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onset muscle soreness—seems to consist, to a large degree, in a hypersensitivity of the fascial envelopes (epimysia) around the involved muscles. In fact, after experimental induction of delayed onset muscle soreness, pain thresholds of the fascia decreased significantly more than those of the underlying muscle tissue. 19 These findings suggest that fascial tissues can play a frequent role in providing nociceptive stimulation (or irritation) to the spinal cord. Whether a nociceptive stimulation leads to pain perception in a specific client depends on many additional factors, including their danger-oriented cortical processing. However, the described findings indicate that the tissue origin often makes a substantial difference, since the central nervous system tends to respond to fascial nociception—in contrast to muscular nociception—with a particularly sensitive pain-associated responsiveness. Manual practitioners who completed their basic training in neurophysiology in the last century often use the "gait control theory" as an explanatory model for the pain-reducing effect of their work. Recent advances in pain sciences have shown this to be only partially correct. 20 Proprioceptive signaling can provide a pain-inhibiting effect, particularly to their specific innervation region at the spinal cord. However, for this effect, the speed of the incoming neural stimulation is apparently not a decisive factor. Instead, novel investigations revealed that the synapses of the polymodal receptors in the posterior horn of the spinal cord are eager for any kind of stimulation from their respective peripheral innervation region. They seem to be easily satisfied in case sufficient proprioceptive information is supplied to them from these tissue regions via these polymodal receptors. However, when the connective tissue matrix surrounding the respective sensory receptors is altered, these interstitial neurons tend to actively lower their threshold for nociceptive stimulation, which may then lead to myofascial pain. In addition, they may actively give off cytokines that sensitize polymodal neurons in their peripheral innervation region and predispose these areas to a nociceptive function. 21 A seemingly miniscule mechanical stimulation, such as a leg-length difference of only 1 mm, can then lead to a nociceptive response within the intricate network of these intrafascial polymodal receptors. FASCIAL INTEROCEPTION The term interoception is usually applied to describe body perceptions that are less concerned with where our body is in space and in relation to gravity, and more with how it is doing in its constant search for homeostasis related to our physiological needs. Interoceptive signaling is therefore associated with somatic perceptions, such as temperature changes, hunger, thirst, nausea, tingling, soreness, oxygen supply, and muscular effort, as well as a sense of belonging (versus alienation) regarding specific body regions. 22 The peripheral sensory receptors related to interoception are all free nerve endings— they are interstitial receptors. Most of those receptors are located in visceral connective tissues and constitute an essential part of what is frequently referred to as the enteric brain. In addition, other interoceptive interstitial receptors are located within perimysial and endomysial intramuscular fascial tissues. The neural stimulation from those interoceptive nerve endings does not follow the usual afferent pathways toward the somatomotor cortex in the brain; rather, these neurons project to the so- called insular cortex, an area of cortical gray matter that is not located on the brain's outer surface but is folded down or internally into the depth of the forebrain. In this walnut-sized brain area, perceptions about internal somatic sensations are associated with emotional preferences, expectations, and feelings. Patients with disturbed functioning of the insula may still have full biomechanical functioning and achieve high IQ levels in respective cognitive tests, but they are usually impaired in their social skills and are unable to make reasonable decisions in complex social situations. 23 Several health-related impairments, such as low-back pain, scoliosis, or complex regional pain syndrome, are associated with 44 m a s s a g e & b o d y wo r k s e p te m b e r/o c to b e r 2 0 2 2 Some pathologies can be characterized by impairments in proprioception, and others with impairments of interoception. A skilled practitioner should be able to elicit a shift of mindful attention (of client and therapist) accordingly, sometimes more to one than to the other perceptual modality. a sense of belonging (versus alienation) regarding specific body regions. peripheral sensory receptors related to interoception are all free nerve endings— they are interstitial receptors. Most of those receptors are located in visceral connective region. They seem to be easily satisfied in case sufficient proprioceptive information matrix surrounding the respective sensory a sense of belonging (versus alienation) regarding specific body regions. peripheral sensory receptors related to interoception are all free nerve