Bidirectional skin tension creates subcutaneous fascia movement

Abstract

Introduction: Can manual bidirectional tension to the skin create subcutaneous movement? The skin and fascia exhibit tensegrity (intrinsic tension). Gracovetsky has considered the issues relating to the transfer of forces from the skin surface to deeper tissues, and suggests “While it is not known how much energy can be transferred from the skin surface to the deeper layers, it can be speculated that at least some of the therapist’s energy, applied to the skin, will end up being transferred”. Gracovetsky points to video illustrations of Jean Claude Guimberteau that demonstrate how a force applied to the surface of the skin ends up being dissipated deep into the tissues via a densely interconnected network of collagenous tissues (Gracovetsky 2016). Viscoelastic responses to mechanical forces are determined by their connective tissue (CT) extracellular matrix (ECM) composition and architecture. Mechanical tension can induce changes in the ECM subsequently modulating biological functions (Guimberteau 2012). CT fibroblasts play a pivotal role in both immediate and long-term CT responses to mechanical forces. Ultrasound elasticity imaging is emerging as a powerful non-invasive technique to quantify biomechanical tissue behavior (Wong et al 2011).