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

Figure 2.4
The multilayer organization of deep axial fascia (DF). (Adapted from Stecco C et al. 2009.)
• Trunk/torso: the superficial layer of the DF is thinner than that found in the
limbs (except for the thoracolumbar fascia – TLF). In some areas this thin
layer envelops the underlying muscles (meaning there is no distinct
epimysium). This presentation is seen in conjunction with the pectoralis
major, latissimus dorsi, trapezius, deltoid and gluteus maximus and
functionally serves as a means to connect the limbs to the trunk/torso. In this
presentation the fascia and muscles move (or not) together (hence the greater
potential for undifferentiated movement patterns in the trunk/torso).
• Limbs: in general the DF of the limbs is not very elastic, although the upper
limb contains more elastin than the lower (providing greater tissue compliance
or a wider range of movement). In the limbs there is a sliding layer between
the DF and underlying epimysium. The DF and underlying muscles can
therefore move independently of one another and when they do not –
pain/dysfunction often ensue. This particular presentation supports force
transmission and perhaps the greater variety of movement potential seen in the
limbs (in comparison to the trunk/torso) (Stecco et al. 2008, Stecco et al.
2011).
Functional Classification
According to Kumka and Bonar (2012), the functional properties of fascia are
reliant on the composition of the ECM, specific cells and filaments, including
but not limited to the ratio of collagen types.
Kumka and Bonar (2012) suggest four primary functional categories: linking;
fascicular; compression; and separating (see Table 2.2).