Structural Integration-The Journal of the ROLF INSTITUTE® December 2016

I am delighted to share this edition of the journal for Rolf SI's. It has a specific focus on Biotensegrity and lots of interesting discussions on the topic. Of course, Dr. Levin is in there and excellent musings from Michael Maskornick but apart from Biotensegrity I was very happy to see an informative interview with my friend and colleague Dr. Wiley Patterson who I hold in high regard. Enjoy the journal which I hope you will find informative. john

Click here to view Journal

Biotensegrity-The Fallacy of Biomechanics Part 2

BioTensegrity

BioTensegrity
Fascia and the fallacy of biomechanics. Part 2 (please note images are missing)
                                             
John Sharkey MSc, Clinical Anatomist, Exercise Physiologist.

Faculty of Medicine, Dentistry and Clinical Sciences, University of Chester/NTC, Dublin , Ireland

*Correspondence to:
John Sharkey MSc.
University of Chester/National Training Centre
16a St Joseph’s Parade
Dorset St
Dublin 7, Ireland
E-mail address: john.sharkey@ntc.ie
www.johnsharkeyevents.com

Introduction

In the first article of this 3 part series I provided a basic explanation of BioTensegrity.
While a growing number of professionals are beginning to understand what Tensegrity is a wider population of bodywork and movement therapists need to know what it is not. Bodywork and movement therapists also want to understand how they can integrate BioTensegrity into their specific model of movement and bodywork within their clinical practice. Understanding BioTensegrity has wide reaching implications for massage therapists of all stripes and for medical specialists including surgeons. The father of biomechanics was born January 28th 1608 and following his death in 1679 (penniless and destitute) Giovanni Alfonso Borelli left behind a legacy that would prevail to the present day. BioTensegrity claims more than a tincture of skepticism when it comes to the classic descriptions of animal movement and human biomechanics as promoted by Borelli. 

I believe that BioTensegrity is one of the most important developments in medical science, bodywork and movement therapy in the modern era.


Outrageous theories

1916 Geologist Alfred Wagener had the audacity to suggest that the continents floated around on the surface of the earth.  Wagener stated that West Africa and the East Coast of South America had at one time fitted together like a jigsaw puzzle and that they had somehow drifted apart from each other due to platonic movement.  Wagener was ridiculed for having had the boldness to bring forward a new radical scientific hypothesis but by the late 1950’s his outrageous theory was being thought in schools as accepted, accurate science and all thanks to his courage. The promotion of a new concept or model in science takes courage, daring, nerve and a thick skin. New concepts and paradigms are rarely accepted straight away. Change takes time. It invariably takes years to break down the barriers associated with changing an accepted and well-established fact, and rightly so. A new paradigm suggests that our current model of reality could be wrong. A new theory needs to be challenged and tested, rebutted and ridiculed. If the new model or hypothesis cannot stand up to scrutiny and provide undisputable answers and better explanations it does not deserve recognition.  While still in the stages of organic evolution BioTensegrity has already passed much rigorous scrutiny with flying colors. In contrast the old biomechanical model of levers, joints and laws developed from observation made in the sixteenth century by pantheons of great scientific minds, scientists and mathematicians of antiquity including Galileo Galilei (1564-1642), René Descartes (1596-1650) and Isaac Newton (1642-1727) have come up short in providing adequate explanations of living mechanics. 

Our Miraculous Construct 

Considering the body exclusively as tissues and bones does not do justice to the wondrously complex and miraculous construct that makes us human beings. We are not simply defined by the fact that we utilise bipedal locomotion. Diving beneath the flesh we discover we have thoughts, emotions, consciousness, we have feelings and we respond. The study of anatomy has led to a reductionist view of what is ultimately a global or wholistic organism. Historically, anatomical study concentrated on specialties, a focus on specific processes or applications. Anatomists viewed their role as the scientific discipline that investigates the structure of the body including the form of structures, microscopic organization and the process by which they develop. BioTensegrity promotes a language of “Whole” (a global view) while recognising that a language of “parts” can be helpful, even necessary, at times. When discussing BioTensegrity classical anatomy provides a foundation upon which we can discuss the part and then place it in the context of the whole.

The language of BioTensegrity is the language of soft matter physics. It is tension and compression with continuity. The premise of BioTensegrity is non-linear continuous matter that is self-generated, self-organising, self-stressing, hierarchical, load distributing and low energy consuming. There are no shear moments, no bending moments, no levers and no joints. 

Let me explain what tensegrity is not?

