An alternative view on the function of fascial adhesions

I recently came across this picture which was posted by Leon Chaitow courtesy of Professor Andrzej Pilat. It posed major discussion and got me thinking as to what it is we are actually seeing. The majority conclusion was that we are visualizing an adhesion between fascial planes. It has previously been shown by Helen Langevin PhD that fascial planes of the lumbodorsal fascia slide and glide freely in asymptomatic patients and become stuck in individuals with low back pain. Based on this one may conclude that what we are seeing here is an abnormal connection between fascial planes. Therefore, we should implement a treatment technique designed to ‘break’ the adhesion and allow for free movement.

Fascial Adhesion

However, there are always two sides to the one story and the question needs to be asked, is this in fact abnormal? Or is the connection between these two fascial planes there for a reason and a good one? I proposed the possibility that we are in fact visualizing a compensatory mechanism whereby the body is re-distributing forces from one fascial plane to the other. Much in the same way the tibia re-distributes force to the fibula via the interroseous membrane. This would mean a different treatment approach and one that is more osteopathic in thinking. 

Let us consider we adopted a treatment approach designed to stress this ‘adhesion’. How would the body respond? Would it be beneficial? If the adhesion is there to distribute force, then when it is subjected to increased force it will respond by strengthening it’s connection to cope with the increased stress. Perhaps this is why local treatment in a lot of cases only provides short-term results. Initially you may have elongated the fibres of this connection allowing initial freedom of movement, however the force used to develop this freedom has stimulated a process that reinforces the connection.

I believe the above approach is flawed for the reasons I have given. What then is the right approach? You may not like my answer but it is INDIVIDUAL to the patient. The human body is an extremely complex organ and hence developing the right treatment approaches do not come about easily. The patient will have a biomechanical problem, or multiple biomechanical problems that have lead to this need for force distribution. It is like adding an extra strut to the framework of a building for extra support. 

It would be great to see a large scale dissection study to see if these adhesions are common. If anyone is aware of any I would love to know. I want to end this post by saying that I am merely hypothesizing as I will do with the majority of my posts. I may be completely wrong at times but it is all in the search for a better understanding.