Healthcare and Medicine Reference
In-Depth Information
Fig. 1.14 (A) The collagen molecules, manufactured in the
fibroblast and secreted into the intercellular space, are polarized
so that they orient themselves along the line of tension and create
a strap to resist that tension. In a tendon, almost all fibers line up
in rows like soldiers. (Reproduced with kind permission from
Juhan 1987.) (B) If there is no 'prevailing' tension, the fibers orient
willy-nilly, as in felt. (Reproduced from Kessel RG, Kardon RH. WH
Freeman & Co. Ltd; 1979.)
conditions that re-impinge on local conditions in an
unending recursive process. 3 3 Understanding of the
myofascial meridians assists in organizing the search
for both the silent culprit and the necessary global
decompensations - reversing the downward spiral of
increasing immobility.
More serious deformations of the fascial net may
require more time, remedial exercise, peri-articular
manipulation (such as is found in osteopathy and chi-
ropracty), outside support such as orthotics or braces,
or even surgical intervention, but the process described
above is continual and ubiquitous. Much restoration of
postural balance, whether via the Anatomy Trains
scheme or any of the other good models currently avail-
able, is attainable using non-invasive techniques. A
preventive program of structural awareness (call it 'kin-
esthetic literacy') could also be fairly easily and produc-
tively incorporated into public education. 34-3 7
In order to build a new picture of the ECM acting as
a whole, and with these prefatory concepts in place, we
are now ready to frame our particular introduction to
fascia within three specific but interconnected ideas:
• physiologically by looking at it as one of the
'holistic communicating systems';
• embryologically through seeing its 'double bag'
arrangement;
• geometrically through comparing it to a 'tensegrity'
structure.
These metaphors are presented in general terms - in
other words, the skeleton is there, but there is no space
to flesh them out fully and still attend to our primary
purpose. For the more scientifically minded, we note
Fig. 1.15 A dissection of the superficial pectoral fascia in the
sternal area. Notice how one leg of the evident 'X' across the
sternum, from upper right to lower left in the picture, is more
prevalent than the other, almost certainly as a result of use
patterns. (Reproduced with kind permission from Ronald
Thompson.)
be it from the chest, belly, hips, or elsewhere, will need
lengthening first, and the structures beneath it rear-
ranged to support the body in its 'new' (or more often
'original', natural) position.
In other words, we must look globally, act locally, and
then act globally to integrate our local remedies into the
whole person's structure. In strategizing our therapy in
this global-local-global way, we are acting exactly as the
ECM itself does, as we will explore below in the section
on tensegrity. Connective tissue cells produce ECM in
response to local conditions, which in turn affect global
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