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Heidi M. Johnson, LMT

Connective Tissue - Clue to Understanding Pain

2/19/2015

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I am intrigued by fascia, or connective tissue. I use myofascial release in many massages and find that it helps to break adhesion, thus decreasing pain and increasing range of motion. Today I read an article in The Scientist by Dr Helene M. Langevin where she explains her research with connective tissue. I'll highlight some of what she wrote below, but you can read the entire article if you want more information.

The Science of Stretch

The study of connective tissue is shedding light on pain 
and providing new explanations for alternative medicine.
Helene M. Langevin is a visiting professor of medicine and Director of the Osher Center for Integrative Medicine at Brigham and Women’s Hospital, Harvard Medical School, and a professor of neurological sciences at the University of Vermont.
Connective tissue is one of the most integral components of the human machine. Indeed, one could draw a line between any two points of the body via a path of connective tissue. This network is so extensive and ubiquitous that if we were to lose every organ, muscle, bone, nerve, and blood vessel in our bodies, we would still maintain the same shape: our “connective-tissue body.”
. . . Connective tissue is something of an orphan child in medicine: although it is an integral part of the musculoskeletal system, connective tissue is basically absent from orthopedic textbooks, which deal principally with bones, cartilage, and muscles.  Orthopedic interest is almost exclusively restricted to the “specialized” connective tissues such as tendons and ligaments, which connect bone to muscles and to other bones, respectively. Nonspecialized connective tissues, which form what’s known as the fasciae and envelop all muscles, nerves, bones, and blood vessels, are typically allotted a short paragraph in current textbooks, if mentioned at all.

However, interest in the field has been growing. . . .

One of the reasons that low-back pain is so difficult to manage is that large numbers of patients have no detectable abnormalities of the spine and associated tissues, and the source of their pain is unknown. Some groups have begun to investigate the possibility that the pain is arising from the nonspecialized connective tissues on either side of the spine. . . .

Connective tissue surrounds nerves, blood vessels, and lymphatics, and reducing changes in tissue tension could affect how these structures function. . . .
[which explains why I am finding that combining myofascial release and manual lymphatic drainage enhance each other.]

In contrast to the general neglect of connective tissue in the conventional medical and scientific fields, “alternative-medicine”  researchers, and especially clinical practitioners, have for many years recognized the potential importance of connective tissue in health and disease. In conventional physical therapy, stretching of surgical scars and joint tissue that has contracted and stiffened after prolonged immobilization is widely believed to cause remodeling of connective tissue. Alternative therapies such as myofascial release and Rolfing focus on stretching as a treatment modality for musculoskeletal pain, even in the absence of an obvious past injury or scarring. Indeed, a variety of alternative manual and movement-based therapies work under the collective assumption that connective-tissue pathology lies at the source of musculoskeletal pain, and that this can be ameliorated with manual treatments. . . 

Integrative Medicine

Clearly, connective tissue needs more attention. A simple PubMed search illustrates this problem, as specific subject headings for “nonspecialized connective tissue” do not exist. By default, alternative medicine has become a motivating force in connective-tissue research and clinical practice. This is an example of an area in which the combination of conventional and alternative medicine, typically referred to as “integrative medicine,” should be understood in a broader sense as integration within medicine itself, inspired by alternative-medicine concepts. The growth and maturation of the field of connective-tissue research will no doubt benefit from exciting new developments resulting from this integration.
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