The fascia: the forgotten structure

Abstract

This paper examines the main characteristics of the human fascial system, considered in its three-dimensional continuity. To better understand the anatomy of the human fascial system, a simple diagram of the subcutaneous tissue must be borne in mind. From the skin to the deepest plane, we find the superficial fascia, dividing the subcutaneous tissue into two fibroadipose layers, superficial and deep, and the deep fascia, which envelops all the muscles of the body, showing different characteristics according to region. Under the deep fascia is the epimysium, occurring in the limbs and some regions of the trunk. Skin ligaments connect the superficial fascia to the skin and to the deep fascia, forming a three-dimensional network among the fat lobules. The typical features of the superficial and deep fasciae and their relationships to nerves, vessels and muscles are reported here, highlighting the possible role of the deep fascia in proprioception and peripheral motor coordination. The main features of the fasciae with imaging techniques are also discussed. This knowledge may contribute to clinicians' understanding of the myofascial system and the role which the deep fasciae may play in musculoskeletal dysfunctions.