Download PDF
Arthritis und Rheuma 2022; 42(03): 159-165
DOI: 10.1055/a-1821-5952
Schwerpunkt

Faszientraining – nur ein neuer Trend oder sinnvolle Therapieergänzung bei chronischen Erkrankungen des Bewegungssystems?

Training of the fascia – just a new trend or a sensible therapy supplement in diseases of the musculoskeletal system?
Kay Niemier
1   Westmecklenburg Klinikum Helene von Bülow, Hagenow
› Author Affiliations
› Further Information
Also available at
    Permissions and Reprints

ZUSAMMENFASSUNG

Immer wieder werden neue Therapieformen für (Schmerz-)Erkrankungen des Bewegungssystems propagiert. Faszientraining ist ein relativ neuer Trend. In der Tat wurde Bindegewebe inklusive der Faszien lange als passive Struktur ohne hohe Relevanz für chronische Schmerzen des Bewegungssystems missachtet. Neuere anatomische, aber auch trainingswissenschaftliche Erkenntnisse zeigen jedoch, dass die Beachtung von Faszien im Präventionssport und in der medizinischen Trainingstherapie ein wichtiges Element sein kann. Einbezogen in ein sinnvolles Trainingsprogramm und einen biopsychosozialen Behandlungsansatz bietet das Faszientraining einen sinnvollen Zusatz zu den etablierten Therapien.

ABSTRACT

Frequently new therapies are propagated for chronic diseases of the musculoskeletal system. Training of the fascia is one relatively new trend. As a matter of fact, connected tissue including the fascia was long seen as a passive tissue without real relevance for chronic pain syndromes of the musculoskeletal system. However, new findings from anatomy and training science indicate that including fascia in training concepts might improve outcome. Included in a sensible training and a bio-psycho-social treatment concept, training of the fascia seems to be an important add on to established therapies.

