shin fascia

Let's take a closer look at the structure of the fascia as an example of muscle structure. As we know, the basic structural unit of muscle tissue is the myocyte - the muscle cell. It is often called a muscle fiber because it is very thin, only a few tens of micrometers thick, but quite long - sometimes up to 10-15 centimeters.

Collapse' without sun. Symptoms of Vitamin D Deficiency and How to Supplement

If you spend all summer in the office and don't see any sun, you can literally collapse because your bones become so brittle! What should I do? Which foods can provide you with enough of the 'sunshine vitamin'?

How dangerous is a vitamin D deficiency for humans? Roskachestvo expert Maria Koroleva, a cardiologist, gives useful information about vitamin D deficiency and how to maintain vitamin D levels in the body.

What is vitamin D and why is it needed?

Vitamin D is involved in cell division, has an anti-inflammatory effect, fights infections, is responsible for calcium and phosphate absorption and reduces the risk of tooth decay in infants, children and adolescents by 36-49%.

The main role of vitamin D is to maintain bone health by increasing calcium absorption in the intestines. Without sufficient vitamin D, the body can only absorb 10-15 % of calcium from food, but with normal vitamin D reserves the absorption is 30-40 %.

Vitamin D is involved in the production of serotonin and dopamine, reduces the risk of atherosclerosis, rheumatoid arthritis, hypertension, cardiovascular disease, cancer and autoimmune diseases, supports reproductive function and promotes weight loss by participating in lipid metabolism.

Taking vitamin D orally along with phosphate supplements is effective in treating bone disease in people with low blood phosphate levels (the genetic disorder hypophosphatemia).

Vitamin D also helps with hypoparathyroidism (underactive parathyroid gland) because it increases the amount of calcium in the blood in people with low parathyroid hormone levels.

There are different forms of vitamin D, including ergocalciferol (vitamin D2) and cholecalciferol (vitamin D3). The functions of vitamin D2 and D3 are almost identical, which is why they are grouped together under the name 'vitamin D'.

The myofascia is a three-dimensional matrix

Fascia forms a continuous three-dimensional matrix that covers the entire body and serves as support for our organs, muscles, joints, bones and nerve fibers. In addition, the multidimensional arrangement of the fascia and the different orientation of the fascial meridians allow us to move in different directions (Myers 2001; Huijing 2003; Stecco 2009).

Have you ever seen parkourists jump from a two or three story building, spin, and seamlessly transition into a run? How come her joints don't break under the force of the fall?

The answer lies in the fact that the internal force (muscle strength) and the external force (gravity and support reactions) are transmitted and distributed to the body primarily via the fascial networks (as long as the forces do not exceed the permissible values). Fascia helps prevent or minimize local tension in the area of a specific muscle, joint or bone and harnesses the energy impulses generated by forces through its viscoelastic properties. This ensures the integrity of the body while minimizing the energy required to perform movements.

The musculo-fascial meridians, described in. 'Anatomical Trends'They give us a clearer picture of how exactly the fascia alleviates tension and force throughout the body, depending on the direction of the applied force (Myers 2001; Huijing 2003; Sandercock & Maas 2009).

The benefits and harms of repetition

According to Davis' law, the soft tissues that make up the fascia can change (become stiffer and denser) along certain fascial lines (Clark, Lucett & Corn 2008). This can have both temporary benefits and long-term side effects. When a particular movement is repeated many times, the soft tissue reshapes itself in the direction of that movement and becomes stronger and more resistant to forces acting in that particular direction. Constant repetition of the same movements can strengthen the fascia along the line of tension but weaken it in other directions, which can lead to more frequent tears of the fascia itself or immobilization of adjacent joints when moving in other directions. The same applies to prolonged lack of exercise, such as sitting or standing for long periods of time, often for days, months and years.

A 1995 study showed that mechanical stress (exercise) can cause hypertrophy of the ligaments that make up the fascia (Fukuyama et al. 1995). New research shows the ability of the fascial system to heal itself after a tear. One such study found that some people with a torn anterior cruciate ligament (ACL) were able to fully restore function without surgery and the torn ligaments healed completely (Matias et al. 2011). Further research leads to the development of new rehabilitation techniques and new approaches to physical training.

causes

Type 1 necrotizing fasciitis is caused by polymicrobial compounds and type 2 is caused by a monoculture of pyogenic streptococci. A polymicrobial lesion usually includes a mixture of aerobic and anaerobic bacteria. Among aerobes, Enterobacteriaceae and Staphylococcus aureus play the most important role, while Bacteroides play the most important role among anaerobes. The entry point for infection can be any place where the integrity of the skin has been compromised: animal or insect bites, abrasions, wounds, needle punctures, wounds caused by trauma or surgery. Cases following laparoscopy, thoracotomy and gastroscopy have been described in the literature. Currently, abscess surgeons are noticing an increase in necrosis of the superficial fascia after plastic surgery. Sometimes fasciitis occurs against the background of other purulent processes. In approximately 20 % patients there are no visible skin lesions.

