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This narrative review explores the role of fascia in force transmission, cellular changes, innervation, dysfunction and pain, as well as treatment modalities. Summarizes structure and function, highlighting implications for musculoskeletal health.
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Fascia—Current knowledge and future directions in physiatry: Narrative review Evan H. Kwong, BSc(Pharm), MD, MSc; Thomas W. Findley, MD, PhD
Aim To address the following questions: • How connective is fascia? • How much of a role does fascia play in force transmission? • What changes in fascia can occur at the cellular level? • Is fascia innervated? • Can fascia become dysfunctional and result in pain? • What does treatment of fascia involve?
Methods Searched MEDLINE and CINAHL, reviewing abstracts and introductions of articles for relevance to narrative review Obtained additional articles from the citations of selected articles Summarized and used information from all articles for each section contained in this narrative review Certain book chapters were also included for a general overview
Results This narrative review summarized several aspects of structure and function of fascia from the gross anatomical level to the cellular level • Fascia is continuous throughout the body, supporting various functions including force transmission and sliding • Fascia has also been shown to be innervated • Changes in fascia could affect normal functions of force transmission or sliding in the musculoskeletal system, leading to pain or proprioceptive issues
Conclusion Once the structure and functions of fascia in the musculoskeletal system are further elucidated, the pathophysiology and consequences of many disorders may be better explained Many neuromuscular and musculoskeletal disorders can be additionally served by research with fascial perspective, to optimize treatment strategies