Our bodies are self constructed on the basis of continuous tension and floating compression. Continuous compression, such as is seen with block on block buildings, would not be a good architectural model for any living structure. When we look at the tissues deep to skin in a cadaveric specimen we can be forgiven for mistaking the non-living form as reflecting evidence of stratification or layers (Fig 2. Courtesy of Stecco, C. 2012). 

Figure 2. (With kind permission from Stecco, C. 2012 personal correspondence). Analogous to a sea of molten lava the body has no stratification until, similar to cooled and rolled lava, the lack of motion and life presents a misguided image. We cut the skin from the sub-cutis or the superficial fatty fascia from the fascia profundus and we sadly declare, “look at these layers”. 
Figures 3 and 4 are examples of what tensegrity structures are NOT. Or put slightly differently they are not tensegrity structures.

 
Figure 3 The sale ship is the most widely used misrepresentation of a tensegrity structure.
 

Figure 4 This bamboo structure needs the wall and not the other way around. (Photo supplied by Serge Gracovetsky private correspondence)


Figure 3, the sale ship, is the most widely misused example for a tensegrity structure. While it does provide examples of tension and compression it is not a continuous structure and the mast needs the ship for support and not the other way around. Figure 4 is similar where the structure needs the wall and not the other way around. Of course the wall itself is a continuous compression structure. 

Let me explain what a tensegrity structure is.

The model of BioTensegrity is an extension of Fuller’s term “tensegrity”, a syntactic of “tension” and “integrity”. A tensegrity structure has both a discontinuous compression member and a continuous tensional member (Levin. 1982). It is imperative that they are continuous with each other. For convenience, in humans the skeletal system would represent the discontinuous member and the softer tissues (fascia, ligaments, tendons etc.) represent the continuous member. Keep in mind that all living tissues are soft matter. Hard matter mechanics cannot work for soft matter so I suggest we need a paradigm shift in that respect. 

The Joint Space

Most readers will be familiar with x-rays of the knee joint (Fig 5). Even while standing the space between the femur and tibia is obvious. This space teasingly hints at the special architecture of the human form. During running, cartilage tissues absorb the crushing forces of three to six times our bodyweight compressing and crashing down on our joints, right? Wrong.
Not even a technologically savvy organization like NASA has invented a material that could do such a job. Text books inform us that cartilage absorbs crushing forces repeatedly, over hours of impact (six times our body weight crushing down on our joints) such as when running a marathon. Thankfully your knee joints are frictionless. This tells us the cartilage is not compressed and therefore has no need to absorb the impact. That is, not in a healthy joint supported by healthy tissue. Of course massage therapists know that good tissues go bad at which time compressive forces damage the cartilage and bone.

Imagine you are standing upright. By magic your skin and soft tissues (muscles, fascia, viscera and all) disappear. What would happen to your skeletal system?  Of course it would crash to the floor. But what if we disappeared all your bones leaving only the soft tissues? Again we would gather in a soft heap on the floor. This begs the question, ”who is holding you up”. In such a scenario it is easy to conclude that it is the relationship between the soft and harder tissues working in continuity that provide humans with what we call “lift”. It is this lift that protects the integrity of the joint space.


 
Figure 5 Note the joint space between the articulating bones. (Photo Sharkey, J. 2009) 
The Trojan work of my colleague Dr JC Guimberteau (Guimberteau. 2010) has, in pioneering fashion, demonstrated in vivo a histological continuum without any clear separation between skin and hypodermis, the vessels, the aponeuroses and the muscles (Fig 6). Such images from Guimberteau have forever changed our view of the living tissues reflecting a fractal, chaotic (but very organized), shape-shifting architecture of these 3 dimensional vacuoles. The work of Dr Guimberteau reflects BioTensegrity in motion under your hands and fingers.


 
Figure 6 The true image of the connective tissue beneath our skin. A moist, fractal, shape- shifting, hydraulic tubular fluid network. Merging, emerging responding to forces. With kind permission of Dr J.C.GUIMBERTEAU and Endovivo Productions


Visible everywhere are structures that ensure a gliding movement between the aponeuroses, the fat structures and the dermis. This also has implications on our view of “stretching” as tissues glide and morph to facilitate movement and perceived elongation. The word gliding is important here specifically as tissues in the human body glide relative to each other but they do not slide relative to each other. In my view the use of the word sliding reflects a common misunderstanding in anatomy. Sliding would result in friction but tensegrity structures (when working as designed) are frictionless as seen in the joints of the body (Fig 5). This is a reason why I say cartilage tissue is not a shock absorber. (http://www.intensiondesigns.com/s_of_tensegrity.html). 

