How Does Fascial Remodeling Affect Mechanoreceptors in the Body?

If you have worked with a manual therapist, you've probably heard of fascia at least once. Fascia is a connective tissue that surrounds and supports muscles, organs, blood vessels, and nerves throughout the body. It forms a continuous web of fibrous tissue that helps maintain structural integrity, provides protection, and facilitates movement. It is now well known that fascia is important for overall mobility, flexibility, function, and pain relief. For this reason, fascial remodeling is becoming a major target for many manual therapies.

After listening to what my clients say about fascial treatments, I realized that the world of fascial therapies can be confusing for many. Some therapists use a very gentle technique while others use deep and painful techniques. Some use techniques that feel just like muscle stretching. Occasionally, some of these therapists claim that their method is the only true fascial therapy, making their clients feel puzzled. This article aims to clarify such confusion.

All of the techniques can be effective if they are chosen for the right reasons. The key to selecting the right method is to understand how various sensory receptors in fascia uniquely respond to different mechanical stress. The following are the list of the sensory receptors in fascia and their response characteristics. They are not the exhaustive lists but detailed enough for you to make an informed decision as to who to work with. After reading this article, you will understand that not only the massage-type of manual therapy but also joint manipulation techniques (like the ones used by chiropractors) can effectively affect fascia and relieve pain if applied with the right intention.

1. Golgi type

   1. Golgi type is found in all dense connective tissues, peripheral joint ligaments, joint capsules, myotendinous junctions (where muscles and tenon blend in together), and aponeurosis attachments.

   2. Gogi type responds to slow stretch technique, resulting in decreasing active muscle tone.

2. Ruffini type

   1. Ruffini type is found in outer layer of dura mater, peripheral joint ligaments, muscle fascia, deep dorsal fascia of the hand, and tissues associated with regular stretching.

   2. Ruffini type responds to constant, slow, and deep pressure. It is also specifically responsive to tangential forces or shearing.

   3. Stimulation of Ruffini type mechanoreceptors results in lowering or inhibition of sympathetic nervous system activation.

3. Pacini type

   1. Pacini type is found in deep portions of the joint capsules, deeper spinal ligaments, investing antebrachial fascia, abdominal fascia, masseter, lateral thigh, plantar/palmar tissues and periosteum.

   2. Pacini type responds to rapid changes in pressure and vibration/oscillation techniques including high velocity low amplitude method.

   3. Stimulation of Pacini type results in increased local proprioceptive attention and self-regulation.

4. Free/interstitial nerve endings

   1. Free nerve endings are found in all fascial tissues, periosteum, interosseous membrane, tendons, and fascial connection to bones.

   2. It responds to deep and steady manual pressure, treatment to periosteum, interosseous membranes, and fascia connected to bones.

   3. Stimulation of free nerve endings results in changes in autonomic function including heart rate, respiration, and vasodilation. It increases vagal activities and muscle relaxation. It also alters local fluid dynamics and tissue metabolism.

References

Schleip, R., & Stecco, C. (2021). Fascia as sensory organ. Fascia in sport and movement, 2, 175-286.

Ward, B. Translating fascia research into techniques you can use (Part II).