Fascia Is Able to Actively Contract and May Thereby Influence Musculoskeletal Dynamics: A Histochemical and Mechanographic Investigation

Abstract

Fascial tissues form a ubiquitous network throughout the whole body, which is usually regarded as a passive contributor to biomechanical behavior. We aimed to answer the question, whether fascia may possess the capacity for cellular contraction which, in turn, could play an active role in musculoskeletal mechanics. Human and rat fascial specimens from different body sites were investigated for the presence of myofibroblasts using immunohistochemical staining for α-smooth muscle actin ( n = 31 donors, n = 20 animals). In addition, mechanographic force registrations were performed on isolated rat fascial tissues ( n = 8 to n = 18), which had been exposed to pharmacological stimulants. The density of myofibroblasts was increased in the human lumbar fascia in comparison to fasciae from the two other regions examined in this study: fascia lata and plantar fascia [ H (2) = 14.0, p < 0.01]. Mechanographic force measurements revealed contractions in response to stimulation by fetal bovine serum, the thromboxane A2 analog U46619, TGF-β1, and mepyramine, while challenge by botulinum toxin type C3–used as a Rho kinase inhibitor– provoked relaxation ( p < 0.05). In contrast, fascial tissues were insensitive to angiotensin II and caffeine ( p < 0.05). A positive correlation between myofibroblast density and contractile response was found ( r s = 0.83, p < 0.001). The hypothetical application of the registered forces to human lumbar tissues predicts a potential impact below the threshold for mechanical spinal stability but strong enough to possibly alter motoneuronal coordination in the lumbar region. It is concluded that tension of myofascial tissue is actively regulated by myofibroblasts with the potential to impact active musculoskeletal dynamics.

Ankle Motion Is Associated With Soft Tissue Displacement in the Dorsal Thigh: An in vivo Investigation Suggesting Myofascial Force Transmission Across the Knee Joint

“…Firstly, histological studies have demonstrated the intrafascial existence of myofibroblasts (e.g., in the gastrocnemius fascia; Bhattacharya et al, 2010). Their contraction, most probably mediated by the vegetative nervous system, can produce substantial increases of tissue stiffness in the long-term (Schleip et al, 2019). Secondly, already within minutes or hours, alterations of the water content, e.g., induced by isometric stretching, have been shown to significantly impact viscoelastic tissue properties (Schleip et al, 2012).…”

A Review of the Theoretical Fascial Models: Biotensegrity, Fascintegrity, and Myofascial Chains

“…Hydration and fluids strongly influence the tension produced by the myofascial tissue, even before the cell contraction of fibroblasts and fibroblasts; mechanical stiffness depends primarily on water and fluids [20,46]. The connective tissue can vary its tension within minutes, and this event could alter the results of the research, as well as the different percentage of muscle fibers and the different angle of the fibers with respect to the longitudinal axis of the muscular district, in relation age, sporting activity or the presence of diseases [47]. The research does not consider in depth the presence of fascial transversal connections to the muscular districts, such as the lacertus fibrosus between the biceps brachial and the antebrachial fascia or other fascial structures not necessarily in a "logical" position with respect to the lines of force of the muscles, such as the fascia of Osborne, the arcade of Struthers [48][49].…”

“Minimally invasive” regional anesthesia and the expanding use of interfascial plane blocks: the need for more systematic evaluation

“…Despite the need to standardize certain steps in cadaveric studies of regional anesthesia, these studies may still not completely explain the mechanism of analgesia because regional anesthetic techniques may involve both loco-regional and systemic effects of local anesthetics. 26,27 For loco-regional effects, the muscular and fascial tissue in the intended area for these blocks can actively contract, 28 and whether or not such changes in musculoskeletal dynamics influence injectate spread cannot be determined from cadaveric studies. In addition, the clinical analgesic effect of local anesthetic from its systemic absorption obviously cannot be evaluated in a cadaveric study.…”

“…Même si l'on parvenait à standardiser certaines étapes des études cadavériques en anesthésie régionale, ces études pourraient malgré tout ne pas expliquer complètement le mécanisme de l'analgésie, les techniques d'anesthésie régionale pouvant être influencées tant par les effets locorégionaux que systémiques des anesthésiques locaux. 26,27 En ce qui a trait aux effets locorégionaux, les tissus musculaires et les fascias de la zone visée par le bloc peuvent se contracter, 28 et les études cadavériques ne nous permettent pas de déterminer si de tels changements dans la dynamique musculo-squelettique influencent la dispersion du produit injecté. De plus, l'effet analgésique clinique d'un anesthésique local observé lors d'une absorption systémique ne peut clairement pas être évalué par une étude cadavérique.…”