What is IIS/fascial dysfunction?

Fascial protection stays contracted 

When you are injured, various cytokines (biochemicals) are produced by your body which have effects such as increased pain, inflammation and tissue contraction.  This is a normal response to injury and helps the area avoid infection and heal.  As the injury heals the cytokines are drained out by the lymphatic system (like the "sewer system" of your body) and your pain and inflammation resolve.  Interstitial Inflammatory Stasis (IIS) is a condition where excessive contraction of the connective tissue or "fascia" compresses the interstitial pathways (the deep fluid-filled channels that surround our cells) which prevents normal drainage of the cytokines.  The entrapped cytokines then cause continued chronic pain, inflammation and the excessive contraction of the fascia.  This "feed-forward" cycle then continues chronically.  The reason(s) for the initial excessive contraction is still being studied, but clinically it appears this type of dysfunction can result from trauma, surgery, postural strain, repetitive motion injuries, and even in response to an inflammatory diet. 


It is important to understand that fascia contracts naturally in a reflex response to protect the deeper structures of the body such as nerves, blood vessels and organs from irritation or strain, and that this type of contraction will also "call in" associated muscles to help in the protection.  In other words, the pain from contracted fascia can look like a common case of back, neck, shoulder, hip, knee, etc. pain that does not respond to traditional treatments.  The external muscle tension may be released temporarily by massage, stretching, ultrasound, electrical stimulation, etc., but the muscle tension will return because the deep fascial dysfunction has not resolved. The most important thing to understand about fascial dysfunction is that it is not detected by any diagnostic imaging such as MRI, X-ray or CT scan.  The tissue "looks" normal on these exams because there is no tissue damage - only the function is impaired. 

 

This type of pain is often diagnosed as myofascial pain (myo = "muscle") and is likely responsible for a large percentage of chronic pain syndromes.  It can occur in all areas of the body and presents as pain, tightness/tension, or numbness/tingling sensations, often variable in location.  Untreated, these chronically contracted dysfunctions also prevent normal movement of a section of the body’s internal tissues and force the body to move abnormally to compensate.  The resulting abnormal movement pattern continually causes excessive mechanical stress somewhere else in the body due to the abnormal motion.  That “somewhere” can be where things begin to “wear out” (become arthritic, unstable, painful).  In other words, in addition to potential pain in the affected area, fascial dysfunction can also be the answer to WHY that side of the lower back is chronically painful, WHY that knee has a meniscus tear or is arthritic and not the other knee, etc.  

 

The fascial dysfunctions are relatively easy to identify since you will have a palpable “tender point” in a specific muscular area that will resolve when the internal dysfunction has released.  The effect is immediate and lasting.  During treatment the goal is to optimally sequence treatment of the identified dysfunctions and provide exercises to allow you to assist in retraining your body to move normally again.  

For more information or to read the article entitled, "Impaired Lymphatic Drainage and Interstitial Inflammatory Stasis in Chronic Musculoskeletal and Idiopathic Pain Syndromes: Exploring a Novel Mechanism" that was published in the Frontiers in Pain Research Journal, visit tuckeypt.com, website of the originator of the Fascial Strain-Counterstrain treatment:  Brian Tuckey, PT, OCS, JSCCI.