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www.amtamassage.org/mtj 145 - - - body mechanics body by joe muscolino by examples of deep fibrous , as are and septa. intermuscular The loosely ture packed of struc subcutaneous fascia allows for a healthy blood supply, giving it strong reparative properties when injured. Alternatively, the dense ar rangement of fibrous fascia does not allow adequate room for blood ves sels; therefore, fibrous fascia has a heal not does and supply blood poor well when injured. In addition fibers and to fibroblasts, both - - - - -

Bodywork and movement Bodywork and movement therapy can help with contracted fascial tissue. , and , which

create the and aponeuroses of muscles, are fascial contraction Fascia can be divided into two general categories: sub cutaneous fascia and deep fascia, also known as muscu lar fascia. Subcutaneous fascia, as the name implies, is located immediately deep to the skin. It is largely com posed of adipose (fat) cells, giving it its gel-like consis Collagen fibers and fibroblast cells are embedded tency. within this mix of adipose cells. Deep fascia is located dense of comprised primarily is and body the in deeper ly packed collagen fibers, accounting for its description as fibrous fascia. Fibroblasts are located between these collagen fibers (Figure 1). 146 mtj/massage therapy journal fall 2008 Fibroblasts body mechanics Collagen fibers FIGURE 1. FIGURE are interspersed. are interspersed. laid parallel to each other. Within this mix of collagen, fibroblast cells active tensionforces. tissue, createscontractile but instead,likemuscle passive tensilemanner, not functiononlyina suggests thatfasciadoes Recent research Fibrous fascia is composed primarily of collagen fibers fibers collagen of primarily composed is fascia Fibrous asvl rss big lengthened being resist passively sue is pulled upon, its collagen fibers be passive. That is, when to the fascial tis considered been has sesses pos it force pulling any However, torn. being without forces (pulling) tensile withstanding at effective ly extreme be it to understood been has collagen, of concentration high its of Because tissue. noncontractile loskeletal system is that it is an inert muscu the within fascia of role the ing stretched. back to their original length after be shorten to ability the them give that fibers elastic contain fascia of types h taiinl nesadn of understanding traditional The A - - - - - long beenheraldedfortheirpassivetensilestrength. have fibers collagen Indeed, muscle. the of tachments tissue tendons transfer that pulling force to the bony at belly contracts and pulls upon its tendons, these fibrous muscle a when example, For tissues. other to forces ing pull these transfer to ability the having stretched, and ocs Ised lk msl tsu, t a as create also contractile activetensionforces. can it tissue, muscle like Instead, forces. tensile transmitting and resisting manner, tensile sive understood is that fascia does not function only in a pas clearly becoming now is What system. musculoskeletal the within fascia of role contractile the of derstanding un sophisticated more a provided has research recent only can create words, other In contract. to ability its in unique tissue varies, but seems to be related to the degree of degree the to related be to seems but varies, tissue ability. contractile its fascia upon confers that molecule ciple ( actin muscle smooth alpha called protein a of presence the be to seems and fibroblasts between myofibroblasts have contractile activity. The distinction that indicating muscle, for word Latin the from comes 2­ (Figure myofibroblasts called cell of B -SMA) in myofibroblasts. -SMA seems to be the prin ni rcnl, uce ise a be considered been has tissue muscle recently, Until The degree of myofibroblasts present within a fascial a within present myofibroblasts of degree The type another contains also fascia that know now We of thoracolumbarfasciaareindicated by arrows. Two of the many cells located within a section fascia. fibrous within located be to known now is cell blast 2. FIGURE Another type of fibroblast cell called a myofibro- a called cell fibroblast of type Another active tension forces. However, ). The root “myo” root The ). - - - - -

photography : From Muscolino JE: Kinesiology: the skeletal system and muscle function, enhanced edition. St. Louis, 2006, Mosby. contractile tension force of myofascial tissue

Although the new evidence of the active contractile strength of fascia is significant, the importance of fascia’s passive strength should not be dismissed. After all, the total tension force of muscle/myofascial tissue is the combination of its active and passive forces. Fascia is extremely resistant to pulling forces, therefore it does not lengthen out. This is important to the functioning of a muscle in two ways. First, when a muscle contracts, it exerts its pulling force upon its fascial or which then transfers that pulling force to the muscle’s bony attachment. Therefore the muscle’s active contraction pull is efficiently and strongly transferred to its attachments to create movement. Second, fascia’s resistance to being lengthened also adds a passive tension force to the muscle. If an external force stretches a muscle to the limit of its fascia’s ability to lengthen, the resistance to stretch by the fascia creates a passive tension force that opposes the force of stretch upon the muscle. This passive resistance force adds to the active contractile tension force of the muscular and fascial tissues. Thus, fascia contributes to a muscle’s total tension force both actively and passively. (It should be added that fascia’s resistance to lengthening creates a stable skeletal framework for the muscle that prevents the muscle from being overstretched and torn, therefore fascia also serves a protective function for muscle.)

