the fascia sheets allow muscles, nerves, and organs to slide efficiently past each other (1). A molecule called Hyaluronan (which is connected to hyaluronic acid which is used in face creams or joint injections) is found between the layers of fascia and is responsible for the layers to be able to glide past each other (6).
Fascia can become dried-out and form adhesions, this results in the fascia losing its malleability and its ability to glide smoothly, resulting in pain, restricted movement and decreased blood flow (5). This can happen due to:
1. Too little physical activity – a lack of movement affects the production and turnover of hyaluronan and increases the viscosity between the fascia sheets
2. Repeated use of one body part
3. Trauma or damage to an area
Any fascial damage and adhesions can be reversed using temperature and mechanical pressure (7,8). When the tissue is warmed up, it helps to restore the original function of the fascia this can be done using massage, but also by using heat pads or a hot water bottle. As well as increasing the temperature, massage can reduce the adhesions found in the fascia by realigning the fibres into the correct direction (9).
Veterinary physiotherapists are able to find and address areas of fascial restriction, alongside any other muscular problems such as trigger points or muscle spasm, and by treating these areas it can reduce pain and improve a horse's movement.
If you have a questions about fascial treatment or any other queries get in touch.
References
1. Bordoni B, Mahabadi N and Varacello M. 2022. Anatomy, Fascia. StatPearls [Internet]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK493232/#:~:text=The%20fascial%20system%20interpenetrates%20and,the%20broadest%20definition%20of%20fascia. (Accessed on: 25/05/2023).
2. Bordoni B, Simonelli M and Morabito B. 2019. The Other Side of the Fascia: Visceral Fascia, Part 2. Cureus, 11(5).
3. Bordoni B, Escher AR, Tobbi F, Ducoux B and Paoletti S. 2021. Fascial Nomenclature: Update 2021, Part 2. Cureus, 13(2).
4. Bordoni B. 2017. Emotions in Motion: Myofascial Interoception. Complementary Medicine Research, 24(2), p.110-113.
5. Gatt A, Agarwal S and Zito PM. 2022. Anatomy, Fascia Layers. StatPearls [Internet]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK526038/ (Accessed on: 25/05/2023).
6. Stecco C. 2021. Hyaluronan and the Fascial Frontier. International Journal of Molecular Sciences, 22(13).
7. Pavan PG, Stecco A, Stern R and Stecco C. 2014. Painful Connections: Densification Versus Fibrosis of Fascia. Current Pain Headache Reports, 18, p.441–444.
8. Hughes EJ, McDermott K and Funk MF. 2019. Evaluation of Hyaluronan Content in Areas of Densification Compared to Adjacent Areas of Fascia. Journal of Bodywork and Movement Therapies, 23, p.324–328.
9. Stecco A, Gesi M, Stecco C and Stern R. 2013. Fascial Components of the Myofascial Pain Syndrome. Current Pain Headache Reports, 17, p.352–359.
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