Fascia
is an exceptionally abundant tissue in the body. Its consistency ranges broadly from thin membranes to relatively thick bands and webs. The primary function of fascial tissue is to provide support, shape, and suspension for the soft tissues of the body. From an orthopedic perspective, the fascia associated with muscle tissue is of primary concern because dysfunction within the fascial system can produce significant movement and functional system problems.
Adhesions
When collagen has formed over an injury it can bind up other tissues that are nearby creating an adhesion. Adhesions can form within muscle tissue or between muscles in the connective tissue or sheaths. Fascia is everywhere! It is common in the hamstrings and can increase the chance of injury and could also limit mobility.
Fascial tearing
The majority of fascia is highly elastic, but extreme tensile stress can cause fascial tearing or perforation. A tensile stress injury to fascia can cause scar tissue to develop, leading to movement restrictions. Fascial tearing is likely to be painful because fascia is richly innervated due to the nervous system running through it.
Fascial shortening
A significant pathological problem involving fascia occurs when it remains in a shortened position for prolonged periods. While fascial tissue has a great deal of elasticity, it tends to adapt to shortened or elongated positions and adhesions can link adjacent fascial fibers. This fibrous cross‐linking within fascial tissue leads to shortening of the fascia, creating resistance to elongation. Fascia has a viscoelastic property so that when it is over‐stretched it can recoil to some degree, but not to its original length.
Recent investigation into the fascia’s physiological properties indicates that it may have contractile cells similar to those found in smooth muscle fibers. Presence of contractile cells within fascia would explain its apparent ability to shorten. This also provides a valuable working theory for the effectiveness of fascial treatment methods. Schleip’s research suggests that the low level tangential forces of myofascial treatment techniques actually cause the contractile units in the fascia to decrease their contractions, creating the characteristic tissue release felt by practitioners. With either chronic shortening or over‐lengthening some degree of dysfunction in fascial tissue can become permanent, which can contribute to postural distortions.
