Fascia Mobility, Proprioception, and Myofascial Pain

Langevin, Hélène M.

doi:10.3390/life11070668

Cited by 43 publications

(38 citation statements)

References 53 publications

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“…The possible causes of myofascial pain have been discussed in several articles: in some experimental studies it was shown that the hypertonic saline solution can cause a more intense and longer lasting pain when injected in fascia than in muscle [ 32 , 33 ]. Langevin et al [ 34 , 35 , 36 ], have hypothesized that reiterated postures, sports, or repetitive motions may generate altered movement patterns, which increase the thickness of the tissue and in turn limiting the sliding between fascia layers. This situation would augment inflammation and pain increasing the stimulation of free nerve endings present in them.…”

Section: Discussionmentioning

confidence: 99%

Fascial Innervation: A Systematic Review of the Literature

Suárez-Rodríguez

Fede

Pirri

et al. 2022

IJMS

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Currently, myofascial pain has become one of the main problems in healthcare systems. Research into its causes and the structures related to it may help to improve its management. Until some years ago, all the studies were focused on muscle alterations, as trigger points, but recently, fasciae are starting to be considered a new, possible source of pain. This systematic review has been conducted for the purpose of analyze the current evidence of the muscular/deep fasciae innervation from a histological and/or immunohistochemical point of view. A literature search published between 2000 and 2021 was made in PubMed and Google Scholar. Search terms included a combination of fascia, innervation, immunohistochemical, and different immunohistochemical markers. Of the 23 total studies included in the review, five studies were performed in rats, four in mice, two in horses, ten in humans, and two in both humans and rats. There were a great variety of immunohistochemical markers used to detect the innervation of the fasciae; the most used were Protein Gene Marker 9.5 (used in twelve studies), Calcitonin Gene-Related Peptide (ten studies), S100 (ten studies), substance P (seven studies), and tyrosine hydroxylase (six studies). Various areas have been studied, with the thoracolumbar fascia being the most observed. Besides, the papers highlighted diversity in the density and type of innervation in the various fasciae, going from free nerve endings to Pacini and Ruffini corpuscles. Finally, it has been observed that the innervation is increased in the pathological fasciae. From this review, it is evident that fasciae are well innerved, their innervation have a particular distribution and precise localization and is composed especially by proprioceptors and nociceptors, the latter being more numerous in pathological situations. This could contribute to a better comprehension and management of pain.

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Section: Discussionmentioning

confidence: 99%

Fascial Innervation: A Systematic Review of the Literature

Suárez-Rodríguez

Fede

Pirri

et al. 2022

IJMS

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“…Due to the repetitive overhead rotational motion during spiking, serving, and blocking, it is well documented that volleyball players often develop excessive external rotation range, and limited internal rotation range. With repetitive movements and micro-trauma, connective tissues can experience deformation, structural changes and may have an altered feedback mechanism for peripheral senses, such as proprioception ( Chen et al, 2021 ; Langevin, 2021 ). A recent systematic review on the effects of rehabilitation of shoulder proprioception suggests a specificity to proprioception deficits ( Ager et al, 2021 ); meaning specific pathologies (shoulder instabilities or rotator cuff dysfunctions, for example) present with specific proprioception deficits.…”

Section: Discussionmentioning

confidence: 99%

Role of active joint position sense on the upper extremity functional performance tests in college volleyball players

Méndez-Rebolledo

Ager

Ledezma

et al. 2022

PeerJ

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Background It has been well established that proprioception plays a decisive role in shoulder stability and sport performance. Notwithstanding, there is a lack of clear association between active joint position sense (AJPS) and the performance of upper-extremity functional performance tests. The aim of this study was to determine whether the AJPS of the shoulder complex is associated with the performance of college volleyball players with the following functional tests: Y-Balance Test-Upper Quarter (YBT-UQ), Closed Kinetic Chain Upper-Extremity Stability Test (CKCUEST), and Seated Medicine Ball Throw (SMBT). The secondary aim was to investigate whether the magnitude of the proprioception error through the AJPS had the ability to act as a predictor for functional test scores. Methods Cross-sectional study with a convenience sampling. Healthy college volleyball players (≥12 h of training/week), 30 males and 22 females, between 18 and 26 years of age were included. AJPS of the shoulder (90° of flexion (90°Flex), 90° of internal rotation at 90° of abduction (90°IR/ABD), 90° of external rotation at 90° of abduction (90°ER/ABD)) and three upper-extremity functional performance tests (YBT-UQ, CKCUEST and SMBT) were assessed. A Pearson’s test and a stepwise multiple linear regression analysis were used to determine possible associations and relationships between outcome measures, respectively. Results The analysis revealed that AJPS at 90°IR/ABD and 90°ER/ABD were the only proprioceptive variables with an association to the YBT-UQ and SMBT. Despite these relationships, only the AJPS at 90°IR/ABD was associated with the performance of the YBT-UQ in; superolateral direction (β = −0.7; 95% CI [−1.3 to 0.1]; p = 0.025); inferolateral direction (β = −1.5; 95% CI [−2.1 to −0.8]; p = 0.001); and composite score (β = −0.8; 95% CI [−1.3 to −0.3]; p = 0.002). From these, AJPS at 90°IR/ABD mainly explained the variability of YBT-UQ (inferolateral direction) performance (R2 = 0.32; %R2 = 0.32). Our findings allow for a possible expanded role for proprioception as a contributing factor in upper limb motor control during functional movements. Further research is required to explore and distinguish the associations between proprioception, motor control and sport performance involving the upper limbs.