The likelihood of developing necrotizing fasciitis increases with conditions that impair the body's ability to defend itself against the effects of infectious agents, including opportunistic pathogens. Risk factors include age over 60 years, diabetes, fatigue, malignancies, trauma, alcoholism, immunosuppressive conditions, long-term use of corticosteroids, obesity, recovery from trauma and surgery, peripheral vascular diseases, subcomplex chronic somatic diseases, intravenous intake of irritating drugs ( mainly narcotics). Experts point out that increasing life expectancy, the increase in diabetes mellitus and the emergence of highly virulent strains of pyogenic streptococci have contributed to the increase in incidence in recent years.

pathogenesis

Thrombosis of the vessels supplying the skin, fascia and subcutaneous fat plays an important role in the development of necrotizing fasciitis. The formation of a thrombus leads to impaired blood circulation, a drastic reduction in the oxygen supply to the soft tissues and the formation of necrotic areas. Due to the rather deep localization of the primary focus of inflammation, the pathognomonic clinical signs are absent or only weakly expressed in the initial stage, which leads to a delayed diagnosis of the pathology. The necrosis spreads at high speed along the fascial sheath: within an hour, necrosis of approximately 2.5 cm of fascia is observed. The underlying muscles are not affected by the pathological process.

The topography of the pathological process is very variable. It can affect any area of the body, but the extremities, anterior abdominal wall, buttocks, and genitals are most commonly affected. The onset of the disease occurs suddenly. The first symptom is increased pain in the affected area. There is increasing swelling of the soft tissues. An erythematous focus develops, which is later covered by a hemorrhagic rash, blisters with serous or hemorrhagic contents form, followed by necrotic areas.

Initially touching the affected area is painful, later the nerve endings die and sensitivity is lost. Palpation reveals a woody thickening of the tissue. Crepitations are often caused by the accumulation of gas bubbles. Fluctuations are unusual and are usually detected only when necrotizing fasciitis develops against a background of purulent inflammation. The area of affected tissue is much larger than that of the skin lesions. There is no regional lymphangitis or lymphangiitis.

General hyperthermia up to 39-40 or more degrees Celsius is observed. Significant daily fluctuations in body temperature are characteristic. Intoxication syndrome includes general weakness, severe headache, insomnia, lethargy, loss of appetite, nausea and vomiting. Tachycardia, hypotension, rapid breathing, hematuria, oliguria, severe dehydration, and intestinal paresis occur. There is a possibility of acute gastrointestinal ulceration with subsequent bleeding.

Specificity of the fascia and its role in the development of pain

Our entire body is covered by a fibrous skeleton that penetrates us. The fascia contains aponeuroses, ligaments and tendons. This skeleton has many pockets that can comfortably accommodate all the cells in our body. In the words of Thomas Myers, a German doctor and researcher, one can travel endlessly through every nook and cranny of our body without ever leaving the fascia. But sometimes the fascia becomes sore and even inflamed.

Why do we need to know this? This is very important to understand why by acting on certain parts of the body we can affect other parts.

We know that we need to be aware of the changes in our environment in order to interact with it. Our central nervous system needs to be constantly informed about what is going on in the body. Because of this, our body is literally oversaturated with all kinds of sensors - receptors.

Internal and external temperature, pressure, vibration, chemical composition - all of this is constantly monitored. And almost all of these receptors are located in the fascia.

But it is very important for us to understand that pain receptors (called nociceptors in medicine) and mechanoreceptors, these are the receptors that monitor the strength and length of muscle contraction, and the receptors with which we sense our body and its position in Determine space. These are practically all of these receptors, which are also located in the fascia. This knowledge helps to create an effective fascia treatment.

Pain is of course also felt through the fascia. Disturbances in the structure and metabolic processes in the fascia can lead to pain. They can also lead to disruptions in the coordinated work of our muscles, which leads to overloading of individual muscle groups, which in turn can cause fascia pain. When the fascia is overloaded, exercises are no longer as effective.

