06/05/2021
Look the Thoracolumbar Fascia.. how sticky to the muscles...
Deep Dive: Thorocolumbar Fascia
Of interest to people with complex or non-specific back pain
This is the thorocolumbar fascia. Nearly every major muscle of the back uses this structure as an anchor point.
It is sensible to assume that this structure is at least partially connected to the phenomenon of referred pain in the back.
This structure also makes it clear as to why when we strain a muscle or “throw our back out” (not a great term, backs don’t go out) that it lights up a wide and varied area.
The imprecise nature of the nerves in the back also lead us to an explanation of why we feel pain one place, but often find the source to be elsewhere.
WORKING WITH THIS STRUCTURE
Work slowly. I mean so slow that you feel like you are not moving. The conversation here is a deep whisper. Don’t try to yell at it and grind it out.
The nervous system needs time to reset, let go, adjust, whatever your preferred term is.
We are not talking about adhesions or breaking up tissue. Those are not real things.
Yes, you read that right, adhesions are not a thing. Normal healthy adults do not have tissues that suddenly decide to bind together.
As for breaking down scar tissue (or any tissue) that’s also a solid no. If you were able to apply that that amount of pressure the skin would break down too (it’s connective tissue).
Surgery and disease processes can bring cause adhesions, but that’s a whole other story.
Deep Anatomy Dive:
The thoracolumbar fascia is a TOUGH fibrous sheet of connective tissue formed by longitudinal and transverse fibers that bridge the aponeuroses of internal oblique and transversalis, costal angles and iliac crest laterally, to the vertebral column and sacrum medially. In doing so, they cover the paravertebral muscles.
It is made up of three layers, anterior, middle, and posterior. The anterior and middle layers insert onto the transverse processes of the vertebral column while the posterior layer inserts onto the tips of the spinous processes, hence it is indirectly continuous with the interspinous ligaments.
The anterior layer is the thinnest and the posterior layer is the thickest. Two spaces are formed between these three layers of the fascia.
Psoas major lies anterior to the anterior layer, with the anterior fascia of this muscle being continuous with the vertebral body and thus the anterior longitudinal ligament.
Between the anterior and middle layer lies the quadratus lumborum muscle.
The erector spinae muscles and the transversospinales muscles are then enclosed between the middle and posterior layers.
Various superficial muscle layers on the posterior thorax and abdomen then arise from the posterior layer. These primarily include latissimus dorsi and serratus posterior inferior.
Got questions? Leave them in the comments.
(Deep Dive derived from Seeley’s Anatomy Text, Wikipedia and the 3D4 Medical Complete Anatomy)
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