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Fascia is too tough for mechanical deformation

PainSci » bibliography » Chaudhry et al 2008
updated
Tags: treatment, quackery, biology, massage, fascia, study_trial, study_lab, manual therapy, professions, contis, controversial, etiology, pro

Three pages on PainSci cite Chaudhry 2008: 1. The Complete Guide to Trigger Points & Myofascial Pain 2. Shin Splints Treatment, The Complete Guide 3. Does Fascia Matter? 

PainSci commentary on Chaudhry 2008: ?This page is one of thousands in the PainScience.com bibliography. It is not a general article: it is focused on a single scientific paper, and it may provide only just enough context for the summary to make sense. Links to other papers and more general information are provided wherever possible.

In this paper, Chaudhry and colleagues show that fascia is much too tough a tissue to “release” by mechanical deformation. This contradicts a defining rationale for therapies focused on manipulating fascia. Although not all therapists assume that fascia is “tight” and needs to be “released,” a great many still do.

The authors imply in their summary that it might be possible to change the thin superficial nasal fascia, but the main text of the paper makes it clear that even that fascia is extremely tough, and would only mechanically deform if subjected to surprisingly intense forces. This is consistent with well-established properties of fascia, namely that it’s extremely tough stuff. Collagen is like that.

If I could write my own conclusion to this paper, it would go more like this:

CONCLUSION: You cannot change the structure of fascia, because it is tougher than Kevlar. If the stuff were much thicker than it is, people would be bulletproof.

CLINICAL IMPLICATIONS: If you want to physically change someone's fascia by force, you're going to have to get medieval. This directly contradicts a major popular rationale for fascial manipulation.

~ Paul Ingraham

original abstract †Abstracts here may not perfectly match originals, for a variety of technical and practical reasons. Some abstacts are truncated for my purposes here, if they are particularly long-winded and unhelpful. I occasionally add clarifying notes. And I make some minor corrections.

CONTEXT: Although mathematical models have been developed for the bony movement occurring during chiropractic manipulation, such models are not available for soft tissue motion.

OBJECTIVE: To develop a three-dimensional mathematical model for exploring the relationship between mechanical forces and deformation of human fasciae in manual therapy using a finite deformation theory.

METHODS: The predicted stresses required to produce plastic deformation were evaluated for a volunteer subject's fascia lata, plantar fascia, and superficial nasal fascia. These stresses were then compared with previous experimental findings for plastic deformation in dense connective tissues. Using the three-dimensional mathematical model, the authors determined the changing amounts of compression and shear produced in fascial tissue during 20 seconds of manual therapy.

RESULTS: The three-dimensional model's equations revealed that very large forces, outside the normal physiologic range, are required to produce even 1% compression and 1% shear in fascia lata and plantar fascia. Such large forces are not required to produce substantial compression and shear in superficial nasal fascia, however.

CONCLUSION: The palpable sensations of tissue release that are often reported by osteopathic physicians and other manual therapists cannot be due to deformations produced in the firm tissues of plantar fascia and fascia lata. However, palpable tissue release could result from deformation in softer tissues, such as superficial nasal fascia.

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