International Journal of Therapeutic Massage & Bodywork (IJTMB)
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The Architecture of the Connective Tissue in the Musculoskeletal System - An Often Overlooked Functional Parameter as to Proprioception in the Locomotor Apparatus
Get PDFThe architecture of the connective tissue, including structures such as fasciae, sheaths, and membranes, is more important for understanding functional meaning than is more traditional
anatomy, whose anatomical dissection method neglects and denies the continuity of the connective tissue as integrating matrix of the body. The connective tissue anatomy and architecture exhibits two functional tendencies that are present in all areas of the body in different ways and relationships. In body cavities, the “disconnecting” quality of shaping space enables mobility; between organs and body parts, the “connecting” dimension enables functional mechanical interactions. In the musculoskeletal system, those two features of the connective tissue are also present. They cannot be found by the usual analytic dissection procedures. An architectural description is necessary.
This article uses such a methodologic approach and gives such a description for the lateral elbow region. The result is an alternative architectural view of the anatomic substrate involved in the transmission and conveyance of forces over synovial joints. An architectural description of the muscular and connective tissue organized in series with each other to enable the transmission of forces over these dynamic entities
is more appropriate than is the classical concept of “passive” force-guiding structures such as ligaments organized in parallel to actively force-transmitting structures such as muscles with tendons.
The discrimination between so-called joint receptors and muscle receptors is an artificial distinction when function is considered. Mechanoreceptors, also the so-called muscle receptors, are arranged in the context of force circumstances—that is, of the architecture of muscle and connective tissue rather than of the classical anatomic structures such as muscle, capsules, and ligaments. In the lateral cubital region of the rat, a spectrum of mechanosensitive substrate occurs at the transitional areas between regular dense connective tissue layers and the muscle fascicles organized in series with them. This substrate exhibits features of type and location of the mechanosensitive nerve terminals that usually are considered characteristic for “joint receptors” as well as for “muscle receptors.”
The receptors for proprioception are concentrated in those areas where tensile stresses are conveyed over the elbow joint. Structures cannot be divided into either joint receptors or muscle receptors when muscular and collagenous connective tissue structures function in series to maintain joint integrity and stability. In vivo, those connective tissue structures are strained during movements of the skeletal parts, those movements in turn being induced and led by tension in muscular tissue. In principle, because of the architecture, receptors can also be stimulated by changes in muscle tension without skeletal movement, or by skeletal movement without change in muscle tension. A mutual relationship exists between structure (and function) of the mechanoreceptors and the architecture of the muscular and regular dense connective tissue. Both are instrumental in the coding of proprioceptive information to the central nervous system
Communicating About Fascia: History, Pitfalls, and Recommendations
Get PDFThe modern reader and author need to be aware of possible ambiguities and misunderstandings stemming from different meanings of the word “fascia” because the general meaning
of the term can be so vague as to imply little more than some form of connective tissue. “Fascia” encompasses both loose and dense, superficial and deep, and multiple- and single-layered connective tissues. To foster communication, we here suggest twelve specific terms to describe specified aspects of fascial tissue:
• Dense connective tissue
• Areolar connective tissue
• Superficial fascia
• Deep fascia
• Intermuscular septa
• Interosseal membrane
• Periost
• Neurovascular tract
• Epimysium
• Intra- and extramuscular aponeurosis
• Perimysium
• Endomysiu
IN-CAM Outcomes Database - Its Relevance and Application in Massage Therapy Research and Practice
Get PDFOne of the most commonly used Complementary and Alternative Medicine (CAM) modalities in North America is Massage Therapy (MT). Research to date indicates many potential health benefits of MT, suggesting that ongoing research efforts to further elucidate and substantiate preliminary findings within the massage profession should be given high priority. Central to the development of a sound evidence base for MT is the use of valid, reliable, and relevant outcome measures in research and practice in assessing the effectiveness of MT. The purpose of this article is to introduce MT researchers and massage therapists interested in using outcome measures in research and clinical practice to the IN-CAM Outcomes Database website by: 1) describing the Outcomes Database, and 2) identifying its utility in MT research and practice. The Database is a centralized location where information on outcomes measures is collected and made accessible to users. Outcome measures are organized in the database within the Framework of Outcome Domains. The Framework includes health domains relevant to conventional medicine and CAM, and health domains that have been identified as important to CAM interventions. Users may use the website to search for information on a specific outcome measure, facilitate planning of research projects, and engage in discussions with other users and members of the CAM research community related to outcomes assessment in the CAM field. As the MT profession continues to evolve and move towards an evidence-informed practice, the IN-CAM Outcomes Database website can be a valuable resource for MT researchers and massage therapists
