The Soft Tissues

Question 1

The soft tissues

Answer 1

• the skeleton provides the architecture for the body and the levers for movement, but soft tissues create the overall shape of the body and define the range and type of movement available
• in medicine, the term soft tissues refers to tissues that connect, support, or surround other structures and organs of the body
• as massage practitioners, we are primarily concerned with the function of the ligaments, the tendons, the muscles, and the fascia
• these four types of soft tissues are responsible for creating movement and also preventing hypermobility (too much movement) in the body
• they play a large role in posture and they help transport fluids and nutrients throughout the body to support the health of the system

Question 2

(Some) types of soft tissue [4]

Answer 2

• fascia
• ligaments
• tendons
• muscle

Question 3

Soft tissue composition [6]

Answer 3

• water
• protein
• lipids (fat)
• salt
• minerals
• sugar

Question 4

Soft tissue functions [4]

Answer 4

• create movement
• prevent hypermobility
• posture
• transport nutrients and fluids

Question 5

Fascia: The Connective Tissue System

Answer 5

• The connective tissue system is referred to by many names, depending on its consistency and function. most common name for any connective tissue that supports or lies between or around other tissue is fascia.
• Fascia is largely made up of water and collagen and other proteins
• Fascia is the soft tissue components of the connective tissue system that permeates the human body
• it interpenetrates and surrounds muscles, bones, organs, nerves, blood vessels, and other structures
• fascia is an uninterrupted, 3D web of tissue that extends from the head to toe, from front to back, from interior to exterior
• it is responsible for maintaining structural integrity; for providing support and protein; and acts as a shock absorber
• fascia has an essential role in hemodynamic and biochemical processes, and provides the matrix that allows for intercellular communication
• fascia functions as the body’s first line of defense against pathogenic agents and infections
• after injury, it is the fascia that creates an environment for tissue repair

Question 6

Myofascia

Answer 6

Fascia associated with the muscle and it’s neutral components

Question 7

Superficial fascia

Answer 7

Refers to those layers of connective tissue just below the skin or closest to the external body that can usually be palpated

Question 8

Deep fascia

Answer 8

Includes the connective tissue between muscle and bones, the periosteum, and membranes of the internal viscera, and other less accessible.

Question 9

Interactions in movements

Answer 9

-generally means interactions between bones and muscles when we talked about the movement of a particular muscle or group of muscles, we may tend to isolate the movement to an area of the body
-In reality, any movement in the body creates movement throughout the body.
-example of facial integration and proprioceptive training: picture of toddler learning to drink from a cup. They’re often unable to judge the weight of the glass or the direction it needs to take to get from the table to their mouths. Overtime, the child Masters the movements necessary to effortlessly lift and drink from a glass.
the seamless integration of all these movements is possible because of the relationship of the connective tissue to the muscle, tendons, and bones
if you remove every other tissue from the body except the connective tissue, you would have before you a perfect architectural model of that organism like looking at the steel girder of a building before the windows and doors are in
like the web of a spider, the connective tissue system is sensitive to any stimulus it receives
Stimuli then travel like a ripple in a pond. Consequently, any disruption in the system can result in far-reaching effects on the dogs health and movement

Question 10

More types of connective tissue:

Periasteum and muscle

Answer 10

connective tissue is found throughout the body and in various forms. It is one of the first tissues to differentiate itself in the development of an embryo and creates the tensions and pulleys that stimulate the body into bone production.
connective tissue surrounds each structure of the body and interspersed with in several of them
Each bone is encased in a sleeve of connective tissue called the periosteum
Each muscle fiber has its own connective tissue membrane, as those each muscle fiber bundle, and ultimately the entire muscle.

Question 11

More types of connective tissue:

Tendons and ligaments

Answer 11

The tendons are formed from the same membranes as they extend off the ends of the muscles.
ligaments are dense connective tissue bands, blood vessels are connective tissue pipelines, and even the eye and brain contain connective tissue constituents
in fact, all connective tissue in the body is woven within one continuous sheet that travels throughout the body in the myriad of directions, gaining density here, stretching to thin watery skin there.

Question 12

More types of connective tissue:

Intercellular fluid

Answer 12

Another function of the connective tissue network is the conduction of intercellular communication
between the cells of the body exists a fluid matrix of proteins and lipids in a solution of water and salts called the intercellular fluid
The nature of the solution is electrically conductive and the components that give cells energy flow in this nutritive bath waiting to be excited chemically and carried to the cells
this exchange occurs on many levels and through several pathways in the body, not the least of which is the fascial network
this constant biochemical interaction assist the nervous system in sending messages between the brain and body and facilitates coordinated and efficient movement

Question 13

Fascial Planes in the Canine

Answer 13

Fascia and myofascia are found in all parts of the body and impact all movement.
however, it is valuable to differentiate specific regions of condensed fascia or particularly influential fascia from the system as a whole
We may refer to these specific sites as fascial sheaths, fascial Planes, or fascial webs

Question 14

Fascial Planes:

