[libribook.com] Traumatic Scar Tissue Management 1st Edition

Clinical Consideration
The presence of higher than normal concentration of MFBs in injured and
scarred fascia further accentuates its ability to contract/influence tension
(e.g. contractures, fibrosis) resulting in subsequent pain and dysfunction.
It is suggested that MFBs also play a role in issues associated with decreased
myofascial tension or hypermobility (e.g. peri-partum pelvic pain due to pelvic
instability, sacroiliac joint force closure dysfunction or back pain due to spinal
segmental instability) (Schleip et al. 2012).
MFBs are also present in normal healthy fascia implying a valid – homeostatic –
functional purpose (Wilson & Dahners 1988, Murray & Spector 1999, Ralphs et
al. 2002). For example, MFBs provide fascia with the ability to remodel itself in
response to normal daily movement and activity demands (adaptation). Recall
from page 12: fibrocollagenous tissue morphology is shaped by tensional
loading. Demand (mechanical/tensile forces) invokes MFB proliferation and
therefore (normally) higher concentrations of MFBs are typically present in
dense presentations of fascia commonly subjected to higher tensional demands
(e.g. those that play a significant role in stability and support, fascia lata, plantar,
crural and thoroacolumbar fascia, perimysium).
Biomechanically, interactions between MFBs and the ECM contribute to whole
body mobility and tensional integrity or biotensegrity (Schleip et al. 2005,
Guimberteau 2007, Ingber 2008, Levin & Martin 2012).
Fibrous Proteins
Fascia is constructed from two predominant fiber types:
• Collagen
• Elastin.