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some areas a local distinction of different tissue elements(such as aponeuroses, ligaments, etc.) is possible, manyareas such as those in proximity to major joints consist ofgradual transitions between different tissue architecturesin which a clear distinction often appears as arbitrary andmisleading (Schleip et al., 2012b).

Previous anatomical terminology often restricted theterm fascia to dense sheets of connective tissues withlattice-like or seemingly irregular fibre architecture. Incontrast, the more comprehensive and novel terminologyproposed by the series of international fascia researchcongresses continues to honour that usage by referring tosuch tissues as proper fascia, but at the same time allowsfor a perceptual orientation in which also the other fibrousconnective tissues mentioned above are included aselements of a body wide fascial net for multi-articulartensional strain transmission (Findley et al., 2007; Huijinget al., 2009; Chaitow et al., 2012) (Fig. 1). It is importantto understand, that the local architecture of this networkadapts to the specific history of previous strain loadingdemands (Blechschmidt, 1978; Chaitow, 1988).

A focused training of this fascial network could be ofgreat importance for athletes, dancers and other move-ment advocates. If ones fascial body is well trained, that isto say optimally elastic and resilient, then it may be relied

on to perform effectively and at the same time to offera high degree of injury prevention (Kjaer et al., 2009). Untilrecently, most of the emphasis in sports has been focusedon the classic triad of muscular strength, cardiovascularconditioning, and neuromuscular coordination (Jenkins,2005). Some alternative physical training activities e suchas Pilates, yoga, Continuum Movement, and martial arts eare already taking the connective tissue network intoaccount. Here the importance of the fasciae is oftenspecifically discussed, though modern insights in the field offascia research have often not been specifically included. Itis therefore suggested that in order to build up an injury-resistant and elastic fascial body network it is essential totranslate current insights from the dynamically developingfield of fascia research into practical training programs.The intention is to encourage physical therapists, sportstrainers and other movement teachers to incorporate theprinciples presented here and to apply them to theirspecific context.

The following presents some basic biomechanical andneurophysiological foundations for a fascia orientedtraining approach, followed by suggestions for some prac-tical applications.

Basic foundations

Fascial remodelling

A recognized characteristic of connective tissue is itsimpressive adaptability: when regularly put underincreasing yet physiological strain, the inherent fibroblastsadjust their matrix remodelling activity such that the tissuearchitecture better meets demand. For example, throughour everyday biped locomotion the fascia on the lateralside of the thigh develops a more palpable firmness than onthe medial side. This difference in tissue stiffness is hardlyfound in wheel chair patients. If we were instead to spendthe majority of our locomotion with our legs straddlinga horse, then the opposite would happen, i.e., after a fewmonths the fascia on the inner side of the legs wouldbecome more developed and strong (El-Labban et al.,1993).

The varied capacities of fibrous collagenous connectivetissues make it possible for these materials to continuouslyadapt to the most challenging regular strains, particularlyin relation to changes in length, strength and ability toshear. Not only the density of bone changes, for example,as happens with astronauts who spend time in zero gravitywherein the bones become more porous (Ingber, 2008);fascial tissues also react to their dominant loadingpatterns. With the help of the fibroblasts, they slowly butconstantly react to everyday strain as well as to specifictraining, steadily remodelling the arrangement of theircollagenous fibre network (Kjaer et al., 2009). For example,with each passing year half the collagen fibrils are replacedin a healthy body (Neuberger and Slack, 1953). Extrapola-tion of these roughly exponential renewal dynamicspredicts an expected replacement of 30% of collagen fibreswithin 6 months and of 75% in two years.

