To borrow from my recent presentation at the Australian Fascia Symposium, we all know we need to move, but how much is too much and how much is too little? Leon Chaitow (2012) described the basis of musculoskeletal dysfunction as either/or a combination of “overuse, misuse, disuse or abuse”, so today we’re going to focus on disuse as the effects can be quite devastating to our fascia…..
So what exactly happens to our fascia when we don’t move? What are the implications for a workforce that is increasingly sedentary? I’ve been fortunate enough to be allowed to continue working during the COVID-19 restrictions, and I would have to say that a higher proportion than ever before of my clients’ symptoms can be attributed to a lack of movement in working from home.
Helene Langevin (2011) reminds us “when fascia is excessively mechanically stressed, inflamed or immobile, collagen and matrix deposition becomes disorganised, resulting in fibrosis and adhesions”. This was clearly demonstrated in studies examining individuals with chronic low back pain with reduced gliding potential – or shear strain – between fascial layers and 25% greater thickness of the thoracolumbar fascia than “normals”.
This is also graphically demonstrated in the following pictures from the seminal work of Järvinen et al from 2002. Picture A illustrates the orientation and distribution of collagen fibres in normal healthy fascia. We can appreciate the collagen fibres running in three different, distinguishable orientations as separate entities in normal perimysium (at very high magnification). In Picture B, the perimysial fibre network is obliterated. The different orientations of the collagen fibres cannot even be differentiated from each other! What’s more shocking is that it took a mere three weeks to go from A to B! (Taken from Organization and distribution of intramuscular connective tissue in normal and immobilized skeletal muscles. Järvinen et al. Journal of Muscle Research and Cell Motility. 23:245-254. 2002).
