Clinical Theory & Application
These articles are all about tracing the path from bench to bedside. They synthesize basic research findings about the neurofascia and they attempt reasonable extensions of those findings into clinical work.
• Application of Fascial Manipulation© technique in chronic shoulder pain—Anatomical basis and clinical implications (Day et al, 2009)
• A theoretical framework for the role of fascia in manual therapy (Simmonds et al 2010).
• Changes in the Structure of Collagen Distribution in the Skin Caused by a Manual Technique (Pohl 2008)
• Chronic headache relief after section of suboccipital muscle dural connections: A case report
• Referred Pain of Peripheral Nerve Origin: An Alternative to the “Myofascial Pain” Construct (Quinnter and Cohen 1994)
• Upper Limb Neural Tension and Seated Slump Tests: The False Positive Rate among Healthy Young Adults without Cervical or Lumbar Symptoms
• Understanding the process of fascial unwinding (Minasny, 2009)
Biomechanics & Force Modeling
We still know very little about how mechanical force moves through the fascial system, how nerves twist, stretch, and slide, and how fascia confers force onto nerve tissue. What happens to the sciatic nerve when you kick a soccer ball? How does fascia deform under a therapist’s hand? How much pull does the lumbodorsal fascia exert on the lumbar plexus nerves? Here’s a selection of free articles on neurofascial biomechanics.
• A three-dimensional mathematical model of the thoracolumbar fascia and an estimate of its biomechanical effect (Gatton et al 2010)
• Extramuscular myofascial force transmission for in situ rat medial gastrocnemius and plantaris muscles in progressive stages of dissection (Rijkelijkuizen et al 2004)
• Mechanics of crural fascia: from anatomy to constitutive modelling. (Stecco et al 2009)
• Shoulder Posture and median nerve sliding (Julius et al 2004)
• Shoulder Restraints as a Potential Cause for Stretch Neuropathies: Biomechanical Support for the Impact of Shoulder Girdle Depression and Arm Abduction on Nerve Strain (Coppetiers 2006)
• Strain and excursion of the sciatic, tibial, and plantar nerves during a modified straight leg raising test. (Coppetiers et al 2006)
• Three-Dimensional Mathematical Model for Deformation of Human Fasciae in Manual Therapy (Chaudhry et al 2008)
Mechanotransduction & the Nervous System
We used to think the nervous system didn’t care about its mechanical environment; that its physiology was more or less constant within a wide range of human movements and postures. We don’t think that anymore. Fascial structures like facet joints and retinacula, once thought “dumb”, may be important sensory organs. Things like action potential, axoplasmic flow, and chronic neuroinflammation are all modulated by mechanical stress. The question is, how much, and in what situations, and why should we care?
• Speed and temperature dependences of mechanotransduction in afferent fibers recorded from the mouse saphenous nerve (Milenkovic et al 2008)
• The relationship between the stomatognathic system and body posture (Cuccia and Caradonna 2009)
• Tensile stretching of cervical facet joint capsule and related axonal changes (Kallakuri et al 2007).
• Understanding Sensory Nerve Mechanotransduction through Localized Elastomeric Matrix Control (Lin et al 2009).
By its very nature, fascia has escaped our classification and visualization. In the last 10 years, major work has been done to elucidate the separations and continuities conferred by this amazing tissue. If we want to understand the nerve-fascia interface, we first need a solid sense of where the fascia is and what it’s shaped like.
• Anatomy and biomechanics of the vertebral aponeurosis part of the posterior layer of the thoracolumbar fascia (Loukas et al 2008)
Pectoral and femoral fasciae: common aspects and regional specializations. (Stecco et al 2009)