In BioTensegrity there is no internal surface on which to move along unless of course the body breaks down and we experience the pain and discomfort of bone on bone or organ or organ. The space witnessed at joints is a result of the bones floating in the tensional connective tissues. Bones are not meant to touch and when they do (and they sometimes do) this is a reflection of something having gone wrong. In effect the system is not performing, as it should.

Tensegrity structures are triangulated allowing force transmission in multiple dimensions. When discussing BioTensegrity structures we must take into account our Neurofascial network.  Understanding that the model of BioTensegrity has major implications for our appreciation of the therapeutic mechanisms behind manual soft tissue techniques used in massage such as Positional Release and Strain Counter-Strain, Soft-Tissue Release and others. In fact in her recent best selling book “Yoga Fascia Anatomy and Movement “ Joanne Avison makes the point “The implications of understanding tensional forces in this context are exceptionally valuable for yoga teaching”. The same can be said for all movement and bodywork models including but not limited to Feldenkrais, Alexander technique, Neuromuscular Therapy, Massage, Osteopathy, Tai Chi and others. 


Four Bar (Multibar) Linkage

The joints in our bodies are not made of overlapping bones with pins at either end to secure their positions accurately in an effort to eliminate transversal shifting forces (See Fig 6). As mentioned, our joints have no pins and allow for a space between the boney articulating surfaces. Our vertebral bodies do not slide off each other when we bend forwards or sideways even with a twist. When we bend forwards or lay on our side our vertebral column becomes a beam. The vertebrae should slide off each other in such circumstances, not what the doctor ordered. 

Figure 5 (Kindly contributed by Joanne Avison)

The Burning Question

We maintain the joint space and its integrity through the omnidirectionality of our living tissues, continuous from finger to toe, from side to side, front to back and top to bottom. The body having originated from one cell has developed, grown and rotated back on itself creating the familiar helical basis of all living structures. The Möbius strip or Möbius band is evident everywhere in the human body from the anatomy of joints to that of the continuous myofascial tissues (I include the hardest of the soft tissues the bone, internal organs and everything else). This moves us from a linear mechanics, hinge like joints and “one muscle works at a time” mentality to a more global, continuously tensioned contractile fabric that facilitates closed chain kinematic linkages. A three bar linkage system would be too rigid and would not allow movement. A four or multi-bar closed chain system provides a cohesive explanation of living movement. It helps to explain, though stored and returned energy in fascia, bone and tendon’s, how the Kangaroo’s tendon does not combust into flames on each hop (Fig 7) and why the northern wheatear, a tiny insect-eating Arctic bird can travel an enormous 9,000 mile return journey every year without cooking itself to death during the migration. It also moves us to a new vision of bones as primary movers.

 
Figure 7 BioTensegrity explains how Kangaroo’s can hop without burning their tendons


The multi-bar (four bars or more) system is a self contained, enclosed system where only one motor is required to drive a motion, similar to a pantograph. BioTensegrity is a force transmission energy efficient system. Coming to grips with BioTensegrity helps to explain why a person may be hurting in one body part (the messenger) while the true source of the pain is at a remove. Excessive compression or tension can express itself at the weakest point within the BioTensegrity resulting in a need to identify and treat the true source of insult and not just kill the messenger.  As an example one of my life’s goals is to work with surgeons to integrate BioTensegrity principles into their surgical techniques. This requires a fascial sparing approach during surgery as well as a global consideration of the body as a whole.

This brings me to the burning question key to all manual therapies. How do we translate forces employed in massage into the BioTensegrity specific resonance that will ensure therapeutic responses at cellular and tissue level? This cannot be achieved by accident nor stumbled across by chance.
It requires expert palpation and soft tissue manipulation skills ensuring continuous, volumetric, non-invasive Guided Stress Transfer (GST). It involves using contact with your client’s skin as the interface. It also requires patience and stillness. Slow intuitive motion is the order of the day. According to BioTensegrity Interest Group (BIG) member Leonid Blyum “Any physical contact between two bodies is, in the first place, being a stress transfer from one to another. That’s the bottom-line physics, a hard fact and a tangible reality. Missing such a step in one’s reasoning is a major disservice both to the practitioner and to the client”.

Stress transfer can occur in many ways. In martial arts a roundhouse kick could provide a stress transfer resulting in a bruise or a break. In massage and manual medicine the stress transfer is seeking to be specific (i.e. Guided) utilizing appropriate vectors such as force, intensity, direction, duration, sequencing, velocity and depth. The surface contact area is also crucial to ensure the appropriate level of strain. Whatever the effects, muscular, metabolic, neural, fascial, lymphatic, are all dependent on the appropriate level and delivery of the stress guided transfer. In exercise physiology this is called specificity. In bodywork therapy it is known as Specific Adaptation to Imposed Demands (SAID). The application of force on a targeted tissue translates into a
change in spatial and textural properties of the matter that it impacts. In the third and final article in this series I will delve deeper into the important difference between force and strain.  I will translate the differences into practical recommendations for massage therapists and movement practitioners. 


