Musculoskeletal System

Components & Associated

Dysfunctions.
Objectives
1. Describe components of the
musculoskeletal system

2. Discuss functions of each

musculoskeletal component.

3. Discuss common dysfunctions

associated with each
musculoskeletal system
component
Components of
Musculoskeletal System
❑ Myo-fascial Component

❑ Skeletal/Articular Component
Myo-fascial Component
❑ Myo means muscle

❑ Fascia: Fibrous connective

tissue that surrounds muscles,
blood vessels, nerves and other
organs.
 
❑ Myo-fascia: Connective tissue
that encloses individual muscles
and muscle groups.
❑ Fascia originate from the
mesoderm layer .

❑ Contains closely packed bundles

of collagen fibres oriented in a
wavy pattern parallel to the
direction of pull

❑ The collagen fibres are produced

by fibroblasts located within the
fascia.
❑ Fasciae are similar to ligaments
and tendons as they are all made of
collagen except that ligaments join
one bone to another bone,
tendons join muscle to bone and
fasciae surround muscles or other
structures.
❑ Fasciae is flexible structures
able to resist great
unidirectional tension forces
until the wavy pattern of fibres
has been straightened out by
the pulling force.
❑ In a healthy state it is a relaxed and
wavy connective tissue

❑ When damaged by local trauma or

inflammation it can lose its malleability
causing its layers to tighten and restrict
the movement of underlying tissues
leading to pain, hindered range of
motion, or decreased blood flow

❑ Fascia may appear passive structurally

but are, in fact, active.
Classification
❑ Superficial fascia:
✔ Found directly under the
skin and superficial adipose
layers.
✔ Thicker in the trunk than in
the limbs and periphery.

❑ Deep fascia:
✔ Covers bones, muscles,
nerves and blood vessels.
❑ Visceral fascia.
✔ Surrounds organs in
cavities e.g. abdomen, lung
(pleura) and heart
(pericardium).

❑ Parietal fascia. 
✔ Lines a body cavity e.g.
parietal fascia is found in
the pelvis.
Functions of Fascia
❑ The function of fascia depends on
its location but generally they can
1. Provide support for
surrounding tissues.
2. Help reduce friction
(Hyaluronan).
3. Transmit mechanical tension
generated by muscular activity
or external forces.
4. Protect deep structures and
❑ The distinct feature of fascia is that it
possesses strength because it is tightly
packed with bundles of collagen and
wrapped tightly.
❑ The fibres are usually oriented in one
direction so that the structure does
not become loose or lax.
❑ Fascia is quite flexible and able to
resist tension
Innervation
❑ One of the richest sensory organs,
embedded with nociceptors,
proprioceptors, thermoreceptors,
chemoreceptors and
mechanoreceptors ( muscles
spindles, Ruffini and Pacini
corpuscles, Golgi endings and free
nerve endings)
❑ Plays a major role in the
perception of posture and
movement affecting our
proprioception and
coordination.
❑ Whenever we change our
posture or move in any way
fascial tissues’
mechanoreceptors deform and
activate, sending afferent
information into the spinal cord
and brain.
Muscle Fascia
❑ Epimysium:
✔ Encloses entire muscle
group.

❑ Perimysium:
✔ Encloses muscle fibre
bundles.

❑ Endomysium:
✔ Surrounds individual
muscle fibres.
Identify the 3 muscle
fascia
Would you have gotten it
right?
Functions of Muscle
Fascia
1. Holds the muscle together
and keeps it in the correct
place.

2. Separate muscles so they can

work independently of each
other (compartments).

3. Provides a lubricated surface

so that the muscles can move
Force transmission and
elastic properties of fascia
❑ Like other soft tissues it has
variable degree of elasticity that
allow it to withstand deformation
when forces and pressure are
applied as it can recover and
return to its starting shape and
size.
❑ The restoration of shape
occurs through elastic recoil
via hysteresis.

❑ When loaded for any length of

time, tissues lengthen and
distort until they reach a point
of balance. If loading is
sustained, over time, chronic
deformation will result
❑ The time needed to return to
normal via elastic recoil depends
on the uptake of water by the
fascia and whether its elastic
potential has been exceeded.

❑ When it dries up and tightens

around muscles, it can limit
mobility and cause painful knots
(trigger points) to develop
Fascial dysfunctions
❑ Aetiology:
❑ Fascia can shorten,
solidifies and thicken in
response to: trauma
(surgery or injury),
poor posture,
inflammation, lack of
movement variations,
sub-optimal nutrition and
habitual postures.
❑ Associated Symptoms
✔ Pain, stiffness, tissue fatigue
and reduced performance
and function.

Note: This reduces fascia’s

ability to glide and slide, which
normally helps the
distribution and transmission
of tension across the body.
Characteristics of fascia pain
❑ Generally: muscle injuries and
joint problems feel worse with
movement.
❑ Contrary : Fascia adhesions tend
to feel better with movement
and also respond well to heat
therapy, which helps bring back
the tissue’s elasticity.
❑ Overtime: Fascial adhesions can
worsen over time result in hard,
tender knots in the muscles
called trigger points. 
Common fascial
dysfunctions
❑ Myofascial pain syndrome
✔ Dfn: A condition
characterized by painful
myofascial trigger points.

✔ Sx: deep muscle pain,

sensitive knots in muscles and
referred pain.
❑ Plantar fasciitis/Fasciopathy. 
✔ Dfn: Inflammation of plantar
fascia causing intense heel
pain.

✔ Sx: Heel pain when walking

in the morning after a night
of being off feet or when you
stand up after sitting for a
long time.
❑ Necrotizing fasciitis
✔ Dfn: A rare and sometimes
fatal condition characterized
by inflammation and necrosis
of fascia, muscle,
subcutaneous fat and
subsequent necrosis of
overlying skin.
✔ Sx: ?
✔ Rx: Radical debridement of
necrotic tissues.
❑ Compartment syndrome
✔ A condition where tissues
within a fascial layer
experience higher than
normal pressures
✔ Sx: Pain, pallor, loss of
pulses and paraesthesia.
✔ Risk: morbid obesity or
following crush injuries,
severe burns and impact
injuries. 
✔ Rx: fasciotomy.
Rx of Fascial dysfunctions
❑ Physiotherapy
✔ Heat, foam rolling, massage,
myofascial release, cupping,
posture training and exercises
e.g. stretching, joint mobilisation
and strengthening designed to
correct biomechanical
deficiencies
❑ Yoga therapy:
✔ a regimen of yoga poses
targeted to treat your area of
pain
❑ Acupuncture:
✔ The insertion of
acupuncture needles
into trigger points can
cause tense tissue fibres
to relax
❑ Surgery
❑ Medical:
✔ NSAIDS
Prevention
❑ Benefits of keeping fascia
healthy include:
✔ flexibility,
✔ better range of motion
✔ experience less pain.
❑ The following can prevent
fascia problems:
✔ Being active throughout the
day helps fascia stay supple.
✔ Stretch regularly:  to reduce
risk of inflammation and
structural problems in the
body.
✔ Focus on posture: Slumping
over a desk or a phone or
walking in an awkward way
to compensate for an injury
can cause fascia to tighten
Test your Knowledge
❑ What are the benefits of keeping
fascia healthy?
❑ What causes unhealthy fascia?
❑ What are symptoms of tight fascia?
❑ What are the physiotherapy
options to improve fascia health