In order to counteract all of this, the fascia must be trained properly. We will talk about this in more detail next time.

What we will talk about in this text:

The fascia surrounds the individual muscles or muscle groups; it is like a coat that at the same time strongly influences the trophism of the tissue and helps people with their support function. The fascia also fixes muscles and organs, helps the body maintain water and salt balance and is responsible for the transmission of nerve impulses.

Human range of motion and flexibility are often incorrectly associated only with muscle tissue. In reality, these parameters (which are particularly important for the training process) directly depend on the condition of the fascia. By the way, fascia also has something to do with the shape of the body: muscles give volume, but it is the connective tissue that gives shape.

Why should you pay attention to your fascia?

Keeping your fascia in good shape is important for many reasons that don't just have to do with your performance. First, the overall health of the body depends on how mobile the fascia is and how well it performs its direct function. If this connective tissue is normal, a person recovers quickly from any injury. Secondly, the condition of the fascia is closely linked to the appearance of the skin. Weak connective tissue causes them to sag and leads to wrinkles and even a second chin. The condition of the fascia is one of the causes of facial skin problems that require regular care and relaxation.

The older a person is, the more he or she should care for the fascia. Otherwise, they can literally injure themselves on the spot with small loads. They can also notice the most unpleasant changes in their skin over time.

Symptoms of water retention in the body

Some of the most common symptoms are.

• swellingespecially in the area of abdomen
• swollen feetankles, thighs
• swelling around abdomenface and thighs
• Lumps on the skin, similar to those you can feel with your fingers after showering
• Difficulty losing weight despite great effort
• sudden weight gain in a short period of time.

How do I know whether it is fluid retention or fat accumulation?

One way to check if you are retaining water is to press your thumb slowly and with enough force on your foot, ankle, or calf. If there is one swellingyou will see an indentation in the skin. Excess water can vary, but if you stick to a strict dietIs it possible to lose 2 kg in a week. On the other hand, you can be sure that if you gain more than 1kg in 24 hours, it is mostly water and not stored fat.

Fun fact: 9,000 calories equals 1kg, and it's unlikely you've made such a big change in your food and drink intake in just one day. In most cases, the main factor that affects how much extra water your body stores is your calorie intake from unhealthy foods and drinks.

Factors affecting wound healing

Wounded skin heals at different rates, depending on individual body and environmental factors:

• A person's general health
• Age – older people have slower skin regeneration times than younger people
• state of the immune system
• eating habits
• weather conditions
• How infected the wound is
• Bad habits (smoking, alcohol, drugs)
• Associated diseases (diabetes, cancer)

treatment of lacerations

There are numerous preparations for the treatment of lacerations, both in the form of active ingredients and dosage forms 4,5,6 .

solutions

povidone iodine

Betadine® is available in a concentration of 10 %. For use on lacerations, it can be used neat or diluted 1:10 as a 1%ige solution (2 x 5 mL (2 teaspoons) and 100 mL (½ cup) of a 10%ige solution) 2,3 . Dilute with saline, Ringer's solution, phosphate buffer solution, water for injections or, as a last resort, clean drinking water.

Povidone iodine has antiseptic, antiviral, antifungal and antiprotozoal effects.

It is effective against gram positive and gram negative bacteria.

Unlike a 5%igen alcoholic iodine solution, povidone iodine can be applied directly to a wound. It does not press, does not dry out the skin and does not impair tissue regeneration.

Chlorhexidine Bigluconate

Chlorhexidine bigluconate is an antiseptic that fights bacteria, fungi, and viruses. It is available as an aqueous and alcoholic solution. A 0.2-0.5% aqueous solution should be used to treat cuts. An alcohol-based preparation can cause uncomfortable burning reactions and slow down the healing process.

hydrogen peroxide

This solution is prepared and used at a concentration of 3 %. Hydrogen peroxide has a hemostatic effect and contributes to the mechanical removal of debris from the wound by the formation of gas bubbles. Using hydrogen peroxide can cause allergic reactions.

Special features of treatment

When heated with high-frequency currents, protein-containing tissue is intensively broken down and the collagen fibers are strengthened. Although the current damages the latter, it leads to the formation of new cells that actively replace the old ones.

In addition to improving collagen repair, it destroys fat cells and promotes blood circulation. As a result, facial wrinkles are smoothed and the appearance of the skin is improved.

How does the procedure work?

