Fascia and the Extra-Cellular Matrix

Fascia | from https://www.anatomytrains.com

Fascia is the biological fabric that holds us together. You are about 70 trillion cells all humming in relative harmony; fascia is the 3-D spider web of fibrous, gluey, and wet proteins that hold them all together in their proper placement.

How fascia works as a whole – our biomechanical regulatory system – is highly complex and under-studied

increasingly in scientific and research circles and professionals worldwide, ‘fascia’ has a wider definition: all the collagenous-based soft-tissues in the body, including the cells that create and maintain that network of extra-cellular matrix (ECM). 

Expanded definition of Fascia:

That definition includes all the tissues traditionally designated as ‘fascia’ in classical anatomy, plus all the other very similar tissues arrayed in different ways around the body; tendons, ligaments, bursae, and all the fascia in and around the muscles – endomysium, perimysium, epimysium.

Also included would be the fascia around the organs:

  • the coelomic bags that hold the organs in the peritoneum and mesentery in your abdominal cavity,
  • the mediastinum, pericardium, and pleura that hold the organs in the chest cavity, and
  • the membranes – dura and pia and perineuria – that surround the brain, spinal cord, and peripheral nerves.

That expanded definition usually does not include the harder tissues – cartilage and bone – but there is an argument that both these tissues lie within the spectrum of ‘fascial’ tissues.  

You would need a large shopping cart to purchase all the materials you would need to make a body, but connective tissue manages to build all of them – strings, wires, elastics, sheets, sacs, insulating material, bushings, struts, and springs – your connective tissue cells wrestle all of these from three simple elements: water, gels, and fibers.

This process of manufacturing connective tissue is defective when we have the genetic mutation(s) at the root of EDS.

However you define it, fascia is everywhere – top to toe, birth to death, micro to macro. The expanded definition emphasizes two elements:

1) Fascia is one network, embryologically and anatomically.  All these different names we give elements within it – this tendon or that ligament – can tend to hide the fact that it is all one connected system.

2) it is our dissection method – analyzing the body by means of a blade – that separates, creates individual structures that we name. Therefore our western science way of understanding the body – cutting it into smaller and smaller parts – has led to great discoveries, but it tends to destroy important connections, and otherwise ignore the whole system responses of the collagenous net.

Our single fascial system starts about 2 weeks into development as a fibrous gel that pervades and surrounds all the cells in the developing embryo. It is progressively folded by gastrulation and the rest of the motions of development into the complex layers of fascia we see in the adult.

Our collagenous network, often called the ‘extra-cellular matrix’ (ECM), is made up of intercellular elements.

Emphatically: these fibers and gels are not cellular in themselves; they are cell-products.

Manufactured by cells and extruded into the intercellular space, they organize themselves – depending on the forces that go through them – into dense or loose tissues, with regular or irregular (felt-like) arrangement.

These arrangements can and do change when the forces acting on those tissues change – either positively in skill-building or negatively in injury or aging.  

Genetics determine only what proteins are able to be manufactured;

Here is where Ehlers-Danlos does its damage. Our collagen (a protein) is not manufactured correctly and ends up defective.

the local environment of how you use your body determines how they are arrayed from day to day.

‘ECM’ is not quite a substitute for our new expanded definition of fascia, because the ECM does not include the cells, and ‘fascia’ would definitely include the fibroblasts, mast cells, and various other cells (like osteoblasts, chondroblasts, osteoclasts, etc.) that create, maintain, and break down the ECM

Many people with EDS also have problems with mast cells and this could be the connection.

If we could magically make everything invisible except the collagen network,

  • we would see dense leathery mesh in the bones, cartilage, tendons, and ligaments.
  • We would see a very loose mesh in the breast, the cheek, and the pancreas.
  • Each muscle would be surrounded and invested with a looser (but still structurally strong) network.
  • Every bone would have a tough plastic wrap layer around the outside.
  • Every organ would be invested and then bagged in a fascial sac.
  • Only the open tubes of the digestive, respiratory, and lymphatic system would be utterly free of the fascial net.

 the fascial net responds and distributes forces as a whole not just locally,

This whole argument is not meant to denigrate the role of the muscles or the nerves – it is the neuromyofascial web acting as a whole that serves us from second-to-second in gravity and the other forces surrounding and affecting us. 

This whole “neruomyofascial web” can be defective due to EDS.

This will affect not just the obvious fragile and stretchy tendons and ligaments which lead to disloactions and subluxation, but also many inner organs.

Defects in this “neruomyofascial web” can affect even neurological functions, which could explain the link between EDS and anxiety.

It is now abundantly clear that fascia is part of the whole picture, and a part less studied than muscle or nerve, therefore the need to include it to get the complete picture. ‘Individual muscles acting on bones across joints’ simply does not adequately explain human stability and movement.

Once examined, the second element of fascial study becomes evident: fascia responds systemically as well as locally, and to understand this systemic response at its most basic level, we need to understand the geometry of tensegrity as applied to the body.

Tensegrity

Tensegrity is a portmaneau of ‘tension + integrity’. Buckminster Fuller, building on the highly original sculptures of Kenneth Snelson, coined the term, to indicate that the integrity of the structure derived from the balance of tension members,

every classroom skeleton you have ever seen is wired together; in the actual skeleton the bones float in a sea of soft-tissue.

Fascial continuity suggests that the myofascia acts like an adjustable tensegrity around the skeleton – a continuous inward pulling tensional network like the elastics, with the bones acting like the struts in the tensegrity mode

several unique features:

  1. Put strain into the structure, and the deformation is distributed all over the structure
  2. Expand the structure in one dimension and every dimension expands.
  3. Tensegrities can be built in hierarchies – each element of a tensegrity can be built of smaller tensegrities – making for the most efficient use of materials, an evolutionary imperative.

Research into fascia has shown how it works on many levels as a distributive network.

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