Fascial fibrosis

Scientific basis

Fibrosis most often occurs after an injury or an inflammation that persists. Under the combined effect of mechanical tension and mediators such as TGF-β, fibroblasts turn into myofibroblasts, which produce collagen and pull on the matrix (Tomasek et al., 2002).

Once under way, fibrosis can become self-sustaining: a stiffer matrix favors the persistence of the cells that produce it (Herrera et al., 2018). Its reversibility varies with the tissue, the cause, the duration and the maturity of the deposited collagen; a functional improvement does not mean that the original architecture has been restored.

Stiffness does not mean fibrosis: it can also result from pain, protective muscle contraction, edema or a transient change in the tissue’s properties. A feeling of “hard” tissue, a limitation of mobility or discomfort when sitting do not allow a conclusion of fibrosis.

Blue Portance / SBNFA™ reading

The SBNFA™ distinguishes fibrosis from the four other alterations (functional modification, densification, adhesion, scar). It reads fibrosis as a lasting reduction in tissue adaptability: the tissue responds less to the variety of demands placed on it. The hypothesis that fixed, repeated stresses can contribute to this trajectory, in a context of injury or inflammation, belongs to the SBNFA™ reading; it does not make fibrosis a consequence of posture alone.

Contribution to the analysis of sitting

Seating analysis cannot diagnose fibrosis. When faced with a stiff or scarred area, it observes the support points, how long positions are held and the ability to redistribute loads around that area.

Not to be confused with

Fascial densification, a change in the tissue between layers, without collagen accumulation; scar, repair tissue formed after an injury; fascial stiffness, an increase in stiffness that can have other causes; stiffness as felt, a sensation or a limitation of mobility.

Related terms

Fascial adhesions · Myofibroblast

Sources and scope

• Tomasek et al. (2002): myofibroblasts and mechanical regulation of connective tissue remodeling (Nat Rev Mol Cell Biol)
• Herrera et al. (2018): the extracellular matrix as a driver of progressive fibrosis (J Clin Invest)
• Pavan et al. (2014): densification or fibrosis of fascia (Curr Pain Headache Rep)