Response to Mechanical Properties and Physiological Challenges of Fascia: Diagnosis and Rehabilitative Therapeutic Intervention for Myofascial System Disorders

Damage to the fascia can cause significant performance deficits in high-performance sports and recreational exercise and may contribute to the development of musculoskeletal disorders and persistent potential pain. The fascia is widely distributed from head to toe, encompassing muscles, bones, blood vessels, nerves, and internal organs and comprising various layers of different depths, indicating the complexity of its pathogenesis. It is a connective tissue composed of irregularly arranged collagen fibers, distinctly different from the regularly arranged collagen fibers found in tendons, ligaments, or periosteum, and mechanical changes in the fascia (stiffness or tension) can produce changes in its connective tissue that can cause pain. While these mechanical changes induce inflammation associated with mechanical loading, they are also affected by biochemical influences such as aging, sex hormones, and obesity. Therefore, this paper will review the current state of knowledge on the molecular level response to the mechanical properties of the fascia and its response to other physiological challenges, including mechanical changes, innervation, injury, and aging; imaging techniques available to study the fascial system; and therapeutic interventions targeting fascial tissue in sports medicine. This article aims to summarize contemporary views.

Thirty years of translational research in Mobility Medicine: Collection of abstracts of the 2020 Padua Muscle Days

More than half a century of skeletal muscle research is continuing at Padua University (Italy) under the auspices of the Interdepartmental Research Centre of Myology (CIR-Myo), the European Journal of Translational Myology (EJTM) and recently also with the support of the A&CM-C Foundation for Translational Myology, Padova, Italy. The Volume 30(1), 2020 of the EJTM opens with the collection of abstracts for the conference "2020 Padua Muscle Days: Mobility Medicine 30 years of Translational Research". This is an international conference that will be held between March 18-21, 2020 in Euganei Hills and Padova in Italy. The abstracts are excellent examples of translational research and of the multidimensional approaches that are needed to classify and manage (in both the acute and chronic phases) diseases of Mobility that span from neurologic, metabolic and traumatic syndromes to the biological process of aging. One of the typical aim of Physical Medicine and Rehabilitation is indeed to reduce pain and increase mobility enough to enable impaired persons to walk freely, garden, and drive again. The excellent contents of this Collection of Abstracts reflect the high scientific caliber of researchers and clinicians who are eager to present their results at the PaduaMuscleDays. A series of EJTM Communications will also add to this preliminary evidence.

Role of fasciae around the median nerve in pathogenesis of carpal tunnel syndrome: microscopic and ultrasound study

This study investigated the connections between the median nerve paraneural sheath and myofascial structures near it, from both macroscopic and microscopic points of view. Four samples of median nerve and surrounding tissues were excised from nine non-embalmed upper limbs for microscopic analysis. Ultrasound images were analysed in 21 healthy subjects and 16 carpal tunnel syndrome patients to evaluate median nerve transversal displacement during finger motion at carpal tunnel and forearm levels. An anatomical continuity between epimysium and paraneural sheath and a reduction of paraneural fat tissue from proximal to distal was found in all samples. Median nerve displacements at both levels were significantly reduced in carpal tunnel syndrome subjects (P < 0.001). It was observed that the median nerve is not an isolated structure but is entirely connected to myofascial structures. Therefore, unbalanced tension of epimysial fasciae can affect the paraneural sheath, limiting nerve displacement, and consequently this must be included in carpal tunnel syndrome pathogenesis.