As we start to consider the fascia, it is natural for us to view this tissue as the ‘glue’ that holds the body together, or the physical substance connecting and creating structure in the body. But the more we study and understand the fascia, the more it challenges our preconceptions. Fascia is not simply an inert structure connecting the muscles, tendons, ligaments and bones of the body – it plays a role in pain perception and creation.
‘When you deal with the fascia you are doing business with the branch offices of the brain.’ (Andrew Taylor Still, the father of osteopathy).
Fascia has six to ten times the number of nerve endings or innervation than muscle tissue. It is our largest sensory and feedback organ and is involved in both proprioception and nociception.
But it is certainly not simple – different kinds of fascia are innervated differently, depending on their density, structure and function.
Some nerve endings that have been identified in the fascia are:
- Ruffinian bodies in the aponeurosis
- Pacinian bodies, in the visceral fascia especially
- Golgi tendon organs in tendons and ligaments
- Interstitial nerves (nociceptors)
- Free nerve endings (nociceptors)
- C-fibres (nociceptors)
The large number of pain receptors available in the fascia may have a role to play in the development of chronic pain syndromes. Painful conditions may also be localized in many cases to the fascia rather than to the muscle tissues, as has been previously assumed.
Fascial pain
Pain in the fascial network is generally considered to have a delayed onset, to be spread over a large area, and to include more than one body segment. It may also occur in a different area or body segment to the original or primary injury.
Over time, fascial pain will spread locally and to more distant areas of the body within the same fascial chain.
Sympathetic nervous system
While the number of nerves in the fascial system greatly surpass the number of nerves in muscle tissue, sympathetic efferent nerve endings are the only kind found in the fascia.
This highlights the connection between the fascia and stress, fear or pain – a connection many of us may have personally experienced. In times of stress, many people will find that their shoulders and neck become tight and painful, and over time headaches can result.
In horses, this connection between stress and fear and the fascial system of the body is also understood from our experience – a fearful or stressed horse will carry the head and neck high and the back dropped, and a disconnect will occur between the front and hindlimbs. We will often palpate pain, hypertonicity and muscle atrophy in these horses in areas such as the back, hindquarter and brachiocephalic region.
Keep learning about fascia
If you want to keep expanding your knowledge and understanding of the fascia, join us live at the Vet Rehab Summit 2023 on the 10th and 11th of November, which is all about myofascial chains.
Vibeke S. Elbrønd and Rikke M. Schultz, authors of Equine Myofascial Kinetic Lines for Professionals, will join us live for 11 hours of fascinating lectures.
At this year’s Vet Rehab Summit 2023, expect:
10 November
- Understanding the fascia from a 3D perspective, Vibeke S. Elbrønd
- The anatomy and function of the fascial lines, Rikke M. Schultz
- Functional testing of the fascial lines (SDL, SVL, LL, DDL, DVL), Vibeke S. Elbrønd
- Local treatment of the fascial lines (SDL, SVL, LL, DDL, DVL),Vibeke S. Elbrønd
11 November
- Functional testing of the fascial lines (frontlimb lines, SL, FL), Rikke M Schultz
- Local treatment of the fascial lines (frontlimb lines, SL, FL), Rikke M Schultz
- Understanding your canine patient from a fascial perspective, Vibeke S. Elbrønd
- Understanding your equine patient from a fascial perspective, Rikke M. Schultz
Purchase your ticket to attend the Vet Rehab Summit 2023 now.
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