Schlüsselwörter

Faszien - Training - Bindegewebe - chronischer Schmerz - Bewegungssystem

Keywords

Fascia - training - connective tissue - chronic pain - musculoskeletal system


Publication History

Article published online:
07 June 2022

© 2022. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

  • Literatur

  • 1 Niemier K. Multimodal, polypragmatisch und kostenintensiv – Rückenschmerzbehandlungen auf dem Prüfstand. Manuelle Medizin 2012; 50: 16-27
    CrossrefGoogle Scholar
  • 2 Stecco C. Functional Atlas of the Human Fascial System. London: Churchill Livingstone Elsevier; 2015
    Google Scholar
  • 3 Adhikari AS, Chai J, Dunn AR. Mechanical load induces a 100-fold increase in the rate of collagen proteolysis by MMP-1. J Am Chem Soc 2011; 133: 1686-1689
    CrossrefPubMedGoogle Scholar
  • 4 Carano A, Siciliani G. Effects of continuous and intermittent forces on human fibrooblasts in vitro. Eu J Orthod 1996; 18: 19-26
    CrossrefPubMedGoogle Scholar
  • 5 Kaux JF, Drion P, Libertiaux V. et al Eccentric training improves tendon biomechanical properties: a rat model. J Orthod Res 2013; 31: 119-124
    CrossrefPubMedGoogle Scholar
  • 6 Hinz B, Phan SH, Thannickal VJ. et al Recent developments in fibroblast biology: paradigms for connective tissue remodeling. Am J Pathol 2012; 180: 1340-1355
    PubMedGoogle Scholar
  • 7 Schleip R, Naylor IL, Ursu D. et al Passive muscle stiffness may be influenced by active contractility of intrasmuscular connective tissue. Med Hypothesesc 2006; 66: 66-71
    CrossrefPubMedGoogle Scholar
  • 8 Schleip R, Duerselen L, Vleeming A. et al Strain hardening of fascia: static stretching of dense fibrous connective tissues can induce a temporary stiffness increase accompanied by enhanced matrix hydration. J Bodywork Mov Ther 2012; 16: 94-100
    CrossrefPubMedGoogle Scholar
  • 9 Abu-Hijleh MF, Roshier AL, Al-Shboul Q. et al The membranous layer of superficial fascia: evidence for its widespread distribution in the body. Surg Radiol Anat 2006; 28: 606-619
    CrossrefPubMedGoogle Scholar
  • 10 Lancerotto L, Stecco C, Macchi V. et al Layers of the abdominal wall: anatomical investigation of the subcutaneous tissue and superficial fascia. Surg Radiol Anat 2011; 33: 835-842
    CrossrefPubMedGoogle Scholar
  • 11 Tsukahara K, Tamatsu Y, Sugawara Y. et al Relationship between the depth of facial wrinkles and the density of the retinacula cutis. Arch Dermatol 2012; 148: 39-46
    CrossrefPubMedGoogle Scholar
  • 12 Stecco A, Gilliar W, Brad S. et al The anatomical and functional relation between gluteus maximus and fascia lata. J Bodywork Mov Ther 2013; 17: 512-517
    CrossrefPubMedGoogle Scholar
  • 13 Abu-Hijleh MF, Harris PF. Deep fascia on the dorsum of the ancle and foot: extensor retinacula revisited. Clin Anat 2007; 20: 186-195
    CrossrefPubMedGoogle Scholar
  • 14 Milz S, Benjamin M, Putz R. Molecular Parameter indicating adaptation to mechanical stress in fibrose connective tissue. Adv Anat Embryol Cell Biol 2005; 178: 1-71
    PubMedGoogle Scholar
  • 15 Huijing PA, Baan GC. Myofascial force transmission causes interaction between adjacent muscles and connective tissue: effect of blunt dissection and compartmental fasciotomy on length force characteristics of rat extensor digitorum longus muscle. Arch Physiol Biochem 2001; 109: 97-109
    CrossrefPubMedGoogle Scholar
  • 16 McCombe D, Brown T, Slavin J. et al The histochemical structure of the deep fascia and its structural response to surgery. J Hand Surg 2001; 26: 89-97
    CrossrefPubMedGoogle Scholar
  • 17 Gao Y, Kostrominova TY, Faulkner JA. et al Age related changes in the mechanical propertiesof the epimysium in skeletal muscles of rats. J Biochem 2008; 41: 465-469
    Google Scholar
  • 18 Järvinen TA, Jozsa L, Kanus P. et al Organization and distribution of intramuscular connective tissue in normal and immobilized skeletal muscles. An immunhistochemical, polarization and scanning electron microscopic study. J Muscle Res Cell Motil 2002; 23: 245-254
    CrossrefPubMedGoogle Scholar
  • 19 Strasmann T. Functional topography and ultrastructure of periarticular mechanoreceptors in the lateral elbow region of the rat. Acta Anat 1990; 138: 1-14
    CrossrefPubMedGoogle Scholar
  • 20 Niemier K, Seidel W. Der Einfluss von muskulo-skeletaler Funktionsstörung auf chronische Schmerzsyndrome des Bewegungssystems. Schmerz 2007; 21: 139-145
    CrossrefPubMedGoogle Scholar
  • 21 Beyer LB, Niemier K. Funktionsstörungen am Bewegungssystems. Funktionelle Reagibilität als Grundlage eines optimalen Bewegungsresultats. Manuelle Medizin 2018; 56: 293-299
    CrossrefGoogle Scholar
  • 22 Niemier K. Funktion-Funktionsstörung-Funktionserkrankung. Ein funktionell-systemischer Zugang zu Erkrankungen des Bewegungssystems. Manuelle Medizin 2021; 39: 167-171
