Anatomy

Superficial fasciae are located directly under the skin and subcutis and are very elastic and able to absorb body fat (in case of weight gain or pregnancy). Deep fasciae lie under a further layer of fat, they are less elastic and have a lower blood supply than superficial fasciae and are responsible for the transmission of pain. Myofibroblasts are an important component of deep fascia.

These are special connective tissue cells that are similar to the muscle cells of smooth muscles, produce collagen and are able to react to mechanical or chemical stimuli with contraction and relaxation. The stiffness of the deep fascia probably depends on the density of the myofibroblasts. An extremely high proportion of myofibroblasts can be found, for example, in Dupuytren’s disease (a disease in which the flexor tendons of the fingers become thicker and stiffer, accompanied by severe restriction of movement).

A special case are the organ fasciae, which envelop the organs. They are less elastic and are responsible for the supporting function and securing of the organs. If the tension of the organ fascia is too loose, this leads to an organ prolapse; if the tension is too tight, the organs are impaired in their necessary sliding ability.

Tasks

Connection: In the broadest sense, fasciae form the connection of all body systems of muscles, tendons, ligaments, bones, joints, nerves, vascular system and the hormonal system. They weave a whole body network of grid-like structure that has no beginning and no end. This connecting tissue ensures that the various structures of our body are brought together and, like interlocking gears, also function as a whole system, provided there is no disruption.
Supporting function: If our body were not supported and held by fasciae, it would collapse, since the bones are only the basic structure.
Fasciae connect all tissues with each other, but at the same time they also cause the mutual demarcation of neighboring muscles and organs from each other and thus serve to make the different tissues glide against each other. Due to their 3D elasticity, fasciae are extremely flexible and can therefore adapt to a wide variety of loads.
As a passive structure, the fascia gives the muscle support during contraction. It can become denser under heavy strain and thus serves as protection for the muscles.
Because the connective tissue intervenes in the muscular transmission of force, the force applied by the muscles starts at the tendon (transition of the muscle to the bone), so the force is not lost in the adjacent tissue.
Protective function: The connective tissue network protects our body from injuries caused by external stresses and penetrating foreign bodies and acts as an elastic shock absorber to cushion movements.
After the skin, the grid of fasciae is the largest sensory organ of our body. The density of sensors (receptors) contained in the fascia is 10 times higher than in the muscles. Due to its high density of receptors, the fascia network forms a large sensory organ that registers the smallest changes in tension, pressure, pain and temperature and transmits the information gained to the brain.
The constant messages from the receptors present in the connective tissue help us to achieve good body perception, through which we are able to perceive the position of all parts of the body in space without eye control, and to change and adjust them if necessary. The large dorsal fascia contains a particularly large number of pain receptors that extend from the neck to the back of the head.
Transport: All components of the connective tissue float in a viscous, 70% water-containing basic substance, the matrix. The entire mass transfer takes place in this moist environment.
Fasciae are filling tissues that store blood and water and serve as passageways for blood, lymphatic fluid and nerves. During movement, the connective tissue reacts like a sponge, which is squeezed out and reabsorbed during the relief phase. The decisive factor in this process is the refilling of the tissue with fluid.

Nutrients are transported and distributed via the connective tissue to the place where they are needed. Through the exchange with the venous and lymphatic system, waste products are removed again. If the transport of substances in the connective tissue matrix is disrupted due to illness or lack of exercise, the tissue thickens and “waste products” are accumulated.
In the connective tissue matrix a continuous remodelling takes place by the fibroblasts.
Fibroblasts constantly produce new collagen and elastic fibers that develop into firm connective tissue, e.g. tensile joint ligaments or loose filling tissue between the organs in the abdominal cavity, while old worn structures are broken down again.
Healing: When the fibroblasts meet injured tissue, they react with an overproduction of collagen fibers and can thus close the wound. After the work is done, these cells die. However, if the healing process is disturbed, e.g. by an inflammation, or if an area of the body is permanently overloaded, the fibroblasts constantly produce more collagen.
The fiber chains become knotted, matted and form small scars (fibroses), which causes pain and restriction of movement (e.g. painful shoulder stiffness, frozen shoulder). Excessive collagen production also plays a decisive role in the growth and spread of tumors.
Immune system: In the fascia there are mobile cells of the immune system (macrophages), which resorb everything in the connective tissue that has no – or a damaging function. These include dead cells, bacteria, viruses and tumor cells. Phagocytizing cells (scavenger cells) are able to remove pathogens via the lymphatic or venous system and thus take on an important function in the immune defense. Mast cells (mastocytes) are particularly active in controlling inflammatory processes.