Very interesting congress presentation by Dr Gracovetsky on fascia and the musculoskeletal system

Recently, I came across this series of conference lectures by Dr. Serge Gracovetsky on fascia, ‘biotensegrity’ and mechano-transduction as it relates to movement and rehabilitation outcomes. Previously, fascia was thought to play a trivial role in movement and over years of research it has been identified to play a critical role in movement control, efficiency, and adaptability as well as protecting anatomical structures (such as the spine) from excessive mechanical stress. This is an area I was introduced to in a presentation by Dan Pfaff and further by the ALTIS group in their Performance Therapy Course (which I highly recommend).

Be sure to watch the full 3-part presentation. I am sure it will provoke a lot of reflection and thought. Especially on what some of the points raised relating to functional anatomy, fascia integrity, posture and the role of the CNS as the body’s key stabiliser, may mean for the preparation of the athlete(s), patients or clients you work with.

Below, I also provide the (un-edited) notes I took whilst watching it.

Enjoy! :)

Part 1

Part 2

Part 3

My notes:

  • Function dictates anatomy. Hence the term functional anatomy

  • The lumbodorsal fascia minimises stress on the spine, permitting muscle to function properly (I.e., pull not push)

  • No fascia = no efficient control of muscles = excessive stress

  • Failed back surgery??? Actually, for the surgeon to go under the layers of fascia and operate, usually he has to create a heck of a lot of damage to the fascia

  • No fascia or damaged fascia = rehabilitation is questionable or may not be able to do it

  • Shut down muscles to minimise stress… There is a trade-off between muscle (20%) and fascia (80%) activities. You do not load a tissue continuously, you are oscillating between tissues

  • We don’t have enough muscle to lift more than 50 kg

  • Be very careful with collagen that works. Because when it works it costs nothing in terms of metabolic and energy consumption

  • Fascia is needed to transmit power to the upper extremities. If you remove the fascia you will be sub-optimal

  • Fascia has a Poisson ratio of 1, which = ultimate efficiency

  • Internal abdominal pressure does not produce significant force on the diaphragm; internal abdominal pressure and lordosis control the force transmission efficiency of the lumbodorsal fascia

  • MSK system is an unstable system, which is stabilised by the CNS

  • Stable structure =/= good function

  • Benefit of instability: mobility degree and speed (e.g., human vs bull)

  • Rehabilitation must expose patient to variability in degrees of movement

  • Continuous postural changes will be necessary

  • Control of lordosis is critical

  • Two mechanisms to control the fascia: trunk flexion and pelvic rotation , which will both change lordosis

  • Gait requires lordotic oscillations to alternate loading issues

  • Fascia’s role is critical to minimise and equalise stress

  • We are structurally unstable - this is a benefit indispensable to survival

  • A static posture does not exist, posture is dynamic and continuously modified

  • Reason being that collagen is visco-elastic and cannot be loaded continuously

  • The fascia trigger a continuous switch of loading and forces between MSK tissues

  • Rehabilitation demands restoration of all involved structures

  • Fascia is more than just a piece of force transmission system

  • Fascia is necessary for the stability and survivability of the spine under load

  • Individuals with damaged fascia = may not be rehabilitated


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Adriano Arguedas S.