Newsletter excerpts: Fascia, Myofascia and Trigger Points--Oct 2018

Michelle Burns
October 9, 2018

Here is some of the information I recently shared in my October newsletter. Each newsletter has a specific focus.  This month is focused on fascia, myofascia and trigger point information. If you would be interested in receiving my newsletters, please head over to my contact page and sign up.


I receive a weekly update on anything published anywhere on the internet that includes information about fascia, myofascia and trigger points.  I try to glean the best of the information and provide a brief synopsis of the information. If you come across any information that you think would be good to share, please also feel free to pass that information along to:

1.  An article, titled Three-dimensional mathematical model for deformation of human fascia in manual therapy by Chaudhry, Schleip, et al., and published in J AM Osteopath Assoc in 2008 concludes: the three-dimensional model’s equations revealed that very large forces, outside the normal physiologic range, are required to produce even 1% compression and 1% shear in fascia lata and plantar fascia. Such large forces are not required to produce substantial compression and shear in superficial nasal fascia, however. The palpable sensations of tissue release that are often reported by osteopathic physicians and other manual therapists cannot be due to deformations produced in the firm tissues of plantar fascia and fascia lata.

2.  An informative article, written by Kimberlie Landers of Swedish Medical Center, titled Fascia: The Mysterious Tissue-N2 Physical Therapy offers an in-depth and understandable review of the tissue. It discusses: What is fascia, how can it relate to or cause pain, and what can be done about dense fascia, including kinesio-taping, Graston, cupping, skin rolling, and a technique called The Stecco Method of Fascia Manipulation, which revolves around “Centers of Coordination”. 

3.  An article, written by the late Leon Chaitow and published in 2009 in Massage Today, titled Research in Water and Fascia: Micro-tornadoes, hydrogenated diamonds and nanocrystals references some information from previous articles:

  • The presence of contractile smooth muscle cells that are embedded in most connective tissues.
  • The extracellular matrix plays a key role in the transmission of forces generated by the organism or externally applied
  • Cell-matrix adhesion sites appear to host a “mechanosensory switch”
  • There appear to be forms of communication within the fascial matrix.

In this article, Mr. Chaitow discusses an article by Dr. Martin Grumble about the characteristics of water in the body and the creation of nanocrystals involved in protein folding.

4.  An article by Simeon Niel Asher, titled Understanding Trigger Points-Embryological Development of Fascia provides an overview of the embryological origin of connective tissues (which) may provide some insights into the formation and location of trigger points. 

5.  An article, Defining the fascial system published at the RMT Education Project, defines fascia as: …a sheath, a sheet, or any other dissectible aggregations of connective tissue that forms beneath the skin to attach, enclose, and separate muscles and other internal organs.  It also defines the fascial system: consists of the three-dimensional continuum of soft, collagen-containing, loose and dense fibrous connective tissues that permeate the body…

6.  An article by Ross Turchaninov and Boris Prilutsky, published at Science of Massage Institute, titled Ischemic Compression: To Be or Not to Be? Science of Trigger Point Therapy offers scientific support to explain the role of ischemic compression in increasing the blood supply to muscle and trigger point areas

7.  A very long article by Paul Ingraham published in Pain Science titled Trigger Point Doubts: a thorough review of the problems with the science of ‘muscle knots’ and myofascial pain syndrome discusses the sketchy science and dogma around the concept of trigger points.

8. A post by Dr. Leon Chaitow, published on LinkedIn on Dec 10, 2016, titled Telocytes: recently identified connective tissue cells summarizes the following information: 

  • Telocytes are recently identified connective tissue cells, functionally distinct from stem cells and fibroblasts, with possible roles in cell signaling tissue homeostasis, remodeling, and angiogenesis
  • Whereas fibroblasts generate the connective tissue matrix, specifically collagen, the function of telocytes appears to be intercellular signaling
  • Telocytes are ubiquitously distributed in the extracellular matrix of all tissue. Telocytes have telopodes, involved in intercellular communication with surrounding structure, such as blood vessels, nerve endings, smooth muscles, glandular elements, and covering epithelia, but direct homo- and heterocellular junction or extracellular vesicles.
  • Extracellular vesicles have many important roles in physiological processes, such as stem cell maintenance, tissue repair, immune surveillance and vascular hemostasis—carrying and releasing lipids, proteins as well as nucleic acids
  • Telocytes appear to be cellular mechano-transducers in smooth muscle tissue. Telocytes seem to sense and translate stretch information for the nucleus and activate genes responsible for protein synthesis—so influencing surrounding cells.
  • Telocytes appear to profoundly influence fascial function…and to possibly be involved in major pathologies when things go wrong..and tho have therapeutic potentials that remain to be identified and researched…
  • There seem to be major signaling features-mechanical, chemical—and based on some evidence-electrical.

9.  A brief discussion on the RMTEducation page, titled The effect of trigger point compression for acute low back pain reviews the results of a study from Japan: From a clinical perspective, myofascial trigger points certainly describe a phenomenon—aching spots, that seem to at least be partially helped by massage. The issue is that there is still uncertainty on the subject of trigger points (eg. what they are and the subjective nature of their identification). To help provide some insight and perspective for therapists, …a study out of Japan that looks at the effects of compression at myofascial trigger points in patients with acute low back pain—Nakamoto, K., Bit, I., Urakawa, S., Sakai, S., Kigawa, M., Ono, T., Nishijo, H. (2015) Effects of compression at myofascial trigger points in patients with acute low back pain: randomized controlled trial. Our J Pain 10, 1186-1196.

10.  An article, published in the European Journal of Histochemistry, and summarized on the fascial fitness Australia site shows: the presence of CB1 and CB2 receptors in fascial fibroblasts suggests their possible role in modulation of fascial pain. The fascial pain is usually related to a fascial inflammation and/or a fascial fibrosis, and both could be related to an alteration of the endocannabinoid system. …The authors also hypothesized a possibility that the endocannabinoid system inside the deep fasciae is stimulated during manipulative treatments and exercises.



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