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Medicina
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Connective Tissue Disorders
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Connective Tissue Disorders

A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Sports Medicine and Sports Traumatology".

Deadline for manuscript submissions: closed (30 April 2021) | Viewed by 18254

Special Issue Editor

Dr. Antonio Stecco

E-Mail Website
Guest Editor
School of Medicine, New York University, New York, NY, USA
Interests: fascia disorders; connective tissue; densification; hyaluronan; biomechanics; muscle stiffness
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

In the past 15 years, multiple articles have appeared that target connective tissue as an important component of treatment in the field of physical medicine and rehabilitation. To better understand the possible actions of connective tissue treatments, there is a need to clarify the interactions of connective tissue with various other structures: muscles, nerves, vessels, organs. Connective tissue is present throughout the body. However, different kinds of connective tissue exist that could affect superficial structures such as the lymphatic system, superficial vein system, and thermoregulation, or deep structures such as mechanical coordination, proprioception, load transmission, and neuro receptors. Due to the different anatomical locations and qualities of the connective tissues, it is important to recognize that different modalities of approach have to be taken into consideration for planning treatment.

Despite a growing number of studies, the etiopathogenesis of connective tissue disfunctions remains poorly understood. Therefore, a better understanding of the available data, as well as a further investigation of the molecular and biomechanical mechanisms, is imperative in order to significantly improve the understanding of their origins and the efficacy of treatments.

Given the importance of connective tissue disorders in the field of medicine and research, the journal Medicina is launching this Special Issue.

We encourage you and your co-workers to submit your articles reporting on this topic. Reviews or original articles dealing with the biomechanical, anatomical, and therapeutic aspects associated with connective tissue disfunctions in experimental models and humans are particularly welcome.

Prof. Dr. Antonio Stecco
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Medicina is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2200 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • connective tissue
  • deep fascia
  • superficial fascia
  • retinacula
  • muscle stiffness
  • hyaluronan
  • densification
  • biomechanics
  • therapies

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Published Papers (3 papers)

