FASCIA: THE BODY'S
SHOCK ABSORBER
by John
F. Barnes, PT
Special to PT Today
Impacts, falls,
high velocity injuries and the various traumas of performance
and life can create a shortening and thickening of the myofascial
system. Trauma stimulates the body to generate additional connective
tissue fibers as a form of compensation during the healing process.
Normally,
these fibers later would be removed and replaced with healthy
tissue at some rate by the natural processes the body uses. Often,
however, the rate of assembly exceeds the rate of removal and
the fibers build up. As a result of this buildup on the cellular
level, the ground substance of the extracellular matrix solidifies.*
This also
creates a dehydration of the ground substance creating electrical
conductivity and a decrease in its ability to absorb shock. Trauma
or malfunction of the fascia can set up the environment for poor
cellular efficiency, necrosis, disease, pain and dysfunction throughout
the body.
MOLECULAR STRUCTURE
Connective
tissue is composed of collagen, elastin and the polysaccharide
gel complex, or ground substance.* These form a threedimensional,
interdependent system of strength, support, elasticity and cushion.
Collagen
is a protein consisting of three polypeptide chains that line
up to form fibrils in such a way as to ensure that there are no
weak points that could give way under tension. Collagen fibers
thus contribute strength to fascial tissue and guard against overextension.
Another
protein, elastin, is intrinsically rubber-like. Its fibers are
laid down in parallel with an excess length of collagen fibers
in places where elasticity is required, such as skin and arteries.
This combination adsorbs tensile forces. Tendons, specialized
for pulling, mainly contain these elastocollagenous fibers.
The polysaccharide
gel complex fills the space between fibers. Its main components
are hyaluronic acid and proteoglycans. Hyaluronic acid is a highly
viscous substance that lubricates the collagen, elastin and muscle
fibers, allowing them to slide over each other with minimal friction.
Proteoglycans are peptide chains that form the gel of the ground
substance. This gel is extremely hydrophilic, allowing it to absorb
the compressive forces of movement (cartilage, which acts as a
shock absorber, contains water-rich gel).
As long
as the forces are not too great the gel of the ground substance
is designed to absorb shock and disperse it throughout the body.
If fascia is restricted at the time of trauma, the forces cannot
be dispersed properly and areas of the body are then subjected
to an intolerable impact. The result is injury. The forces do
not have to be enormous; a person who just does not have enough
"give" can be severely injured.
This begins
to explain the sports and performance injuries that reoccur despite
extensive therapy and strengthening and flexibility programs.
An athlete with fascial restrictions will not efficiently absorb
the shocks of continued activity. The body then absorbs too much
pressure in too small an area, and during performance the body
keeps "breaking down."
This same
effect takes place over time from the microtrauma of having discrepancies
of leg length due to a torsioned pelvis. Each step sends imbalanced
forces throughout the body. The body must compensate through muscular
spasm and fascial restrictions, ultimately producing symptoms.
Myofascial
release techniques are performed to reduce these symptoms. In
addition to increased range of motion, the enormous pressure of
the fascial restrictions are eliminated from pain-sensitive structures,
alleviating symptoms and restoring the normal quantity and quality
of motion and the body's ability to absorb shock.
Reference:
Massage, Issue Number 44, July/August 1993