Effects of Lower Limbs Stretching on the Neck Range of Motion: Preliminary Evidence for Myofascial Sequence?
DOI:
https://doi.org/10.12974/2313-0954.2023.09.02Keywords:
Fascia, Myofascial chain, Posterior line, Stretching, Range of motionAbstract
In recent years, various studies have demonstrated that the fascia can transmit the mechanical tensions generated by muscle activity over a distance. However, it is not yet clear whether this transmission follows precise anatomical lines. The present study aims to understand if the exercises at a distance can influence the range of motion of the neck, and if the effects are different by performing the exercises in various directions. The study was attended by 30 healthy volunteers aged between 19 and 32 years. Anterior flexion of the neck was checked before the protocols and retested to compare the difference after stretching the hamstrings and adductors. All evaluations were performed by the same operator using an electronic goniometer. Cervical ROM increased during both procedures, but after the hamstrings stretch it increased significantly more than after the adductors stretch (6.22° versus 1.44°). This study highlighted how fascia can transmit forces at a distance, but only according to precise myofascial sequences. Consequently, it is important to know the fascial organization in order to properly train the fascial system.
References
Maas, H.; Baan, G. C.; Huijing, P. A. Intermuscular interaction via myofascial force transmission: effects of tibialis anterior and extensor hallucis longus length on force transmission from rat extensor digitorum longus muscle. Journal of biomechanics, 2001; 34(7), 927-940. https://doi.org/10.1016/S0021-9290(01)00055-0
Yucesoy, C. A.; Koopman, B. H.; Baan, G. C.; Grootenboer, H. J.; Huijing, P. A. Effects of inter- and extramuscular myofascial force transmission on adjacent synergistic muscles: assessment by experiments and finite-element modeling. Journal of biomechanics, 2003. 36(12), 1797-1811. https://doi.org/10.1016/S0021-9290(03)00230-6
Bojsen-Møller, J.; Schwartz, S.; Kalliokoski, K. K.; Finni, T.; Magnusson, S. P. Intermuscular force transmission between human plantarflexor muscles in vivo. Journal of applied physiology (Bethesda, Md.: 1985), 2010; 109(6), 1608-1618. https://doi.org/10.1152/japplphysiol.01381.2009
Huijing, P. A.; Maas, H.; Baan, G. C. Compartmental fasciotomy and isolating a muscle from neighboring muscles interfere with myofascial force transmission within the rat anterior crural compartment. Journal of morphology, 2003; 256(3), 306-321. https://doi.org/10.1002/jmor.10097
Huijing, P. A.; van de Langenberg, R. W.; Meesters, J. J.; Baan, G. C. Extramuscular myofascial force transmission also occurs between synergistic muscles and antagonistic muscles. Journal of electromyography and kinesiology: official journal of the International Society of Electrophysiological Kinesiology, 2007; 17(6), 680-689. https://doi.org/10.1016/j.jelekin.2007.02.005
Maas H. Significance of epimuscular myofascial force transmission under passive muscle conditions. J Appl Physiol. 1985; 2019 May 1; 126(5): 1465-1473. doi: 10.1152/japplphysiol.00631.2018. Epub 2019 Jan 3. PMID: 30605398.https://doi.org/10.1152/japplphysiol.00631.2018
Smeulders, M. J.; Kreulen, M.; Hage, J. J.; Huijing, P. A.; van der Horst, C. M. Spastic muscle properties are affected by length changes of adjacent structures. Muscle & nerve, 2005; 32(2), 208-215. https://doi.org/10.1002/mus.20360