References:

Avison, J. 2015. YOGA Fascia, Form and Functional Movement. Handspring Publishing.

Findley, T., 2012. Fascia  Science and  Clinical Applications: A Clinical/Researcher’s Perspectives. Editorial. Journal of Bodywork and Movement Therapies 16, 64-66 

Guimberteau J, Delage J, McGrouther D, Wong J., 2010. The microvacuolar system: how connective tissue sliding works. J Hand Surg Eur. 2010;35(8):614–622. 

Huijing,P. A., 2003. Muscular force transmission necessitates a multilevel intergrative approach to the analysis of function of skeletal muscle. Excerc, Sport Sci. Rev. 31, 167-175.

Huijing, P. A., 2009. Epimuscular force transmission: a historical review and implications for new research. International Soceity of Biomechanics Muybridge Award Lecture,Taipe, 2007. Journal of Biomechanics. 42(1), 9-21.

Huijing, P.A., Baan, G.C., 2001. Extramuscular myofascial force transmission within the rat anterior tibial compartment: Proximo-disstal differences in muscle force. Acta Physiol. Scand, 173, 1-15.

Ingber, D., 2008. Tensegrity and mechanotransduction. Journal of Bodywork and Movement Therapies. 12(3), 198-200.

Langevin, H. M., 2008. Potential role of fascia in chronic musculoskeletal pain. In J. Audette, and A. Bailey (Eds). Integrative pain management: The science and practice of complementary and alternative medicine in pain management. (pp. 123-132). New Jersey, USA. Humana Press.

Levin, S. M., 1981. The icosahedron as a biologic support system; Houston. Alliance for Engineering in Medicine and Biology. p 404.

Levin, S. M., 1982. Continuous tension, discontinuous compression, a model for biomechanical support of the body. Bulletin of Structural Integration, Rolf Institute, Bolder:31-33.

Levin, S. M., 1995. The Importance of Soft Tissues for Structural Support of the Body.
Spine: State of the Art Reviews, Volume 9/Number 2, May

Purslow, P.P., Delage, J.P., 2012. General structure and composition of muscle fasciae. In: Scheilp, R., Findley, T.W., Chaitow, C., Huiling, P.A., Fascia: the tensional network of the human body. Elsevier, Oxford, pp. 5-10.

Schleip, R., 2003a. Fascial Plasticity-A new neurobiological explanation: Part 1. Journal of Bodywork and Movement Therapies. 7(1), 11-19.

Schleip, R., 2003b. Fascial Plasticity-A new neurobiological explanation: Part 2. Journal of Bodywork and Movement Therapies. 7(2), 104-116 

Schleip, R., and Muller, D.V., 2013. Training principles for fascial connective tissues: Scientific foundation and suggested practical applications. Journal of Bodywork and Movement Therapies. 17, 103-115. 

Sharkey, J. 2008.  Concise Book of Neuromuscular Therapy: a trigger point manual. Chichester, UK: Lotus Publishing. North Atlantic Books, California.

Standring, S., (2008). Gray’s Anatomy, The Anatomical Bases of Clinical Practice. (40th ed.). Edinburgh, United Kingdom: Elsevier Churchill Livingston.

 Stecco, C., Gagey, O., Belloni, A., 2007b. Anatomy of the deep fascia of the upper limb. Second part: study of innervations. Morphologie, 91, 38-43.

Stecco, A., Macchi, V., Stecco, C. Porzionato, A., Day, J.A., Delmas, V., De Caro, R., 2009. Anatomical study of myofascial continuity in the anterior region of the upper limb. Journal of Movement and Bodywork Therapies. 13(1). 53-62.

Van der Wal, J., 2009. The architecture of the connective tissue in the musculoskeletal system- an often overlooked functional parameters as to proprioception in the locomotor apparatus. International Journal of Therapeutic Massage and Bodywork. 2(4), 9-23.

Wood Jones, F., 1946.  Buchanan’s Manual of Anatomy, 7th edn. London: Bailliere, Tindall and Cox.