Cervical fascia

Answer 14

Encases the neck

Question 15

Fascial Planes:

Omobrachial fascia

Answer 15

Broad, flat surface of the shoulder

Question 16

Fascial Planes:

Antebrachial fascia

Answer 16

Sleeve around forearm

Question 17

Fascial Planes:

Thoracolumbar fascia

Answer 17

Extends from the withers to sacrum

Question 18

Fascial Planes:

Fascia Latae

Answer 18

Enfolds the stifle (knee) & dictates it’s flexibility

Question 19

Fascial Planes:

Crural fascia

Answer 19

Wraps calf

Question 20

Fascial Planes:

Gluteal fascia

Answer 20

Caudal (end) thoracolumbar fascia to dock of tail

Question 21

Fascial Planes:

Retinaculum

Answer 21

Sheaths around joints of the limbs (support & flexibility)

Question 22

Fascial Health and Injury

Answer 22

Healthy fascia is flexible and resilient.
it should assist smooth and free movement of the skin over the underlying tissues and provides a slippery contact between deep tissues. Fascia possesses a natural tone similar to a muscle a trust neither loose nor too firm. The matrix of fascia is like a woven tapestry so that a tug or strain at one spot creates a tightening and loosening simultaneously and surrounding areas, thus maintaining the constant tension necessary to create flexible support.
In contrast, unhealthy fascia will either possess too much tonus or too little. tight unrestricted fascia will create ratcheted or strained movement and will eventually lead to cessation of movement.
Restricted fascia may feel wrinkled, dry, leathery, or stiff and will be dehydrated.
The surrounding tissues will not move freely, but will instead exhibit patterns of pulling and may appear stretched, puckered, or crowded.
Fascia that is loose and overly fluid is less common, but may be seen as chronic or pocketed swelling. Loose fascia has lost its supportive function so structures may appear to sag or hang, and movement may be sloppy or hypermobile. Massage is an effective way to influence the texture and function of fascia. We will explore specific massage techniques designed to directly address the fascial system in the practicum.

Question 23

The Nerves:

CNS & PNS

Answer 23

The nervous system is separated into two major divisions:

• Central nervous system (CNS)
• Peripheral nervous system (PNS)

The central nervous system is comprised of the brain and spinal cord and acts as the hard drive of the body processing and storing information and selecting responses.
On the other hand, the peripheral nervous system is dispersed throughout the body and is responsible for the collection of information or stimuli. All aspects of the nervous system are made up of individual nerve cells.

Question 24

The function of all nerve cells…

Answer 24

…is to transmit electrical signals, called action potential. It is these action potentials that excite the chemical exchange within the muscle fibers that creates both muscle contraction and the return to the resting state. The transmission of an action potential along a nerve has been measured at speeds of 250 miles per hour making many of our responses nearly instantaneous. It is important to recognize that these action potentials are transferred from one nerve cell to the next through an element-rich liquid medium. The fluid dynamic is critical to the proper functioning of the nervous system.

Question 25

ANS

Answer 25

The autonomic nervous system (ANS) is another aspect of the nervous system relevant to massage. The ANS is the part of the CNS that controls the involuntary activities of the body such as heartbeat, glandular secretions, etc. These responses do occur in response to stimuli, but there is not usually the conscious effort associated with voluntary movements such as running or picking up an object.

Question 26

Two opposing branches of the ANS

Answer 26

There are two opposing branches of the autonomic nervous system. The sympathetic branch is contained within the cervical, thoracic, and lumbar portion of the spinal cord and is considered the fight or flight or excitatory aspect of the ANS. The parasympathetic branch is contained within the cranial and sacral nerve groups. It is considered the rest and digest aspect of the ANS.

Within the nervous system, there are several kinds of specialized nerves that serve specific functions. The muscles utilize two of these specialized nerves for proprioception. The two specialized types of muscle nerves are the:
• Muscle spindle fiber
• Golgi tendon organ

Both nerves serve as proprioceptors or cells that give the brain information about the body’s orientation in and through space. They are critical to balance, posture, and to coordinated movement.

Question 27

MSF

Answer 27

The muscle spindle fiber (MSF) is like a trigger wire. When excited by a stimulus, it can force the muscle into rapid contraction. For example, when an object is placed in someone’s hand and the object is much heavier than expected the biceps muscle contracts strongly and immediately to bear the load and prevent tearing of the muscle or tendon. The MSF is actually a bundle of several fibers that are both muscle and nerve in origin. Because of its unique physiology, the MSF can measure the rate and degree of a muscle contraction. Within the MSF are both sensory and motor capabilities. Nowhere else in the body is the connection between the stimulus and the reaction so closely tied. The MSF has the power to both feel and act at the level of the spinal cord rather than the brain creating a shortened feedback loop. Thus, it can impose an excitatory action upon a muscle very quickly.

Question 28

GTO

Answer 28

The Golgi Tendon Organ (GTO) is found in the musculotendinous junction where the two tissues interface. It specifically measures the tension or amount of load on a muscle so that it can trigger the muscle to shut-down in the face of overload. For example, this is often seen in marathon running when an exhausted runner, maybe only steps away from the finish, collapses as the muscles of the legs shut down to prevent fatal overheating. The action of the GTO on the muscle tissue is therefore inhibitory.

