target with the application of various soft-tissue therapies should not be the “muscle” as is commonly believed, but rather the ab-errant reorganization of the surrounding connective tissues/fascia where the fibrosis occurs. You might be wondering why the intended tissue makes a dif-ference? It would be easy to assume that the soft-tissue thera-pies currently being utilized have been working on the fascia all along. However, this assumption is incorrect. This is because the research that has been performed on this amazing tissue demon-strates that it does not respond in the same manner as muscular tis-sue. Thus many changes in soft-tissue application must be made in order to expect permanent, favourable changes in fascial structure with soft-tissue application. Although it would be out of the scope of this article to review all of the literature concerning the responses of fascial tissue to load application, we can generalize that it seems the application of the load must be delivered for much longer periods than many current treatment approaches afford. As such, new treatment approaches have been created to incorporate all that is known regarding the responses of fascial tissue.* have been specifically developed based on this research in order to effect favourable changes in fascia composition and mechanics. However, as always, further clinical and scientific research needs to be done to confirm and support the concepts presented. • *One such treatment approach, Functional Range Release™, a system created by the author, was developed in the context of the cur-rent literature available on this important tissue. CONCLUSION The current research available on fascia has demonstrated the sig-nificance of this tissue in various body functions, not the least of which is its effect on movement and biomechanics. It has also dem-onstrated that injury can lead to alterations of fascial tissue, which can significantly hinder movement and contribute to the develop-ment of pain symptoms. New techniques of soft-tissue application REFERENCES • van der Wal, J. The Architecture of the Connective Tissue in the Mus-culoskeletal System – An Often Overlooked Functional Parameter as to Proprioception in the Locomotor Apparatus. International Journal of Therapeutic Massage and Bodywork 2009; 2(4):1-15. • Kawamata, S, Ozawa, J, Hashimoto, M, Kurose, T, and Shinohara, H. Structure of the rat subcutaneous connective tissue in relation to its sliding mechanism. Archives of Histology & Cytology 2003; 66(3):273-279. • McCombe, D, Brown, T, Slavin, J, and Morrison, WA The histochemi-cal structure of the deep fascia and its structural response to surgery. Jour-nal of Hand Surgery, British and European Volume 2001; 26B(2):89-97. • Wilson, IF , Schubert, W , and Benjamin, CI. The distally based radial forearm fascia-fat flap for treatment of recurrent de Quervain’s tendon-itis. Journal of Hand Surgery 2001; 26:506-509. • Kragh, JF , Jr., Svoboda, SJ, Wenke, JC, Brooks, DE, Bice, TG, and Wal-ters, TJ. The role of epimysium in suturing skeletal muscle lacerations. Journal of the American College of Surgeons 2005; 200:38-44. • Humphreys BK, Nevin S, Hubbard BB. Investigation of connec-tive tissue attachments to the cervical spinal dura mater. Clin Anat 2003;16(2):152-9. www.canadianchiropractor.ca CANAdiAN CHiROpRACTOR | MAY 2011 • 29
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