 

BioTensegrity-Anatomy for the 21st Century

BioTensegrity

The fallacy of biomechanics. Part 1

John Sharkey, Clinical Anatomist
MSc., Department of Clinical Sciences, University of Chester/NTC, Dublin , Ireland

*Correspondence to:

John Sharkey MSc.
University of Chester/National Training Centre
16a St Joseph’s Parade
Dorset St
Dublin 7, Ireland

E-mail address: john.sharkey@ntc.ie
www.johnsharkeyevents.com

Introduction

Biotensegrity is emerging as one of the most significant developments in human anatomy in recent years.

With important ramifications for a wide range of medical practitioners including surgeons, bio-engineers and human movement specialists. Bespoke dissection techniques are providing a new vision and understanding of the continuity of the human form. A fresh look at the human fasciae highlights its role in providing continuous tension throughout its network. The term “Tensegrity” was coined by Buckminster Fuller combining the words ‘tension’ and ‘integrity’.

Fuller’s student Kenneth Snelson built the first floating compression structure of “tensegrity” in 1949 while Dr Stephen Levin an orthopedic surgeon was the protagonist of “BioTensegrity” as early as the 1970’s. As a Clinical Anatomist I have investigated this model and the role of fascia in my fresh from frozen cadaver dissections to better understand the mechanisms of human movement and chronic pain while providing new anatomical knowledge and awareness leading to less invasive surgical and non-surgical therapeutic interventions. This new anatomical awareness is essential for Medical Massage practitioners and movement specialists.

Understanding BioTensegrity

Borrowing from Fuller’s term “tensegrity”, a syntactic of “tension” and “floating integrity”, Levin (1975) added the term “Bio” referring to living structures. BioTensegrity is the application of Fuller's tensegrity concepts to biologic structure and physiology. In the BioTensegrity model the limbs are not a collection of rigid body segments. The upper and lower limbs are semi-rigid, non-linear, viscoelastic bony segments. These segments are interconnected by non-linear, viscoelastic connectors including cartilage, joint capsules and ligaments, with an integrated non-linear, viscoelastic active motor system, the muscles, tendons and fascia (connective tissue). BioTensegrity counters the notion that the skeleton provides a frame for the soft tissues to hang upon. Instead BioTensegrity structures are integrated pretensioned (self-tensioned) continuous myofascial networks with floating discontinuous compression struts (skeleton) contained within them. A column whose center of gravity is constantly changing while its base is rapidly moving horizontally would require forces too great to consider. The forces become incalculable if the column is composed of several rigid bodies, hinged together by flexible, virtually frictionless joints.

A rigid column needs to be base heavy to support the incumbent load above. Internal shear forces are created by the weight of the structure, which in turn would be destabilizing. Energy would be required in large amounts to keep the structure intact. Humans are Omni directional, as are all biological organisms, in order that the tension elements function at all times in tension regardless of the direction of applied force, while the compression elements in biological structures "float" in a tension network (Levin 1995).

Building a living structure

To construct a biologic organism on the principles of tensegrity, the tensegrity truss must be linked in a hierarchical construction. Starting at the infinitely small sub cellular component. Importantly it must have the potential to build itself. The structure would be one integrated tensegrity truss that evolved from infinitely smaller trusses that could be both structurally independent and interdependent at the same time. Ingber (2000) described this truss as the icosahedron.

Ingber found conclusive evidence that tensegrity provides the best explanation for the cytoskeleton of the cell. In fact Ingber also states that it is not possible to explain why skin stretches when muscle contracts other than by tensegrity.

No bones about it

Bone brittleness is approximately the same in Marsupials as in a Rhinoceros as the stiffness and strength of bones is roughly the same in all animals. Animals bigger than a lion, such as horses, running or jumping on their slim limbs, would break and fracture their bones with a leap. Based on linear mechanical laws, which are the foundation of biomechanical models, animal mass must cube as their surface area is squared. This should mean that animals as big as a Rhinoceros will collapse under their own weight. Working elastically at strains around a thousand times higher than strains that ordinary technological solids can withstand demonstrates that biological tissues behave differently than non-biologic materials. If this was not the case Levin (1982) informs us that the skull should explode with each heart beat due to the blood vessels expanding and crowding out the brain. As they reach fullness the urinary bladder should thin and burst. The pregnant uterus should burst with the contractions of delivery. Not exclusively, mechanical but also physiologic processes would be inconsistent with linear physics. Pressure within a balloon decreases as a balloon empties. The heart of the problem is that there are several assumptions regarding biologic tissues that are not valid. Biologic tissues, including muscles and fascia, have nonlinear stress/strain curves. Unfortunately, in biomechanics the initial premise that muscles, fascia, and indeed, any biologic material, can be bound by the rules of hard matter physics is, according to the information coming out of the condensed soft matter laboratories, flawed. Ligaments and fascia, bones and cartilage would do little to support our upright forms if not for the collective activity of an integrated myofascial system.