Interestingly, the fascial tissues of young people showstronger undulations e called crimp -within their collagen

Figure 1 Different connective tissues considered here asfascial tissues. Fascial tissues differ in terms of their densityand directional alignment of collagen fibers. E.g. superficialfascia is characterized by a loose density and mostly multidi-rectional or irregular fibre alignment; whereas in the densertendons or ligaments the fibres are mostly unidirectional. Notethat the intramuscular fasciae e septi, perimysium and endo-mysium e may express varying degrees of directionality anddensity. The same is true e although to a much larger degree efor the visceral fasciae (including soft tissues like the omentummajus and tougher sheets like the pericardium). Depending onlocal loading history, proper fasciae can express a two-directional or multi-directional arrangement. As indicated,there are substantial overlaps areas in which a clear tissuecategory will be difficult or arbitrary. Not shown here areretinaculae and joint capsules, whose local properties mayvary between those of ligaments, aponeuroses and properfasciae.

2 R. Schleip, D.G. Muller

+ MODEL

Please cite this article in press as: Schleip, R., Muller, D.G., Training principles for fascial connective tissues: Scientific foundation andsuggested practical applications, Journal of Bodywork & Movement Therapies (2012), http://dx.doi.org/10.1016/j.jbmt.2012.06.007

fibres, reminiscent of elastic springs, whereas in olderpeople the fibres appear as rather flattened (Staubesandet al., 1997). Research has confirmed the previously opti-mistic assumption that proper exercise loading e if appliedregularly e can induce a more youthful collagen architec-ture, which shows a more wavy fibre arrangement (Woodet al., 1988; Jarniven et al., 2002) and which alsoexpresses a significant increased elastic storage capacity(Fig. 2) (Reeves et al., 2006; Witvrouw et al., 2007).

However, it seems to matter which kind of exercisemovements are applied: a controlled exercise study witha group of senior women using slow-velocity and low-loadcontractions only demonstrated an increase in muscularstrength and volume; however, it failed to yield any changein the elastic storage capacity of the collagenous structures(Kubo et al., 2003). While the latter response could possiblybe also related to age differences, more recent studies byArampatzis et al. (2010) have confirmed that in order toyield adaptation effects in human tendons, the strainmagnitude applied should exceed the value that occursduring habitual activities. These studies provide evidenceof the existence of a threshold or set point at the appliedstrain magnitude at which the transduction of themechanical stimulus influences the tensional homeostasisof the tendons (Arampatzis et al., 2007).

The catapult mechanism: elastic recoil of fascialtissues

Kangaroos can jump much farther than can be explained bythe force of the contraction of their leg muscles. Undercloser scrutiny, scientists discovered that a spring-likeaction is behind the unique ability: the so-called catapultmechanism (Kram and Dawson, 1998). Here, the tendonsand the fascia of the legs are tensioned like elastic rubber

bands. The release of this stored energy is what makes theamazing jumps possible. The discovery soon thereafter thatgazelles also utilize the same mechanism was hardlysurprising. These animals are also capable of impressiveleaping as well as running, though their musculature is notespecially powerful. On the contrary, gazelles are generallyconsidered to be rather delicate, making the springy easeof their incredible jumps all the more interesting.

The possibility of high-resolution ultrasound examina-tion made it possible to discover similar orchestration ofloading between muscle and fascia in human movement.Surprisingly, it has been found that the fasciae of humanshave a similar kinetic storage capacity to that of kangaroosand gazelles (Sawicki et al., 2009). This is not only madeuse of when we jump or run but also with simple walking, asa significant part of the energy of the movement comesfrom the same springiness described above. This newdiscovery has led to an active revision of long-acceptedprinciples in the field of movement science.

In the past, it was assumed that in a muscular jointmovement, the skeletal muscles involved shorten and thisenergy passes through passive tendons, which results in themovement of the joint. This classic form of energy transferis still true e according to these recent measurements e forsteady movements such as bicycling. Here, the musclefibres actively change in length, while the tendons andaponeuroses scarcely grow longer. The fascial elementsremain quite passive. This is in contrast to oscillatorymovement with an elastic spring quality, in which thelength of the muscle fibres changes little. Here, the musclefibres contract in an almost isometric fashion (they stiffentemporarily wit