Bordoni, B.; Myers, T. A Review of the Theoretical Fascial Models: Biotensegrity, Fascintegrity, and Myofascial Chains. Cureus, 2020; 12(2), e7092. https://doi.org/10.7759/cureus.7092
Wilke, J.; Krause, F.; Vogt, L.; Banzer, W. What Is Evidence-Based About Myofascial Chains: A Systematic Review. Archives of physical medicine and rehabilitation, 2016; 97(3), 454-461. https://doi.org/10.1016/j.apmr.2015.07.023
Wilke, J.; Niederer, D.; Vogt, L.; Banzer, W. Remote effects of lower limb stretching: preliminary evidence for myofascial connectivity? Journal of sports sciences, 2016; 34(22), 2145-2148. https://doi.org/10.1080/02640414.2016.1179776
Hyong, In & Kang, Jong. The Immediate Effects of Passive Hamstring Stretching Exercises on the Cervical Spine Range of Motion and Balance. Journal of Physical Therapy Science. 2013; 25. 113-116. https://doi.org/10.1589/jpts.25.113
Aparicio, E. Q.; Quirante, L. B.; Blanco, C. R.; Sendín, F. A. Immediate effects of the suboccipital muscle inhibition technique in subjects with short hamstring syndrome. Journal of Manipulative and Physiological Therapeutics, 2009; 32(4), 262-9. https://doi.org/10.1016/j.jmpt.2009.03.006
Cruz-Montecinos, C.; González Blanche, A.; López Sánchez, D.; Cerda, M.; Sanzana-Cuche, R.; Cuesta-Vargas, A. In vivo relationship between pelvis motion and deep fascia displacement of the medial gastrocnemius: anatomical and functional implications. Journal of anatomy, 2015; 227(5), 665-672. https://doi.org/10.1111/joa.12370
Cruz-Montecinos, C.; Cerda, M.; Sanzana-Cuche, R.; Martín-Martín, J.; Cuesta-Vargas, A. Ultrasound assessment of fascial connectivity in the lower limb during maximal cervical flexion: technical aspects and practical application of automatic tracking. BMC sports science, medicine & rehabilitation, 2016; 8, 18. https://doi.org/10.1186/s13102-016-0043-z
Wilke J, Debelle H, Tenberg S, Dilley A, Maganaris C. Ankle Motion Is Associated With Soft Tissue Displacement in the Dorsal Thigh: An in vivo Investigation Suggesting Myofascial Force Transmission Across the Knee Joint. Front Physiol. 2020 Mar 6; 11: 180. https://doi.org/10.3389/fphys.2020.00180
Grieve, R.; Goodwin, F.; Alfaki, M.; Bourton, A. J.; Jeffries, C.; Scott, H. The immediate effect of bilateral self-myofascial release on the plantar surface of the feet on hamstring and lumbar spine flexibility: A pilot randomised controlled trial. Journal of bodywork and movement therapies, 2015; 19(3), 544-552. https://doi.org/10.1016/j.jbmt.2014.12.004
Do, Kwang-Sun & Kim, Jaeeun & Yim, Jongeun. Acute effect of self-myofascial release using a foam roller on the plantar fascia on hamstring and lumbar spine superficial back line flexibility. Physical Therapy Rehabilitation Science. 2018. 7. 35-40. 10.14474/ptrs.2018.7.1.35. https://doi.org/10.14474/ptrs.2018.7.1.35
Williams, W.; Selkow, N. M. Self-Myofascial Release of the Superficial Back Line Improves Sit-and-Reach Distance. Journal of sport rehabilitation, 2019; 29(4), 400-404. https://doi.org/10.1123/jsr.2018-0306
Jung, Jihye & Choi, Wonjae & Lee, Yonghyuk & Kim, Jiwoo & Kim, Hyunju & Lee, Kyoungho & Lee, Jaewoo & Lee, Seungwon. (2017). Immediate effect of self-myofascial release on hamstring flexibility. Physical Therapy Rehabilitation Science. 6. 45-51. https://doi.org/10.14474/ptrs.2017.6.1.45
