Mechanistic basis of manual therapy in myofascial injuries. Sonoelastographic evolution control

SummaryThe term myofascia is referred to the skeleton of muscle fibres organized as an interconnected 3D network that surrounds and connects the musculoskeletal system. Extracellular matrix muscle is relevant in tissue structural support and transmission of mechanical signals between fibres and tendons. Acute and chronic musculoskeletal injuries (muscle strain) are one of the major problems faced by those who practice any type of sport, regardless of whether they are professionals or amateurs. Therapeutic boarding is of uncertain value in most cases because there are many contributing factors such as type, severity, functional implication of the damaged tissue, progression or risk of relapse. Different studies suggest that the musculoskeletal cell matrix is essential for the development, maintenance and regeneration of skeletal muscle. In this article, we highlight the action of “non-contractile” structures, in particular the myofascial system or muscle fascia, which can be responsible for the pathophysiology and healing process of muscular injuries. Manual therapy plays a predominant role in the treatment of these types of injuries and is key in the process of obtaining a scar capable of transmitting mechanical information. The scientific basis of this process is described in this article. Through real-time sonoelastography we have accurate information regarding the current stage of the repair process and, thus, guide our treatment at all times. Some new concepts are introduced, including local elasticity, the relationship between fascial pretension and the different stages of the physiological myofascia repair process, scar modelling technique, and sonoelastographic evolution control.