The connective and myofascial system


The connective and myofascial system

In about 4 billion years of life on this planet, humans have evolved as aggregates of about 6 trillion four different types of cells dispersed within a fluid element: nerve cells, specialized in conduction, muscle cells specialized in contraction, epithelial cells specialized in secretion (enzymes, hormones, etc.) and connective cells. What needs to be considered is that connective cells create the environment for all other types of cells, building both the scaffolding that holds them together and the communication network between them. The connective tissue is actually a real system, this time fibrous, which connects all the various parts of our body. It forms an ubiquitous network, with a tensegrity structure, which envelops, supports and connects all the functional units of the body, participating in an important way in the general metabolism. The physiological importance of this tissue is actually greater than is normally assumed. But not only that, today we know that, through specific membrane proteins (integrins), the connective system is able to interact with cellular mechanisms such as cell adhesion and cell migration, cell growth and division, survival, apoptosis and cell differentiation, support for immune system etc. (Hynes R, 2002).
We are faced with a real continuous and dynamic supramolecular network that extends into every corner and body space composed of a nuclear matrix internal to a cellular matrix immersed in an extracellular matrix. Unlike the networks formed by the nervous, endocrine and immune systems, the connective system presents a perhaps apparently more archaic but certainly no less important method of communication: the mechanical one. It “simply” pulls and pushes, thus communicating from fiber to fiber, from cell to cell and from internal and external environment to the cell and vice versa, through the fibrous weft, the fundamental substance and sophisticated mechanical signal transduction systems. In addition to this it should be remembered that any mechanical force capable of generating a structural deformation stresses the inter-molecular bonds producing a slight electric flux, that is the piezoelectric current (Athenstaedt, 1969). In such cases, the collagen fibers of the connective tissue distribute the positive charges on their convex surface and the negative ones on the concave one, thus transforming into semiconductors (they allow the flow of electrons on their one-way surface). This represents a three-dimensional and real-time communication system connective-cell system through electromagnetic bio-signals capable of involving important biochemical changes; for example, in bone, osteoclasts cannot "digest" piezoelectrically charged bone (Oschman, 2000). As a component of the ECM (extracellular matrix) the connective system physically and physiologically supports the other organic networks. It is in the crystal of the connective system that our global state is determined and recorded.
Among the various types of connective tissue (connective tissue proper, elastic tissue, reticular tissue, mucous tissue, endothelial tissue, adipose tissue, cartilage tissue, bone tissue, blood and lymph), the connective fascia is of particular interest from a postural point of view.
The connective and myofascial systemTaking a cue from the schematization proposed by F. Willard (2007), we can consider the band divided into approximately four layers forming longitudinal cylinders which are concentric interconnected.






1) The outermost layer / cylinder covering the whole body and present under the dermis, represents the superficial fascia. The superficial fascia is composed of loose connective tissue (subcutaneous in which there may be a weave of collagen and above all elastic fibers) and adipose (therefore its thickness, as well as its location, depends on our diet). Through fibers, this fascia forms a continuum with the dermis and epidermis outwards and, at the same time, anchors itself to the underlying tissues and organs. The superficial fascia represents an important storage site for water and fat, protects from deformations and mechanical and thermal insults (insulating layer), is a passageway for nerves and blood vessels and allows the skin to slide over the deep fascia. Like the deep fascia it has little vascularization.


The connective and myofascial system2) Under the superficial fascia there is the deep fascia, also called cervico-thoraco-lumbar, which represents a rather cohesive cylindrical layer around the body (trunk and limbs). It is made up of irregular dense connective tissue, formed by wavy collagen fibers and elastic fibers (arranged in a transverse, longitudinal and oblique pattern) and forms a membrane that covers the external muscular part. This sheath covers the body extending from the skull, at the level of the margin of the jaw and the cranial base with which it is fused, from here it goes towards the upper limbs (until it merges with the superficial fascia at the level of the retinacles of the palm of the hand) and anteriorly it passes under the pectoral muscles, covers the intercostal muscles and the ribs, the abdominal aponeurosis and connects to the pelvis. The deep fascia turns posteriorly connecting to the transverse processes and then to the vertebral spinous processes thus forming two compartments (right and left) containing the paravertebral muscles.
At the level of the sacrum, this fascia forms an unbearable "knot" (as it is fused with the bone) in which the various fascial compartments of the body converge and from which the portion of the deep fascia that runs through the lower limbs departs merge with the superficial fascia, at the level of the sole of the foot in the retinacles of the talus.
A distinctive feature of the deep fascia is that of forming structural and functional compartments, that is, containing certain muscle groups with specific innervation. The compartment also confers specific morpho-functional characteristics to the muscle: a muscle that contracts inside a sheath develops a pressure that supports the contraction itself. The transversus abdominis muscles constitute the active part of the thoraco-lumbar fascia.
At the level of the single muscle, the deep fascia continues, through the septa, the aponeuroses and the tendons (formed by parallel and almost completely inextensible collagen fibers), with the muscular fascia constituted by the epimysium (fibro-elastic connective tissue that covers the whole muscle) which extends into the muscle belly forming the perimysium (loose connective tissue that lines the muscle fiber fascicles) and the endomysium (delicate connective lining of the muscle fiber).



In physiological conditions, these septa and coatings allow the sliding of the muscle fibers as well as their nourishment. This fascia is directly linked both anatomically and functionally to the neuromuscular spindles and to the Golgi tendon organs (Stecco, 2002).
Like the superficial fascia, the deep fascia is poorly vascularized and provides passageways for nerves and vessels. The deep fascia is of enormous postural and spinal protection importance (Chetta, 2010).
The cylinder consisting of the deep fascia contains two further longitudinal cylinders placed one behind the other and forming, the anterior one, the visceral fascia and the posterior one the meningeal





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