To achieve a positive result, two principles of action are used:

• Diathermy. Diathermy involves heating the skin. The substance that transmits the current contains heat. The thermal effect is particularly strong in fabrics with high resistance. This includes fat and skin. Devices based on this principle have metal electrodes.
• UHF. In this technique, the tissue is heated using an electromagnetic field. The mechanism of action is similar to that of microwaves: the particles change their position at the same frequency as the electromagnetic field. Such devices use electrodes coated with a dielectric.

During such a facelift, the skin and the layers beneath the skin are heated to up to 50 degrees. The collagen fibers transform into spirals, forming a solid skeleton and supporting intercellular connections.

Under the influence of heat, fat is dissolved and eliminated in a physiological manner. One can therefore speak of a lipolytic lifting effect.

Who can benefit from the treatment?

The procedure is suitable for patients of all ages. Young women undergo radiofrequency lifting to eliminate acne scars and scarring. Patients of Balzac age have the opportunity to maintain or restore elasticity and eliminate wrinkles.

It is advisable to start treatments after the age of 35 to 45 or at the first signs of aging.

The effectiveness of treatment in mature women (50 years and older) is controversial. At this age, menopause occurs, which indicates a decline in the body's regenerative functions. During this time, skin production actively decreases:

Therefore, not 1 or 2 treatments, but up to 10 sessions are required to maintain the elasticity of the skin. Also, the beautician may recommend combining this treatment with mesotherapy and biorevitalization. These stimulate the restoration of skin turgor.

This is useful for people using this method:

The treatment can also be performed for people who want to treat the skin around the eyes. This is an area where deep and fine wrinkles appear earlier. The method triggers neo-collagenesis, which promotes natural collagen production. It works against droopy eyelids, dark circles under the eyes and caterpillars.

For a long-lasting and quick effect, RF lifts are combined with injection techniques. A good effect can be achieved on pigment spots and enlarged vascular formations.

The result is most visible at a young age. This is because natural repair mechanisms weaken over time.

Some beauty salons offer radiofrequency lifting not only for the face, but also for the body. With this it is possible to cope:

It is possible to tighten loose skin after significant weight loss or pregnancy.

contraindications

MRI of the soft tissues of the thigh is contraindicated if there are metal-containing objects or electronic devices in the patient's body that cannot be removed during the procedure. The examination is limited in patients with severe claustrophobia, obesity grade 3 or 4, schizophrenia or other severe mental disorders and in the first 12 weeks of pregnancy.

Contrast-enhanced scans are not performed in patients with gadolinium allergy, severe renal failure, liver damage, endocrine gland diseases, congestive diabetes mellitus, multiple myeloma and end-stage diseases.

If possible, you should postpone the procedure if you feel unwell, have a high body temperature or have an acute infection.

How is magnetic resonance imaging of the soft tissues of the thigh performed?

Magnetic resonance imaging is performed in a room equipped with the necessary equipment.

The examination takes 30-40 minutes.

The procedure consists of three stages: preparation for the examination, palpation of the area to be examined and decoding the results.

The preparatory phase of the MRI scan of the soft tissues of the thigh begins when the patient enters the room. The patient undresses. He can stay in his clothes or put on special equipment. It is very important that he does not leave any metal parts on. In addition to clothing, jewelry, belts, watches and hearing aids must also be removed. If the patient actually has non-removable objects in the body, the doctor must provide a document proving the compatibility of these objects with the MRI machine. At this stage, the patient must also sign a consent form for the MRI scan, be informed and ask questions. Once the preparations are complete, the patient and the radiologist go into the scanner.

The scanning phase is the most responsible phase. The patient takes a horizontal position on the belt of the device. The arms and legs are stretched out along the body. The doctor checks whether the position is correct and secures the limbs with additional supports. During the contrast examination, the specialist asks the nurse to insert the catheter into the peripheral vein. When everything is ready, the patient is placed in the tunnel of the machine. The doctor goes into an adjoining room where the necessary equipment is available. From here, he performs an MRI of the soft tissues of the thigh, monitors the patient's condition and, if necessary, communicates with the patient via an attached microphone. After turning on the scanner, characteristic sounds will be heard, which should not be scary. If necessary, earplugs or headphones with music can be inserted into the ear canal before the MRI scan. An MRI scan scans an area with electromagnetic radiation and creates images layer by layer. These images are fed into a computer, which analyzes and processes them. Once the diagnostic exam is completed, the CT scanner stops. The doctor leaves his room and goes to the patient. He unbuckles the patient, asks him how he feels and helps him get back on his feet.

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• fasciitis.
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• is liquorice.
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• Child with Komarovsky clubfoot.
• cysts in the ankle.