One other factor needs to be considered when looking at the total contractile tension force of muscle/myofascial tissue, that is its elasticity. Elasticity is a passive pulling force that causes a structure to bounce back toward its center after being stretched (think of an elastic band), therefore this pulling force can be added to the total pulling force of a muscle. Fascia is inelastic, so the elasticity of a muscle is provided by the muscle tissue itself. Specifically, within muscle fibers, there is a large protein called titin that connects the myosin filament to the actin filaments and Z lines of the sarcomere. Titin has a region that is coiled and springlike, which provides the elasticity to muscle/myofascial tissue. Elasticity is an passive force, however, unlike the passive force of fascia that simply resists being lengthening out, titin’s elasticity adds a pulling force that continues to act until the muscle is returned to its resting length.

Elasticity is extremely efficient. A muscle that is stretched can rely upon its passive elasticity to create movement without any active contractile force created by the sliding filament mechanism. For example, if I stretch my upper back into extension by concentrically contracting my extensor muscles of the upper spine, when I want to return to the initial position, I do not need to actively contract my spinal flexors, rather I need only relax. Upon relaxation of the spinal extensor musculature, my stretched muscular tissues in the front of the trunk will naturally pull me back into flexion. In this manner, the motion of our body can be very efficient. A muscle on one side of a joint expends energy to contract and move us in one direction, and we can then passively return to our starting position merely by relaxing and letting the stretched tissues on the other side of the joint elastically recoil back, without the expenditure of energy and effort. 148 mtj/massage therapy journal fall 2008 body mechanics consider fascial contractile forces when evaluating the to evaluating when forces needs contractile fascial kinesiology consider of field the First, multifold. are broblasts. been found to be particularly well populated with myofi have thigh the of lata fascia the and foot, the of fascia particular, the thoracolumbar fascia of the back, plantar In experiencing. are they forces tensile the of face the in integrity tissue their maintain to force pulling tion contrac isometric sufficient exert to found been have dynamics, musculoskeletal impact to strong sufficiently not while concentrations, myofibroblast Lower tissues. these upon placed forces tensile pulling of cumulation theac to inresponse developed have myofibroblasts these absent, In is trauma degree. physical overt an alesser where cases to albeit myofibroblasts, contain tribute tomovementofthebody. con to enough strong are forces pulling active their is, strong force to impact musculoskeletal mechanics—that sufficiently have to found been have myofibroblasts of concentrations high with tissues Fascial healing. wound undergoing are and injured been have that tissues cial myofi fas in concentration greatest the in found are broblasts reason, this For experiencing. the is that tissue fascial force pulling the opposes and counters that force pulling anactive create then can myofibroblasts These fibers.” “stress as known also are myofibroblasts reason, this For tissue. fascial the of fibroblasts normal the from develop myofibroblasts more and more fascia, the upon placed are forces tensile greater and greater physical stress that the fascial tissue is experiencing. 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This would most likely oc fas on destructive—effect even unhealthy—perhaps an the fascial tissue within which it is located, it may create upon placed demands the to compared excessive is tion contrac myofibroblastic if that possibility the to points also it However, tissue. wounded together binding and sue to exert contractile forces that are helpful in closing tis scar fascial of ability the to points knowledge this that they should be factored in. In the field of pathology, enough significant are forces contraction fascial these forces, contraction muscular than degree in weaker far Albeit system. musculoskeletal the of forces contractile Robert Schleip, and Robert publishedby Elsevier, 2007. Findley W. Thomas by edited Care, Health Complementary and Conventional for Implications and Science Basic Research, Fascial see please contraction, fascial on information more *For tion classes.* educa continuing and curriculum core both in taught and incorporated be to fascia of function and structure the of understanding sophisticated more this for allow and attention close pay to need may professions ment cula of massage therapy and other bodywork and move curri the however, increases, base knowledge our As The research on fascial contraction is still emerging. emerging. still is contraction fascial on research The & Kinesiology, The Skeletal System author ofThe Manual Redding, Connecticut. He is also the The Art and Science of Kinesiology in for Massage Therapy and the owner of instructor at the Connecticut Center Joseph E. Muscolino, DC, is an ------