FASCIAL MANIPULATION AND FIBROBLASTIC ACTIVITY
"The human body must be considered as a functional unit, where every area is in communication with another through the fascial continuum, consequently originating perfect tensegritive equilibrium... The fibroblasts represent the foundation of the fascial system, a structure of connective tissue that covers and affects every body area... and are an invaluable instrument, essential to the understanding of the therapeutic effects of osteopathic treatment."
In September of last year, the journal Evidence-Based Complementary and Alternative Medicine carried the Italian study called Understanding Fibroblasts in Order to Comprehend the Osteopathic Treatment of the Fascia. I am not going to spend a great deal of time on the anatomy of FASCIA, as much of it in this article is quite detailed, not to mention that fact that I have covered much of it on my site. I am, however, going to talk a bit about a type of cell called Fibroblasts, and their relationship to the tissue known as Fascia.
Any time you hear the word "blast," think builder. In other words, Fibroblasts "build" fibrous tissues. They are a form of metabolically active stem cell that are responsible for building and maintaining the bulk of the body's framework via excretion of the materials that become COLLAGEN FIBERS, HYLURONIC ACID (HA), Reticular Fibers (fibers that crosslink together into a very fine mesh), a number of different Gellatinous Glycoproteins that make up what is known as the Extracellular Matrix, Elastic Fibers such as Elastin (Elastin can stretch half again it's own length and then return to normal), along with others.
According to this paper, the whole purpose of Osteopathic Treatment of people with various forms of FASCIAL ADHESIONS is to, "allow the various layers of the connective system to slide over each other." Some of the problems they immediately mention as being associated with loss of function in the Fascia (most particularly, the Fibroblasts) include...
Fascia's "communication" abilities are interesting in light of what the STECCOS (Italian Physicians who are possibly the world's foremost experts on the tissue) have determined about the relationship between the Fascial System and the Acupuncture Meridians. "A characteristic of the fascia that is supposed to affect the expression of movement is the ability to carry electrical activity. The collagen proteins have semiconductive, piezoelectric, and photoconductive properties, in vitro; therefore, the fascial continuum is theorized to produce and distribute electrical activity through the extracellular matrix. The fascial system is supposed to be electrically activated, similar to some neuronal patterns...." Plainly stated, "The fascia becomes an organ that can affect an individual’s health." None of this is really news to those who have studied it.
After saying that EPIGENETIC EVENTS affect Fascial health, the authors state that, "The mechanical environment [of Facia] can be directly affected by the fibroblasts, thanks to their ability to control and modulate the extracellular matrix, which indirectly determines the function of the different systems dealing with the fascial continuum. The fibroblasts and the extracellular matrix are closely related to each other through some contact proteins, such as the integrins; the amount of elements composing the extracellular matrix varies depending on tensional information. This relationship can be noxious when there is excessive tension, developing fibrosis, or it can remain functional, increasing the sustainability of the mechanical forces, through a correct viscous and elastic environment."
The authors then mention Fibrosis, which is the same thing that I often refer to as microscopic "SCAR TISSUE" with my patients. If you really want to understand how certain "Epigenetic Events" (chiefly INFLAMMATION) affect Fascia, you need to read these posts (HERE, HERE, HERE, and HERE). In case you have not figured it out, CHRONIC INFLAMMATION not only causes sickness and disease, but it causes dysfunction and Chronic Pain as well. This is probably why some of the most brilliant scientists and physicians of our era are saying that problems in the Fascia are the root of almost every single health issue you can name --- not to mention most you can't (HERE).
The thing you need to remember is that not all Inflammation is bad. While we certainly do not want "Systemic Inflammation" coursing through our systems, "Local Inflammation" is of critical importance for healing injuries, whether large or minute. "Multiple cytokines, chemokines, and prostanoids [all of these would be considered to be the chemicals we refer to as "Inflammation," with a number of others being mentioned later in the paper] are synthesized. The fibroblasts play a significant active role in stimulating inflammatory processes, because they are responsible for a suitable cleaning, repair, and replacement of the elements of the fascial continuum that have been and are affected by traumas resulting from daily use. These fibroblastic characteristics aim to ensure a correct performance in managing the tension, perceived and produced."
Before talking about the various CONTRACTILE LAYERS of Fascia, and after mentioning HA ("Hyaluronic acid acts as a lubricant, and its quantity affects the temperature among the fibroblasts. According to research, some specific fibroblastic cells, called fasciacytes, supposedly produce hyaluronic acid, ensuring an optimal viscous and elastic environment") and the fact that, "The fibroblasts contain receptors for the growth hormone (GH), and depending on the levels of growth hormone circulating they can secrete insulin-like growth factors (IGFs). The IGF is a molecule characterized by multiple activities, such as facilitating tissue repair and influencing the metabolic environment," they talk a bit more about pain.
Listen to the way that the Fibroblasts in Fascia are said to modulate pain responses. "There is a close relationship between the endocannabinoid or endorphin system and the fibroblasts. The cannabinoid receptor or CB1 is mainly housed in the nervous system, but it can be found in the fascial system and in the fibroblasts as well, particularly near the neuromuscular junction. This relationship is believed to better manage any inflammation and pain information originating in the fascial tissue, as the fascia undergoes continuous remodeling during the day." This is why SMOKING WEED (cannabis), while probably better than some of the therapies I will mention shortly, is still just covering symptoms without addressing underlying causes.
WHAT ALL OF THIS MEANS IN TERMS OF TREATING
Dr. Schierling completed four years of Kansas State University's five-year Nutrition / Exercise Physiology Program before deciding on a career in Chiropractic. He graduated from Logan Chiropractic College in 1991, and has run a busy clinic in Mountain View, Missouri ever since. He and his wife Amy have four children (three daughters and a son).