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Article publié par
Dynamic Chiropractic
August 18, 2000, Volume 18, Issue 18
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Several months ago I attended a four-day course ("Fascial Anatomy of
the Lower Extremity") at the University of Toronto. The lecturer was Guy
Voyer,MD,DO, from Marseilles, France. He was a student and eventual
colleague of I.A. Kapandji (whose text many of us studied in college).
He is a natural anatomist who has studied the fascial system for years
and lectures worldwide on fascial analysis and treatment. He recently
lectured to French surgeons in Paris to help them avoid dysfunctional
postoperative fascial adhesions.
Dr. Voyer is probably the most knowledgeable person I have encountered on the
fascial system (internal and external), having dissected and treated the fascia
for many years. The following are some tidbits about the fascial system from his
course that you might find interesting: The fascia is that band or sheet of
aereolar or fibro-elastic tissue which envelopes the body beneath the skin
(superficial fascia), which forms the covering (deep fascia) for the muscles and
the other organs, separates the muscles into layers, and surrounds the
structures known as nerves, blood vessels and lymphatics.
Specialized fascia such as plantar, iliotibial, gluteal, thoracolumbar,
cervical and cranial aponeurosis stabilize and maintain standing posture. Dr.
Voyer refers to these as "postural fascia," and they serve a special function,
being the first to display changes with postural faults. I have found that
releasing these particular fascial planes and other areas often improves chronic
cases of those faults. Changes in tension due to postural imbalance, the pull of
gravity, trauma or inflammation are basic factors involved in physiological
changes and relate to original causes which must be taken into consideration in
the etiology of disease.
Dr. Voyer listed some functions of the fascia:
- It limits a muscle or group of muscles within a given area.
- It prevents muscles from tearing and breaking, and also prevents muscle
hernias. If muscles were not surrounded by fascia, their action would not be
even and coordinated, and they would rupture and tear. They would not reach
the strength or power that they are capable of achieving.
- The elastic property of the fascia helps to push on and maintain venous
openings after they have been squeezed by contraction. Lesions of the fascia
and the adjacent muscle inhibit venous return and lead to congestion and
eventual pathology. The movement of venous blood and lymph depends to a
large degree on muscular activity that works against and along the fascial
planes. Thickening and/or shortening of the fascia combined with
insufficient muscular activity slow the influx of blood and lymph.
- Fascial thickening develops as a response to forces of tension and
mechanical demands. Excessive thickening is frequently accompanied by
shortening, which results in excessive restriction so that movement in the
area becomes restricted, and the integrity of the relationships is
compromised. Movement at the individual vertebral levels is decreased, and
this continues until the restricted tissue is "normalized" to the point
where harmonious muscle action becomes possible.
- The state of the myofascial tissues is directly related to the structure
and function of the musculo-osseous and articular structures.
- Fascia includes the immediate environment of every living cell in the
body, and consequently we can see why it influences directly or indirectly
the cellular metabolism. Abnormal pressure or tension will affect the
diffusion of the nutritional elements of the body, and, in turn, will alter
the functioning of the cells. The fascia taken as collagen fiber tissue can
be seen as enveloped by a basic substance that is an amorphous semi-liquid
gel. The colloid gel may be the universal internal environment with which
every living cell is in contact. The application of pressure is in fact the
addition of energy to the colloid tissue. It is well known in physics that
the addition of energy can transform a colloid gel into a colloid "solution"
which explains the structural changes that occur with fascial treatment.
Dr. Voyer travels to Toronto and gives four-day workshops each year. There
are 12 "somatotherapy" courses. Each course is divided between lecture and
"hands-on" practical training. One upcoming course features myofascial
stretching, where each of the stretches uses a specific fascial chain, acting
from below to stabilize one spinal segment and a second specific fascial chain
acting from above, to distinguish the superior spinal segment from the one
below.
Warren Hammer,MS,DC,DABCO
Norwalk, Connecticut