    CrossrefGoogle Scholar
  • 23 Niemier K. Schmerzen des Bewegungssystems. Neue Erklärungsmodelle notwendig?. Sportärztezeitung 2021; 04: 20-24
    Google Scholar
  • 24 Beyer L, Liefring V, Niemier K, Seidel E. Funktionsstörungen im Bewegungssystem – ihre Bedeutung in Prävention, Kuration und Rehabilitation. Manuelle Medizin 2019; 57 (06) 447-450
    CrossrefGoogle Scholar
  • 25 Schulz J, Vitt E, Niemier K. A systematic review of motor control tests in low back pain based on reliability and validity. J Bodywork Mov Ther 2022; 29: 239-250
    CrossrefPubMedGoogle Scholar
  • 26 Niemier K, Seidel W, Engel K. et al Motor and Postural Control in Patients With Chronic Nonspecific Low Back Pain: A Blinded And Controlled Cross-Sectional Study Comparing The Quantity Of Motor And Postural Control Disturbances Between Healthy Controls And Patients With Chronic Non-Specific Low Back Pain. Adv Ortho and Sports Med 2020: AOASM-133 DOI: 10.37722/AOASM.20205
    CrossrefGoogle Scholar
  • 27 El-Labban NG, Hopper C, Barber P. Ultrastructural finding of vascular degeneration in myositis ossificans circumscripta (fibrodysplasia ossificans). J of oral Pathol and Med 1993; 22: 428-431
    CrossrefPubMedGoogle Scholar
  • 28 Kjaer M, Langberg H, Heinemeier K. et al From mechanical loading to collagen synthesis, structural changes and function in human tendon. Scand J of Med and Science in Sports 2009; 19: 500-510
    CrossrefPubMedGoogle Scholar
  • 29 Wood TO, Cooke PH, Goodship AE. The effect of exercise and anabolic steroid on the mechanical properties and crimp morphology of the rat tendon. American J of Sports Medicine 1988; 16: 153-158
    CrossrefPubMedGoogle Scholar
  • 30 Reeves ND, Narici MV, Maganaris CN. Myotendinous plasticity to aging and resistance exercise in humans. Experimental Physiol 2006; 91: 483-498
    CrossrefPubMedGoogle Scholar
  • 31 Wirtouw E, Mahieu N, Roosen P. et al The role of streching in tendon injuries. Brit J of Sports Med 2007; 41: 224-226
    CrossrefPubMedGoogle Scholar
  • 32 Kram R, Dawson TJ.. Energetics and biomechanics of locomotion by red kangaroos (Macropus rufus): Comparative Biochem and Physiol. 1998 B120 41-49
    PubMedGoogle Scholar
  • 33 Sawickie GS, Lewi CL, Ferris DP. It pays to have a spring in your step. Exercise and Sports Science Reviews 2009; 37: 130-138
    CrossrefPubMedGoogle Scholar
  • 34 Fukunaga T, Kawakami Y, Kubo K. et al Muscle and tendon interaction during human movements. Exercise and Sport Sciences Reviews 2002; 30: 106-110
    CrossrefPubMedGoogle Scholar
  • 35 Kawakami Y, Muraoka T, Ito S. et al In vivo muscle fiber behavior during counter movement exercise in humans reveals a significant role for tendon elasticity. J of Physiol 2002; 540: 635-646
    CrossrefPubMedGoogle Scholar
  • 36 Chaitow L. Research in water and fascia. Micro-tornados, hydrogenated diamonds and nanocrystals. Massage Today 2009; 09: 1-3
    Google Scholar
  • 37 Lu Y, Chen C, Kallakuri S. et al Neural response of cervical facet joint capsule to stretch: a study of whiplash pain mechanism. Stapp Car Crash J 2005; 49: 49-65
    PubMedGoogle Scholar
  • 38 Proske U, Gandevia SC. The kinematic senses. J of Physiol 2009; 587: 4139-4146
    CrossrefPubMedGoogle Scholar
  • 39 Ianuzzi A, Pickar JG, Khalsa PS. Relation between joint motion and facet joint capsule strain during cat and human lumbar spine motion. J of Manipulative and Physiological Therapies 2011; 34: 420-431
    CrossrefPubMedGoogle Scholar
  • 40 Benetazzo L, Bizzego A, De Caro. et al 3 D reconstruction of the crural and thoracolumbar fascia. Surg Radiol Anat 2011; 33: 855-862
    CrossrefPubMedGoogle Scholar
  • 41 Tesarz J, Hoheisel U, Wiedenhofer B. et al Sensory innervation of the thoracolumbar fascia in rats and humans. Neuroscience 2011; 194: 302-308
    CrossrefPubMedGoogle Scholar
  • 42 Taimela S, Kankaanpää M, Luoto S. The effect of lumbar fatigue on the ability to sense a change in lumbar position. A controlled study. Spine 1999; 24: 1322-1327
    CrossrefPubMedGoogle Scholar
  • 43 Lambertz D, Hoheisel U, Mense S.. Distribution of synaptic field potentials induced ba TTX-resistant skin and muscle afferents in rat spinal segment L4 and L5: Neuroscience Letters. 2006; 409: 14-18
    PubMedGoogle Scholar
  • 44 Mosley GL, Zalucki NM, Wiech K. Tactile discrimination, but not tactile stimulation alone, reduces chronic limb pain. Pain 2008; 137: 600-608
    CrossrefPubMedGoogle Scholar
  • 45 Schleip R, Müller DG. Training principles for fascial connective tissues: Scientific foundation and suggested practical applications. J Bodywork Mov Ther 2013; 17: 103-115
    CrossrefPubMedGoogle Scholar