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Senses & Fascia

Innervation of fascia

The fascia is the most richly innervated system in the body. The fascia is innervated by mechano or proprioceptors that are responsible for positioning and balance. There are also free nerve endings in the fascia that are nociceptors that are embedded in the fascia itself. These nerves are responsible for sensation and touch. When fascia is disrupted with abnormal in growth of fascial fibers and substance, entrapment of these nerves can occur and result in pain.

People with collagen disorder and disruption and changes to the fascia, experience their body and world through the senses in a very different manner than those who have more normal connective tissue. 

Stecco C, Gagey O, Belloni A, et al. Anatomy of the deep fascia of the upper limb. Second part: study of innervation. Morphologie. 2007a;91:38–43.

Yahia L, Rhalmi S, Newman N, Isler M. Sensory innervation of human thoracolumbar fascia. An immunohistochemical study. Acta Orthop Scand. 1992 Apr;63(2):195-7.

Tanaka S, Ito T. Histochemical demonstration of adrenergic fibers in the fascia periosteum and retinaculum. Clin Orthop Relat Res. 1977;126:276–281.


Sense of smell

People with changes in their connective tissue have a heightened sense of smell. In these people, there is enhanced odor acuity, greater reactivity to smells and also increased odor awareness compared to controls with normal connective tissue.

Burón E, Bulbena A, Bulbena-Cabré A, Rosado S, Pailhez G. Both anxiety and joint laxity determine the olfactory features in panic disorder. Psychiatry Res. 2018 Apr;262:420-426.

Internal Function - Interoception

Interoceptive sensitivity is the ability to sense internal bodily arousal like digestion and blood flow. Collagen laxity is linked to interoceptive sensitivity. Interoceptive sensitivity may mediate the relationship between state anxiety and hypermobility. Hypermobile individuals display a heightened neural reactivity to sad and angry scenes within brain regions implicated in anxious feeling states, notably insular cortex.

Mallorquí-Bagué N, Garfinkel SN, Engels M, Eccles JA, Pailhez G, Bulbena A, Critchley HD. Neuroimaging and psychophysiological investigation of the link between anxiety, enhanced affective reactivity and interoception in people with joint hypermobility. Front Psychol. 2014 Oct 14;5:1162.

Anxiety, the senses, collagen disorder

Panic Disorder is high associated with changes in collagen disorder. It is thought to be associated with the enhancement of senses that those with collagen disorder experience. Anxiety is associated with increased physiological reactivity and also increased "interoceptive" sensitivity to such changes in internal bodily arousal.

Moreno-Peral P, Conejo-Cerón S, Motrico E, Rodríguez-Morejón A, Fernández A, García-Campayo J, Roca M, Serrano-Blanco A, Rubio-Valera M, Bellón JÁ. Risk factors for the onset of panic and generalised anxiety disorders in the general adult population: a systematic review of cohort studies. J Affect Disord. 2014 Oct;168:337-48.

Bulbena-Cabre A, Duñó L, Almeda S, Batlle S, Camprodon-Rosanas E, Martín-Lopez LM, Bulbena A. Joint hypermobility is a marker for anxiety in children. Rev Psiquiatr Salud Ment. 2019 Apr - Jun;12(2):68-76.

Autonomic Nervous system 

The nervous system itself is composed of connective tissue,  the epineurium and perineurium. Therefore abnormalities and changes in connective tissue will affect the nervous system. The fascial layers are also heavily embedded with nerve endings so any changes to the fascia will affect the nervous system. Entrapment, deformation, and biophysical deformative stresses exerted upon the nervous system may alter gene expression, neuronal function and phenotypic expression. There is also evidence of increased numbers and hypersensitivity of nerves in people with connective tissue laxity.

Bulbena A, Pailhez G, Bulbena-Cabré A, Mallorquí-Bagué N, Baeza-Velasco C. Joint hypermobility, anxiety and psychosomatics: two and a half decades of progress toward a new phenotype. Adv Psychosom Med. 2015;34:143-57.

autonomic nervous system dysfunctions and interoceptive and exteroceptive processes.

Henderson FC Sr, Austin C, Benzel E, Bolognese P, Ellenbogen R, Francomano CA, Ireton C, Klinge P, Koby M, Long D, Patel S, Singman EL, Voermans NC. Neurological and spinal manifestations of the Ehlers-Danlos syndromes. Am J Med Genet C Semin Med Genet. 2017 Mar;175(1):195-211.

Aktar R, et al. Mo1599 - Abdominal Pain in Hypermobility-Type Ehlers Danlos Syndrome is Associated with Proliferation and Hypersensitivity of Colonic Nociceptive Nerve Endings.  Gastroenterology. 2018 May; 154(6): S765-766

Xu XJ, Zhang YL, Liu L, Pan L, Yao SK. Increased expression of nerve growth factor correlates with visceral hypersensitivity and impaired gut barrier function in diarrhoea-predominant irritable bowel syndrome: a preliminary explorative study. Aliment Pharmacol Ther. 2017 Jan;45(1):100-114.

Beckers AB, Keszthelyi D, Fikree A, Vork L, Masclee A, Farmer AD, Aziz Q. Gastrointestinal disorders in joint hypermobility syndrome/Ehlers-Danlos syndrome hypermobility type: A review for the gastroenterologist. Neurogastroenterol Motil. 2017 Aug;29(8).

How can you get more answers?

Dr. Wang can work with you to figure things out. Dr. Wang uses the Stecco Method of fascial manipulation as well as Fascial Hydrodissection(TM), a technique she developed, to release adhesions.