The Cellular Level

At the cellular level, using fluoroscopic imaging, Guimberteau et al (2010) provided strong visual evidence that fascia contains a water filled vacuolar system that is capable of sliding independent of the rate of contraction of muscle.  In turn it is capable of facilitating and supporting capillaries throughout the fascia. Sharkey (2012) provided fresh frozen cadaver images of the fascia profundus at the macro level reflecting this fractal microvacuolar structure while revealing an icosahedron like (tensegrity) composition where fractal elements inter-relate, creating a body wide framework or network. This structure is able to change or maintain shape and form within a fluid base allowing deformation followed by a return to its original state, whilst maintaining volume. This creates a stable, yet flexible environment necessary for fascia to act as a medium for force transmission (Huijing, 2009).

This new model for biologic structures based on the concept of tensegrity identifies fascia as the tensional, continuous member. In a tensegrity continuous tensile forces (from the myofascia tissue) provide an “ocean” within which the struts float (in the human body these could be the bones which are not continuous with each other and they do not transmit compression directly onto each other). The tensional members are continuous and distribute their tension load directly to all other tensional members as described by Fuller in 1961. The fascial oceans become seas, lakes, rivers, streams and brooks (Sharkey. 2008). Newtonian, Hookean and linear mechanical properties are the basis for the building of all things non-biological (Levin 1995). This description supports the more recently accepted image of a continuous tissue, ubiquitous in nature, connecting left to right, front to back, top to bottom, embracing and permeating the entire body.  Mesenchyme derived connective tissues providing a body wide network of communication (Schleip and Muller. 2013).

The visceral organs integrate structurally and physiologically into this system. There are no limb segment boundaries and the smaller bones and joints of the hands and feet fully integrate into the BioTensegrity model. The spine is a tensegrity turret that integrates with the limbs, head and tail and also to the visceral system. A change of tension anywhere within the system, such as the mid back, is instantly signaled to everywhere else in the body such as the sphenobasilar synchondrosis chemically and mechanically. There is a total body response by mechanical transduction. The structure works equally well right side up, upside down, in the sea, land, in the air or in space. It resolves many of the inadequacies of present biomechanical models.

Van der Wal (2009) suggests this dynamic connection between the connective tissue and the muscle is a “structural support” capable of adapting to increasing or decreasing joint range and also distance between bones throughout the joint range of motion. Van der Wal (2009) refers to these dynamic connections as “Dynaments”. These dynaments are not necessarily situated directly next to the joint cavity or in the deep part of the joint region. Van der Waal contends that some muscles have these specialised connective tissue structures at the proximal end only, some at the distal end only, some at both ends, and some at neither end. Fascia plays an important role in supporting muscle contraction as it links muscles together and non-muscular structures by means of these myofascial pathways and by direct attachment of muscles into the connective tissue structures around the joint. Van der Wal, (2009) has informed us that none of the muscle fibers of supinator insert directly onto the humeral epicondyle, but attach by means of a connective tissue apparatus. Nerve endings in these structures are in greater number where the stresses are the highest, particularly in the proximal or distal end of the ‘dynament’.

Several research studies have revealed fascial connections resulting in myofascial force transmission between both adjacent and antagonistic muscles (Bojsen-Moller et al. 2010). A vital mechanism for interaction between muscles is extramuscular myofascial force transmission, which is essentially the generator for intermuscular myofascial force transmission. Myofascial interaction was shown for synergistic muscles involving both intermuscular and extramuscular transmission (Huijing and Baan 2001; Huijing. 2003).

Dictated by changes in movement and posture mechanical forces, comprising of tension and compression (the members of BioTensegrity) may provide a means of communication resulting in connective tissue signalling.  Similar to Langevin (2005), Purslow and Delage (2012) propose that the fascia translates these signals into a whole body communication system. Such connective tissue signaling would be affected by changes in posture and motion and may lose mobility in pathological conditions or when experiencing pain. Due to the intrinsic relationship that connective tissue has with, among others, the lungs, intestines, heart, spinal cord and brain, connective tissue signaling may have a reciprocal influence on the functions, normal or pathological, of a wide spectrum of organ systems.

Reeds discovery (in Findley 2012) that hyaluronans, which are osmotically active compounds, are an essential ingredient in the interstitial matrix, and when given free access to fluid will swell, is potentially an important finding and one that requires more attention and investigation. This swelling is restrained by extracellular matrix fibers through β 1 integrin-mediated contraction when connective tissue cells actively tense them. This demonstrates the role that tension plays in restraining the extracellular ground substance, which normally would be under-hydrated, from retaining fluid thereby reducing its capacity to swell.