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Research

11 pages, 1376 KiB  
Article
Pilot Study of Sacroiliac Joint Dysfunction Treated with a Single Session of Fascial Manipulation® Method: Clinical Implications for Effective Pain Reduction
by Dennis Bertoldo, Carmelo Pirri, Barbara Roviaro, Luigi Stecco, Julie Ann Day, Caterina Fede, Diego Guidolin and Carla Stecco
Medicina 2021, 57(7), 691; https://doi.org/10.3390/medicina57070691 - 6 Jul 2021
Cited by 10 | Viewed by 5670
Abstract
Background and Objectives: Sacroiliac joint dysfunction (SIJD) generally refers to pain in the lower back due to abnormal sacroiliac joint movement, either from hypomobility or hypermobility. It is considered to be the principal cause in up to 40% of low back pain cases. [...] Read more.
Background and Objectives: Sacroiliac joint dysfunction (SIJD) generally refers to pain in the lower back due to abnormal sacroiliac joint movement, either from hypomobility or hypermobility. It is considered to be the principal cause in up to 40% of low back pain cases. In literature, it emerges that the “fascia”, by its anatomical continuity, if altered or densified in different regions of the body with respect to the sacroiliac joint and its surroundings, may have a fundamental role in the genesis of SIJD and low back pain. The purpose of the present study is to evaluate the effectiveness of incorporating a single session of Fascial Manipulation®-Stecco method®, treating the muscular fasciae at distance from the painful region. Materials and Methods: Twenty patients with acute and chronic sacroiliac joint dysfunction (SIJD) were recruited (16 males and 4 females, mean age of 46.6 ± 12.98 years). Patients underwent a predefined assessment protocol, followed by an evaluation of myofascial pain and subsequent manipulation of the fascia at points at least 20 cm away from the posterior inferior iliac spines (PIIS). Each patient underwent three pain evaluations: pre-treatment (t0), post-treatment (t1), and at a 1-month follow-up (t2). For the evaluation in t0, t1 the numerical rating scale (NRS) for the intensity of pain and the algometer for the pain threshold at the PIIS were used; in t2 only the NRS scale. Results: The results obtained by comparing the algometer measurements with the NRS values between t0 and t1 were in both cases statistically significant (p < 0.0001), whereas the comparison between the NRS values at t1 and at t2 was not statistically significant (p > 0.05). Conclusions: A single Fascial Manipulation treatment, even when applied at least 20 cm from the PIIS, can potentially decrease pain around the SIJ. The inclusion of this type of approach in SIJD can allow for improved patient management, better tolerance for other treatments and a more rapid application of pain-free exercise programs. Full article
(This article belongs to the Special Issue Connective Tissue Disorders)
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10 pages, 2277 KiB  
Article
Myofascial Injection Using Fascial Layer-Specific Hydromanipulation Technique (FLuSH) and the Delineation of Multifactorial Myofascial Pain
by Tina Wang, Roya Vahdatinia, Sarah Humbert and Antonio Stecco
Medicina 2020, 56(12), 717; https://doi.org/10.3390/medicina56120717 - 20 Dec 2020
Cited by 7 | Viewed by 3755
Abstract
Background and objectives: The aims of this study were to delineate the contribution of specific fascial layers of the myofascial unit to myofascial pain and introduce the use of ultrasound-guided fascial layer-specific hydromanipulation (FLuSH) as a novel technique in the treatment of [...] Read more.
Background and objectives: The aims of this study were to delineate the contribution of specific fascial layers of the myofascial unit to myofascial pain and introduce the use of ultrasound-guided fascial layer-specific hydromanipulation (FLuSH) as a novel technique in the treatment of myofascial pain. Materials and Methods: The clinical data of 20 consecutive adult patients who underwent myofascial injections using FLuSH technique for the treatment of myofascial pain were reviewed. The FLuSH technique involved measuring the pain pressure threshold using an analog algometer initially and after each ultrasound guided injection of normal saline into the specific layers of the myofascial unit (superficial fascia, deep fascia, or muscle) in myofascial points corresponding with Centers of Coordination/Fusion (Fascial Manipulation®). The outcome measured was the change in pain pressure threshold after injection of each specific fascial layer. Results: Deep fascia was involved in 73%, superficial fascia in 55%, and muscle in 43% of points. A non-response to treatment of all three layers occurred in 10% of all injected points. The most common combinations of fascial layer involvement were deep fascia alone in 23%, deep fascia and superficial fascia in 22%, and deep fascia and muscle in 18% of injected points. Each individual had on average of 3.0 ± 1.2 different combinations of fascial layers contributing to myofascial pain. Conclusions: The data support the hypothesis that multiple fascial layers are responsible for myofascial pain. In particular, for a given patient, pain may develop from discrete combinations of fascial layers unique to each myofascial point. Non-response to treatment of the myofascial unit may represent a centralized pain process. Adequate treatment of myofascial pain may require treatment of each point as a distinct pathologic entity rather than uniformly in a given patient or across patients. Full article
(This article belongs to the Special Issue Connective Tissue Disorders)
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10 pages, 1124 KiB  
Article
Effects of Cesarean Section and Vaginal Delivery on Abdominal Muscles and Fasciae
by Chenglei Fan, Diego Guidolin, Serena Ragazzo, Caterina Fede, Carmelo Pirri, Nathaly Gaudreault, Andrea Porzionato, Veronica Macchi, Raffaele De Caro and Carla Stecco
Medicina 2020, 56(6), 260; https://doi.org/10.3390/medicina56060260 - 27 May 2020
Cited by 22 | Viewed by 8208
Abstract
Background and objectives: Possible disorders after delivery may interfere with the quality of life. The aim of this study was to ascertain whether abdominal muscles and fasciae differ in women depending on whether they experienced transverse cesarean section (CS) or vaginal delivery [...] Read more.
Background and objectives: Possible disorders after delivery may interfere with the quality of life. The aim of this study was to ascertain whether abdominal muscles and fasciae differ in women depending on whether they experienced transverse cesarean section (CS) or vaginal delivery (VA) in comparison with healthy nulliparous (NU). Materials and methods: The thicknesses of abdominal muscles and fasciae were evaluated by ultrasound in 13 CS, 10 VA, and 13 NU women (we examined rectus abdominis (RA); external oblique (EO); internal oblique (IO); transversus abdominis (TrA); total abdominal muscles (TAM = EO + IO + TrA); inter-rectus distance (IRD); thickness of linea alba (TLA); rectus sheath (RS), which includes anterior fascia of RS and posterior fascia of RS (P-RS); loose connective tissue between sublayers of P-RS (LCT); abdominal perimuscular fasciae (APF), which includes anterior fascia of EO, fasciae between EO, IO, and TrA, and posterior fascia of TrA). Data on pain intensity, duration, and location were collected. Results: Compared with NU women, CS women had wider IRD (p = 0.004), thinner left RA (p = 0.020), thicker right RS (p = 0.035) and APF (left: p = 0.001; right: p = 0.001), and IO dissymmetry (p = 0.009). VA women had thinner RA (left: p = 0.008, right: p = 0.043) and left TAM (p = 0.024), mainly due to left IO (p = 0.027) and RA dissymmetry (p = 0.035). However, CS women had thicker LCT (left: p = 0.036, right: p < 0.001), APF (left: p = 0.014; right: p = 0.007), and right IO (p = 0.028) than VA women. There were significant correlations between pain duration and the affected fasciae/muscles in CS women. Conclusions: CS women showed significant alterations in both abdominal fasciae and muscle thicknesses, whereas VA women showed alterations mainly in muscles. Thinner RA and/or dissymmetric IO, wider IRD, and thicker LCT and APF after CS may cause muscle deficits and alteration of fascial gliding, which may induce scar, abdominal, low back, and/or pelvic pain. Full article
(This article belongs to the Special Issue Connective Tissue Disorders)
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