Question 29

MSF & GTO and final notes on Nerves

Answer 29

The MFS and GTO, two specialized fibers, support one another although they may create opposite actions within the muscle. Together they determine the mass of an object by measuring that object’s resistance to movement.

Recall our discussion of the proprioceptive process that happens as a child learns how to drink from a cup rather than a bottle? With repeated effort, the child’s body learns how much tension is created in the muscle by the glass and how much the muscle must contract and at what speed to move the glass on a smooth trajectory to the mouth. This constant interaction is one of the ways by which the body learns its capabilities and develops consistent responses or repeated behavior. By repeatedly and gently challenging these capabilities we can encourage the body to learn new patterns of movement or increase its capabilities (i.e. weightlifting). Oftentimes, abrupt challenges to these proprioceptive settings result in injury (strains or tears) or dysfunction (guarding, spasm).

As massage practitioners, we can influence the nervous system directly at the MSFs and the GTOs. We can indirectly affect the nervous system by addressing the fluid dynamics in the body to enhance transmission or accessing the autonomic nervous system to entice the body into an excitatory or meditative state.

Question 30

The Ligaments

Answer 30

A ligament is like a tough rope composed of both elastic (yellow) fibers and inelastic (white) protein fibers. Ligaments connect bone to bone. This tissue must be very strong to provide support and protection for the skeleton and joints. Strength and flexibility have an indirect relationship; one exists at the expense of the other. Therefore ligaments are less flexible than the other soft tissues we will discuss.

Question 31

Ligament Health and Injury

Answer 31

Although a ligament will allow for movement within the designed range-of-motion at a joint excessive or abnormal movement at a joint can overstretch the ligaments and create a sprain with small tears in the tissue. Sprained ligaments are extremely painful, but may not always exhibit excessive inflammation due to their limited vascular supply. Severed ligaments may exhibit less pain due to a loss of the nerve stimulus, but will generally be accompanied by inflammation and hypermobility. Ligament injuries are less common than tendon or muscle injuries, but they will require a longer rehabilitation period.

Question 32

Two Examples of Ligament Systems:

Collateral Ligament System

Answer 32

These ligaments are found on the lateral and medial aspects of the synovial joints. They are also called capsular ligaments. The combination of ligaments and muscles provide such well-engineered support for a joint that dislocation of the joint is rare.

Question 33

Two Examples of Ligament Systems:

Dorsal Ligament System

Answer 33

This group of ligaments provides support for the axial skeleton. The dorsal ligament system refers to the cooperative action of four ligaments. (See the following illustration.)

The first two parts are the nuchal ligament (#11) in the neck and the supraspinous ligament (#9 and #10) along the spine.

The third part of the dorsal ligament system is made up of two ligaments (the sacroiliac ligament (#12) and the sacrotuberous ligaments (# 54) which suspend the pelvis and provide attachment sites for some of the large neighboring muscle groups.

Question 34

The Tendons

Answer 34

Just as ligaments provide support to the articulating bones tendons provide an anchor between the muscles and the bones. Like a ligament, a tendon is composed of both elastic (yellow) fibers and inelastic (white) protein fibers. Tendons have a higher percentage of elastic fibers than ligaments, so they allow for a greater degree of movement between the muscles and bones. Tendons are composed of connective tissue fibers that run throughout a muscle, condensing at the ends of the muscles into thick bands. The area where the muscle fibers begin to thin out and the connective tissue increases in density is called the musculotendinous junction. Beyond that point, the tendon attaches to a bony landmark through the periosteum (a connective tissue which envelopes the bone).

Question 35

Tendon Health and Injury

Answer 35

In addition to serving as an anchor for the muscles, the tendons have special nerves that measure the amount of stress a muscle is under due to load or fatigue. When these nerves are not functioning properly, both the tendon and the muscle are vulnerable to strain or tearing. Tendon injuries also occur when a muscle is used to repeat a motion over time. This chronic overuse can cause inflammation in the membrane around the tendon. This condition is called tendonitis and can occur in animals the same way it does in humans. The presence of pain, swelling, and gradual loss of range of motion are common signs associated with a tendon injury. A tendon has a greater blood supply than a ligament. Consequently healing generally occurs faster in a tendon than in a ligament given an injury with similar severity.

Question 36

Ligament and Tendon Facts at a Glance

Answer 36

Ligament Facts:
• Connect bone -> bone 
• Tough rope 
• Elastic yellow fibers 
• Inelastic white protein fibers 
• LESS flexible than other soft tissues 

Tendon Facts 
• Connect muscle -> bone 
• Supports articulating bones 
• Tendons have connective tissue fibers throughout a muscle. 
• Elastic yellow fibers 
• Inelastic white protein fibers 
• MORE flexible than ligaments = Higher % of elastic fibers 
• Greater blood supply than ligaments