Definition of Fascia Explored
Creating a new language for fascia so that all healthcare practitioners can agree and communicate is difficult. There is no other structure that creates such controversy, diverse definitions, or confusion.
The science of Classifying Fascia
There are several types of fascia in the body so using the term fascia by itself can ambiguous.
Defining the location and direction of the fibers may lead to precise treatment and replicable findings. This model is an adequate learning tool but overlooks the fascia is not segmented like muscles, it is instead one continuous structure.
The segmented model of medicine is so ingrained in healthcare practitioners and individuals it makes classifying fascia difficult. Often impossible for most to mentally and visually accept fascia in one continual network of tissue.
Langevin etc. al. made a distinction between twelve terms to describe either the location of the fascia or specified aspects of the fascia using ultrasound diagnostics.
Twelve specific terms to describe specified aspects of fascial tissue:
- Dense connective tissue
- Areolar connective tissue
- Superficial fascia
- Deep fascia
- Intramuscular septa
- Interosseal membrane
- Neurovascular tract
- Intramuscular and extramuscular aponeurosis
Let’s take a look at the most familiar terms.
- Dense connective tissue – contains collagen fibers closely packed, irregularly arranged
- Areolar – is loosely and irregularly arranged collagen fibers
- Superficial fascia – is the fascia layer beneath the skin containing dense, areolar connective tissue and fat.
- Deep fascia – is a continuous sheet of mostly dense, irregularly arranged connective tissue that limits the changes in the shape of underlying tissues, the deep fascia may be continuous with epimysium and intramuscular septa and can contain layers of areolar connective tissues.
Kumka, MD. Ph.D. and Bonar created a model to classify fascia into Four Categories.
- Linking Fascia – dense, regular, parallel, ordered, unidirectional connective tissue proper with collagen type 11. Linking fascia includes fascia of muscles, aponeurosis, tendinous arches, and neurovascular sheaths.
- Dynamic – movement
- Passive – maintains continuity
- Fascicular Fascia – forms adaptable tunnels within muscle, tendon, bone, and nerves. Fascicular fascia plays an important role in organization, transport, strength, and locomotion
- Compression – significant in the role of locomotion and venous return. Compression provides tension
- Separating Fascia –divides the body into visible sheets and layer of varying fibers to absorb forces and disperse friction in all directions, allows for efficient sliding of tissues over one another
The Fascia Training Institute’s (FTI) definition defined on clinical observation and experience of function. The primary goal is to produce results and take away the pain.
FTI understands that the fascia is inseparable from all structures, it creates continuity, communication, enhances function and support. Fascia is the fabric that holds the body together. Similar to the energy or the dark space the holds the stars and the universe in position. This space allows for movement and change but maintains the balance, the location of all others stars, planets. The fascia maintains balance in the organs, cells, and atoms. FTI believes this space is where the essence of the soul/body exists.
Understanding fascia is essential to comprehending function, performance and why there can be lingering pain or dysfunction after surgery, injury or trauma. Creating a universal language of terms and definitions will help practitioners communicate with patients and each other with clarity. This clarity is essential if fascia therapy is to become a recognized standard for the treatment of injuries, concussion, and pre and post-surgical events.
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If you missed our last blog on concussion and fascia please visit. https://www.simonefortier.com/blog/
The Fascia Training Institutes offers a more extensive review of the function of fascia in courses and workshops. https://www.fasciatraininginstitute.com/