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“…In addition, a loose connective tissue rich in hyaluronic acid (HA) occurs between the deep fascia and the underlying epimysium, which again allows the gliding between the muscles and the deep fascia [ 84 , 85 ]. Remarkably, changes in viscoelasticity of the deep fascial system, accumulation of high-molecular-weight (HMW) chains of HA, and altered mobility of fascial adjacent layers have been recently emerging as important causes of fascial nociceptor activation and thus as possible “pain generators” in the MPS [ 62 , 64 , 86 , 87 , 88 , 89 ].…”

Section: A Brief Overview Of the Human Fascial System And Its Role As...mentioning

confidence: 99%

“…In recent years, some papers discussed strong morphological and functional evidence for a nociceptive capacity of deep fascia and thus its contribution to various painful musculoskeletal conditions [ 58 , 60 , 61 , 62 , 63 , 64 ]. Clinical trials on healthy human volunteers demonstrated that electrical high-frequency stimulation of TLF or injection of pain-inducing substances into the TLF evokes long-term potentiation-like pain amplification while generating pain sensations that are more intense and unpleasant when compared to subcutaneous and muscular tissue [ 58 , 104 , 105 , 106 , 107 ].…”

Section: A Brief Overview Of the Human Fascial System And Its Role As...mentioning

confidence: 99%

“…In this regard, it is worthy of mentioning that compared to the underlying muscles, the fascial tissue shows a greater innervation with multiple sensory nerve fibers including those with nociceptive capability [ 57 , 58 , 59 ]. Thus, the fascial system is recently, though gradually, emerging as a major contributor in the pathogenesis of musculoskeletal pain and dysfunctions including MPS [ 58 , 60 , 61 , 62 , 63 , 64 ].…”

Section: Introductionmentioning

confidence: 99%

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Molecular Mechanisms Underlying the Pain-Relieving Effects of Extracorporeal Shock Wave Therapy: A Focus on Fascia Nociceptors

Ryskalin

Morucci

Natale

et al. 2022

Life

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In recent years, extracorporeal shock wave therapy (ESWT) has received increasing attention for its potential beneficial effects on various bone and soft-tissue pathologies, yielding promising outcomes for pain relief and functional recovery. In fact, ESWT has emerged as an alternative, non-invasive, and safe treatment for the management of numerous musculoskeletal disorders, including myofascial pain syndrome (MPS). In particular, MPS is a common chronic painful condition, accounting for the largest proportion of patients affected by musculoskeletal problems. Remarkably, sensory innervation and nociceptors of the fascial system are emerging to play a pivotal role as pain generators in MPS. At the same time, increasing evidence demonstrates that application of ESWT results in selective loss of sensory unmyelinated nerve fibers, thereby inducing long-lasting analgesia. The findings discussed in the present review are supposed to add novel viewpoints that may further enrich our knowledge on the complex interactions occurring between disorders of the deep fascia including changes in innervation, sensitization of fascial nociceptors, the pathophysiology of chronic musculoskeletal pain of MPS, and EWST-induced analgesia. Moreover, gaining mechanistic insights into the molecular mechanisms of pain-alleviating effects of ESWT may broaden the fields of shock waves clinical practice far beyond the musculoskeletal system or its original application for lithotripsy.

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Fascia Mobility, Proprioception, and Myofascial Pain

Cited by 43 publications

References 53 publications

Fascial Innervation: A Systematic Review of the Literature

Fascial Innervation: A Systematic Review of the Literature

Role of active joint position sense on the upper extremity functional performance tests in college volleyball players

Molecular Mechanisms Underlying the Pain-Relieving Effects of Extracorporeal Shock Wave Therapy: A Focus on Fascia Nociceptors

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