Fascia- A Question of Proprioception

Sensory neural fibers have been identified within fascia utilizing unique staining techniques coupled with electron microscopy. Stecco et al (2007b), suggest that this provides the evidence that fascia contributes to proprioception and nociception.  Schleip (2003) argues that fascia is the main organ of perception, providing propriception, nociception and visceral interoception.  Van der Wal (2009) states that fascia has almost 1000% more sensory nerves when compared to muscle including Golgi, Paccini and Ruffini endings. 

Also included are a large number of microscopic unmyelinated ‘free’ nerve endings. These nerve endings are found in a near ubiquitous manner in fascial tissues including periosteum, endomysial and perimysial layers, and in visceral connective tissues. Other researchers confirm that fascia and fascial structures play a significant role in the facility of proprioception (Langevin 2006; Benjamin 2009).  Fascial components such as membranes, septa, deep and superficial fascia are supplied with ample proprioceptors to suggest it is functionally important in proprioception  (Wood Jones 1946; Standring 2008).

Van der Wal (2009) argues that rather than being due to its topography the ability of the fascial structures to provide centripetal mechanoreceptive information is due to its structural and architectural relationship with musculoskeletal tissue. Stecco et al (2008) consider the tensional forces transferred to the fascial expansions and tendons and the possible affects on proprioceptors. In this way forces are spread across a wide area in several directions providing the necessary feedback via proprioception for economical and efficient movement at local and more distant sites. Van der Wal’s (2009) research highlights the activity and role of the mechanoreceptor. Defined not only by its functional properties, but also by its architectural environment. He argues that it is the architecture of the fascial connective tissue in relation to the muscular tissue components and skeletal elements that play a major role in the coding of the proprioceptive information being provided.  As already stated fascia architecture has the ability to mediate forces that cause deformation of receptors that are not directly attached to the fascia itself representing the main stimulus for mechanoceptors, effecting proprioceptive output (Van der Wal, 2009).

Mechanoreceptive information needed for the process of proprioception originates not only from fascia and other connective tissue structures but also from mechanoreceptive or even tactile information from skin, muscles, joint surfaces, and joint structures. Van der Wal’s research demonstrates that mechanorecptors are triggered by mechanical deformation. Proprioceptors monitor timing, intensity, duration and release of tissue deformation in a very precise manner. Myofascial connections provide anatomical continuity linking synergistic muscles to allow reciprocal feedback via multiple pathways, of a mechanical and neural nature, as parts of a specific fascia would be tensioned in a selective manner resulting in a specific pattern of proprioceptive activation (Sharkey 2008).

Stecco (2009) observed that muscle spindles attach to the perimysium suggesting that the spindles are monitoring the connective tissue tension as a primary function. Free nerve endings are, for the most part, nociceptive. Pacinian corpuscles and Golgi organs, which are encapsulated, monitor and respond to local tissue compression as a result of rapid movements and vibration. Encapsulated Ruffini endings, which are only partially encapsulated, respond to changes in axial tension.

Guimberteau et al (2010) has provided the foundation for a new vision of anatomy. This new vision embraces global dynamics and continuous matter (a tissue continuum) and sheds new light on the relationships between the connective tissues of the human body such as dense sheets of muscle coverings, aponeuroses, specific local adaptations including ligaments, tendons, blood vessels, lymphatic’s and nerves encased. This and other recent research supports and encourages a more global perspective encouraging surgeons to appreciate that they are working on an organ system and not simply an individual muscle, thus encouraging a sparring approach when incising tissue in an effort to curtail the disruption of the surrounding fascial tissues and architecture of the anatomical location. This new vision calls into question the very foundations of the classical anatomical views held to date and should have a profound impact on current procedures and methodologies for a wide range of surgical procedures and post surgical medical exercise interventions. Guimberteau et al (2010) demonstrated that the continuity of the connective tissue is not interrupted despite distension during sliding or gliding motions. Sharkey (2012) provided a strong visual record of the continuity of the fascia superficialis.

Guimberteau further suggested this network resembled a Tensegrity icosahedron. In the icosahedron the outer shell is under tension.  The vertices are held apart by internal compression "struts" that float in the tension network (Levin. 1975). The icosahedron tensegrity is a naturally occurring, completely triangulated, truss that is 3 dimensional (Sharkey, J. 2010 hypothesized that BioTensegrity works on the 4th Dimension). BioTensegrity is gravity independent, flexible hinged Omni-directional structure whose mechanical behavior is non linear.

