Fascia as an Organ of Proprioception and its Relationship to Chronic Pain

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FASCIA, PROPRIOCEPTION,
AND CHRONIC PAIN

“Fascia contains mechanoreceptors and proprioceptors.  In other words, every time we use  a muscle, we stretch fascia that is connected to  spindle cells, Ruffini and Paccini corpuscles and  Golgi organs.  The normal stretching of fascia thus  communicates the force of the muscle contraction  and the status of the muscle regarding its tone, movement, rate of change in muscle length, and  position of the associated body part to the central  nervous system.”  From Dr. Warren Hammer, the chiropractic profession’s leading expert in soft tissues and fascia (The Fascial System is a Sensory Organ).  Dr. Hammer went on to say in another article (Why We Need to Fix the Mechanoreceptors) that, “One of the most relevant discoveries in the world of anatomy over these many years is that muscle spindles, the chief proprioceptive cell affecting our muscles, are not in the muscle, but in the fascia surrounding the muscle and its muscle bundles. A mechanoreceptor is stimulated when it is deformed, but when it is restricted in fascia that is unable to glide… it is unable to stretch, which is critical for the function of the spindle cell.”

“This study demonstrated an abundant innervation of the fascia consisting in both free nerve endings and encapsulated receptors, in particular, Ruffini and Pacini corpuscles.  The hypothesis that the fascia plays an important role in proprioception, especially dynamic proprioception, is therefore advanced. In fact, the fascia is a membrane that extends throughout the whole body and numerous muscular expansions maintain it in a basal tension. During a muscular contraction these expansions could also transmit the effect of the stretch to a specific area of the fascia, stimulating the proprioceptors in that area.  From a 2007 study from the journal Morphologie (Anatomy of the Deep Fascia of the Upper Limb)

“It is now recognized that fascial network is one of our richest sensory organs. The surface area of this network is endowed with millions of endomysial sacs and other membranous pockets with a total surface area that by far surpasses that of the skin or any other body tissues. A myriad of tiny unmyelinated ‘free’ nerve endings are found almost everywhere in fascial tissues, but particularly in periosteum, in endomysial and perimysial layers, and in visceral connective tissues. If we include these smaller fascial nerve endings in our calculation, then the amount of fascial receptors may possibly be equal or even superior to that of the retina, so far considered as the richest sensory human organ. However, for the sensorial relationship with our own body – whether it consists of pure proprioception, nociception or the more visceral interoception – fascia provides definitely our most important perceptual organ.”  Dr. Robert Schleip from Fascia as an Organ of Communication

“There really is a sixth sense: it’s called proprioception. It is the sense of position and movement. It is produced by nerves in our connective tissues (ligaments, bone, fascia) and our 300-or-so muscles. Without proprioception, you couldn’t stand up (standing up is actually shockingly complicated). You couldn’t so much as scratch your nose, because you wouldn’t be able to find it.”  Paul Ingraham from his article, Proprioception, The True Sixth Sense.  I included Ingraham’s article only because he was a previous editor of Gorski & Novella’s SCIENCE-BASED MEDICINE and has written a large article decrying fascia as being an important target of manual therapies.