Fousekis, K., Eid, K., Tafa, E., Gkrilias, P., Mylonas, K., Angelopoulos, P., Koumoundourou, D., Billis, V., & Tsepis, E. (2019). Can the application of the Ergon® IASTM treatment on remote parts of the superficial back myofascial line be equally effective with the local application for the improvement of the hamstrings' flexibility? A randomized control study. Journal of physical therapy science, 31(7), 508-511. https://doi.org/10.1589/jpts.31.508
Joshi, D. G.; Balthillaya, G.; Prabhu, A. Effect of remote myofascial release on hamstring flexibility in asymptomatic individuals - A randomized clinical trial. Journal of bodywork and movement therapies, 2018; 22(3), 832-837. https://doi.org/10.1016/j.jbmt.2018.01.008
Wilke, J.; Niederer, D.; Vogt, L.; Banzer, W. Is remote stretching based on myofascial chains as effective as local exercise? A randomised, controlled trial. Journal of Sports Sciences. 2016; 35. https://doi.org/10.1080/02640414.2016.1251606
Burk, C.; Perry, J.; Lis, S.; Dischiavi, S.; Bleakley, C. Can Myofascial Interventions Have a Remote Effect on ROM? A Systematic Review and Meta-Analysis. Journal of sport rehabilitation, 2019; 29(5), 650-656. https://doi.org/10.1123/jsr.2019-0074
Stecco C.; Pirri C.; Fede C.; Yucesoy C.; De Caro R.; Stecco, A. Fascial or Muscle Stretching? A Narrative Review. Applied Sciences. 2020. 11. 307. https://doi.org/10.3390/app11010307
Krause, F., Wilke, J., Vogt, L., & Banzer, W. (2016). Intermuscular force transmission along myofascial chains: a systematic review. Journal of anatomy, 228(6), 910-918. https://doi.org/10.1111/joa.12464
Carey, M. A.; Laird, D. E.; Murray, K. A.; Stevenson, J. R. Reliability, validity, and clinical usability of a digital goniometer. Work (Reading, Mass.), 2010; 36(1), 55-66. https://doi.org/10.3233/WOR-2010-1007
Luedtke, K.; Schoettker-Königer, T.; Hall, T.; Reimer, C.; Grassold, M.; Hasselhoff-Styhler, P.; Neulinger, C.; Obrocki, M.; Przyhoda, P.; Schäfer, A. Concurrent validity and reliability of measuring range of motion during the cervical flexion rotation test with a novel digital goniometer. BMC musculoskeletal disorders, 2020; 21(1), 535. https://doi.org/10.1186/s12891-020-03525-6
Prushansky, T.; Deryi, O.; Jabarreen, B. Reproducibility and validity of digital inclinometry for measuring cervical range of motion in normal subjects. Physiotherapy research international: the journal for researchers and clinicians in physical therapy, 2010; 15(1), 42-48. https://doi.org/10.1002/pri.443
Correll, S.; Field, J.; Hutchinson, H.; Mickevicius, G.; Fitzsimmons, A.; Smoot, B. Reliability and validity of the Halo Digital Goniometer for shoulder Range of motion in healthy subjects. International journal of sports physical therapy, 2018; 13(4), 707-714. https://doi.org/10.26603/ijspt20180707
Ferreira-Valente, M.A.; Pais-Ribeiro, J.L.; Jensen, M.P. Validity of four pain intensity rating scales. Pain. 2011; Oct; 152(10): 2399-2404. https://doi.org/10.1016/j.pain.2011.07.005
Dischiavi, S.L.; Wright, A.A.; Hegedus, E.J.; Bleakley, C.M. Biotensegrity and myofascial chains: A global approach to an integrated kinetic chain. Med Hypotheses. 2018 Jan; 110: 90-96. https://doi.org/10.1016/j.mehy.2017.11.008
Stecco, C.; Pavan, P.; Pachera, P.; De Caro, R.; Natali, A. Investigation of the mechanical properties of the human crural fascia and their possible clinical implications. Surgical and radiologic anatomy: SRA. 2014; 36(1), 25-32. https://doi.org/10.1007/s00276-013-1152-y
Wilke, J.; Schleip, R.; Yucesoy, C.A.; Banzer, W. Not merely a protective packing organ? A review of fascia and its force transmission capacity. J Appl Physiol (1985). 2018 Jan 1; 124(1): 234-244. https://doi.org/10.1152/japplphysiol.00565.2017