Kania's "Fascia" Lecture - Kathleen

Question 1

Fascia definition and components, according to Dr. Kenia

Answer 1

Fibrous connective tissue masses that binds together the structures of the body

Matrix made up of proteoglycans,
Polysaccharide chains:
 - glucosamine
 - hyaluronic
 - chondroitin sulfate

Question 2

Glycosaminoglycans

Answer 2

Hydrophilic sugar
- determines oncotic pressure of surrounding tissue

Provides form and stiffness for connective tissue

Question 3

Composition of fascia

Answer 3

fibroblasts, fibroglia, collagen fibrils, elastic fibrils

Question 4

Properties of loose/areolar connective tissue

Answer 4

Stretchy, connects many adjacent structures

Matrix is soft, thick gel with hyaluronic acid

Question 5

Creep

Answer 5

Myofascial adaptation as a result of sustained stress

Continued deformation of a viscoelastic material under constant load over time

• release of stored kinetic energy
• tendency of solid material to slowly move or deform permanently under stress
• undergo deformation to accommodate load

Question 6

Hysteresis

Answer 6

Myofascial return to initial state after release of load
- doesn’t regain pre-load structure

• generally involves lag time, as this implies a cause and effect sequence of events

Change in energy content of tissue due to permanent changes

Question 7

Stress

Answer 7

force normalized over the area on which it acts

• normal stress perpendicular to cross-section
• shear stress is parallel

Can deform a structure, permanently or temporarily

Question 8

Strain

Answer 8

Change in shape due to stress

Question 9

Stiffness

Answer 9

ratio of load to the deformation/strain it causes

Question 10

Compliance

Answer 10

inverse of stiffness

“Your mom is compliant”

Question 11

Characteristics of elastic materials

Answer 11

Amount of deformation is the same for a given amount of stress

Material returns to original length or conformation when the stress is removed

Question 12

Characteristics of viscoelastic materials

Answer 12

Viscous

• nonlinear properties
• magnitude of stress depends on rate of loading
• stored mechanical energy not completely returned when stress is removed

Question 13

Stored mechanical energy of tissue after stress is applied

Answer 13

Hooke’s law applies - tissue acts like a spring under stress, stores E

Question 14

What is the yield point for tissue?

Answer 14

Point at which tissue will permanently retain stress energy, molecular components permanently displaced

Question 15

What is residual strain?

Answer 15

Difference in tissue at molecular level after applied load is released, with a higher level of strain

(Difference between hysteresis and residual strain is unclear)

Question 16

Piezoelectric model

Answer 16

Stress creating change in energy content - bioelectric current changes the orientation of fibrin and collagen

• negative charge stimulates osteoblasts
• positive charge stimulates osteoclasts

Question 17

Palpation

Answer 17

Needs to be done with

• intention
• attention
• activation

Question 18

Goals of myofascial release

Answer 18

Relaxation of contracted mm, tightened or tethered tissues

Normalization of ROM

Restore 3D fxnal symmetry

Don’t aggravate hypermobility

Increased circulation to poorly perfused tissues

Increased drainage, reduced edema of tissues

Question 19

Complications of myofascial release

Answer 19

Iatrogenic trauma
Temporary worsening of symptoms
Older patients are more likely to experience post-OMT flareups

Question 20

MFR Contraindications

Answer 20

Absolute

• absence of somatic dysfxn
• lack of patient consent/cooperation

Relative

• open wounds
• fractures
• acute thermal injury
• infections
• DVT
• neoplasm
• aortic aneurysm

Question 21

What is direct MFR?

Answer 21

Restrictive barrier is engaged for myofascial tissues and tissue is loaded with force until tissue release occurs

Identifies the restrictive barrier in all planes

Brings bodies to restrictive barrier and applies a corrective force

Question 22

What is indirect MFR?

Answer 22

Dysfxn’l tissues are guided along the path of least resistance until free movement

Identifies the position of free motion in all planes = neutral

Brings the body to neutral place and waits for the body to initiate the corrective action

Question 23

Types of direct MFR

Answer 23

Respiratory cooperation in the phase which encourages tissue tension

Tissue inhibition

Oscillation

Eye, tongue, jaw, head or limb movements

Question 24

Indirect MFR Steps

Answer 24

Movement of a patient by the physician, followed by tissue release or fascial unwinding

Regional compression, distraction, or torsion

Tissue inhibition or traction

Respiratory cooperation in the phase which encourages tissue relaxation

Eye, tongue, jaw, head or limb movements