 

In part 2 of this series:

John Sharkey will discuss BioTensegrity, Four Bar Linkage and Guided Stress Transfer (GSF) with Clinical Implications for medical massage and movement therapies.

About the author

John Sharkey MSc is a Clinical Anatomist, Exercise Physiologist, author and founding member of the BioTensegrity Interest Group (B.I.G.). John is a popular international presentor on topics of bodywork and movement therapies. He is a member of the editorial team of the Journal of Bodywork and Movement Therapies and International Journal of Therapeutic Massage & Bodywork and a reviewer for the International Journal of Osteopathic Medicine. John also provides short courses in human anatomy Thiel soft fix and fresh frozen cadaver dissection with a special focus on BioTensegrity.

References:

Findley, T., 2012. Fascia  Science and  Clinical Applications: A Clinical/Researcher’s Perspectives. Editorial. Journal of Bodywork and Movement Therapies 16, 64-66

Guimberteau J, Delage J, McGrouther D, Wong J., 2010. The microvacuolar system: how connective tissue sliding works. J Hand Surg Eur. 2010;35(8):614–622.

Huijing,P. A., 2003. Muscular force transmission necessitates a multilevel intergrative approach to the analysis of function of skeletal muscle. Excerc, Sport Sci. Rev. 31, 167-175.

Huijing, P. A., 2009. Epimuscular force transmission: a historical review and implications for new research. International Soceity of Biomechanics Muybridge Award Lecture,Taipe, 2007. Journal of Biomechanics. 42(1), 9-21.

Huijing, P.A., Baan, G.C., 2001. Extramuscular myofascial force transmission within the rat anterior tibial compartment: Proximo-disstal differences in muscle force. Acta Physiol. Scand, 173, 1-15.

Ingber, D., 2008. Tensegrity and mechanotransduction. Journal of Bodywork and Movement Therapies. 12(3), 198-200.

Langevin, H. M., 2008. Potential role of fascia in chronic musculoskeletal pain. In J. Audette, and A. Bailey (Eds). Integrative pain management: The science and practice of complementary and alternative medicine in pain management. (pp. 123-132). New Jersey, USA. Humana Press.

Levin, S. M., 1981. The icosahedron as a biologic support system; Houston. Alliance for Engineering in Medicine and Biology. p 404.

Levin, S. M., 1982. Continuous tension, discontinuous compression, a model for biomechanical support of the body. Bulletin of Structural Integration, Rolf Institute, Bolder:31-33.

Levin, S. M., 1995. The Importance of Soft Tissues for Structural Support of the Body.

Spine: State of the Art Reviews, Volume 9/Number 2, May

Purslow, P.P., Delage, J.P., 2012. General structure and composition of muscle fasciae. In: Scheilp, R., Findley, T.W., Chaitow, C., Huiling, P.A., Fascia: the tensional network of the human body. Elsevier, Oxford, pp. 5-10.

Schleip, R., 2003a. Fascial Plasticity-A new neurobiological explanation: Part 1. Journal of Bodywork and Movement Therapies. 7(1), 11-19.

Schleip, R., 2003b. Fascial Plasticity-A new neurobiological explanation: Part 2. Journal of Bodywork and Movement Therapies. 7(2), 104-116

Schleip, R., and Muller, D.V., 2013. Training principles for fascial connective tissues: Scientific foundation and suggested practical applications. Journal of Bodywork and Movement Therapies. 17, 103-115.

Sharkey, J. 2008.  Concise Book of Neuromuscular Therapy: a trigger point manual. Chichester, UK: Lotus Publishing. North Atlantic Books, California.

Standring, S., (2008). Gray’s Anatomy, The Anatomical Bases of Clinical Practice. (40th ed.). Edinburgh, United Kingdom: Elsevier Churchill Livingston.

 Stecco, C., Gagey, O., Belloni, A., 2007b. Anatomy of the deep fascia of the upper limb. Second part: study of innervations. Morphologie, 91, 38-43.

Stecco, A., Macchi, V., Stecco, C. Porzionato, A., Day, J.A., Delmas, V., De Caro, R., 2009. Anatomical study of myofascial continuity in the anterior region of the upper limb. Journal of Movement and Bodywork Therapies. 13(1). 53-62.

Van der Wal, J., 2009. The architecture of the connective tissue in the musculoskeletal system- an often overlooked functional parameters as to proprioception in the locomotor apparatus. International Journal of Therapeutic Massage and Bodywork. 2(4), 9-23.

Wood Jones, F., 1946.  Buchanan’s Manual of Anatomy, 7th edn. London: Bailliere, Tindall and Cox.