endings— they are interstitial receptors. Most of those receptors are located in visceral connective tissues and constitute an essential part of what is frequently referred to as the enteric brain. In addition, other interoceptive their respective peripheral innervation region. They seem to be easily satisfied in case sufficient proprioceptive information is supplied to them from these tissue regions via these polymodal receptors. matrix surrounding the respective sensory neurons tend to actively lower their threshold for nociceptive stimulation, which may then lead to myofascial pain. In addition, they may actively give off cytokines that sensitize polymodal neurons a sense of belonging (versus alienation) regarding specific body regions. peripheral sensory receptors related to interoception are all free nerve endings— they are interstitial receptors. Most of those receptors are located in visceral connective tissues and constitute an essential part of what is frequently referred to as the enteric brain. In addition, other interoceptive interstitial receptors are located within their respective peripheral innervation region. They seem to be easily satisfied in case sufficient proprioceptive information is supplied to them from these tissue regions via these polymodal receptors. However, when the connective tissue matrix surrounding the respective sensory receptors is altered, these interstitial neurons tend to actively lower their threshold for nociceptive stimulation, which may then lead to myofascial pain. In addition, they may actively give off cytokines that sensitize polymodal neurons in their peripheral innervation region and predispose these areas to a nociceptive A seemingly miniscule mechanical stimulation, such as a leg-length a sense of belonging (versus alienation) regarding specific body regions. peripheral sensory receptors related to interoception are all free nerve endings— they are interstitial receptors. Most of those receptors are located in visceral connective tissues and constitute an essential part of what is frequently referred to as the enteric brain. In addition, other interoceptive interstitial receptors are located within perimysial and endomysial intramuscular their respective peripheral innervation region. They seem to be easily satisfied in case sufficient proprioceptive information is supplied to them from these tissue regions via these polymodal receptors. However, when the connective tissue matrix surrounding the respective sensory receptors is altered, these interstitial neurons tend to actively lower their threshold for nociceptive stimulation, which may then lead to myofascial pain. In addition, they may actively give off cytokines that sensitize polymodal neurons in their peripheral innervation region and predispose these areas to a nociceptive A seemingly miniscule mechanical stimulation, such as a leg-length difference of only 1 mm, can then lead to a nociceptive response within the intricate network of these intrafascial polymodal a sense of belonging (versus alienation) regarding specific body regions. peripheral sensory receptors related to interoception are all free nerve endings— they are interstitial receptors. Most of those receptors are located in visceral connective tissues and constitute an essential part of what is frequently referred to as the enteric brain. In addition, other interoceptive interstitial receptors are located within perimysial and endomysial intramuscular fascial tissues. a sense of belonging (versus alienation) regarding specific body regions. 22 peripheral sensory receptors related to interoception are all free nerve endings— they are interstitial receptors. Most of those receptors are located in visceral connective In this walnut-sized brain area, perceptions brain's outer surface but is folded down or internally into the depth of the forebrain. In this walnut-sized brain area, perceptions about internal somatic sensations are associated with emotional preferences, expectations, and feelings. Patients with disturbed functioning of the insula may still have full biomechanical functioning perimysial and endomysial intramuscular fascial tissues. The neural stimulation from those interoceptive nerve endings does not follow the usual afferent pathways toward the somatomotor cortex in the brain; rather, these neurons project to the so- function. 21 mechanical stimulation, such as a leg-length difference of only 1 mm, can then lead to a nociceptive response within the intricate network of these intrafascial polymodal receptors. central nervous system tends to respond to fascial nociception—in contrast to muscular nociception—with a particularly sensitive makes a substantial difference, since the central nervous system tends to respond to fascial nociception—in contrast to muscular nociception—with a particularly sensitive pain-associated responsiveness. Manual practitioners who completed their basic training in neurophysiology in the last century often use the "gait control In addition, they may actively give off cytokines that sensitize polymodal neurons the spinal cord. Whether a nociceptive stimulation leads to pain perception in a specific client depends on many additional factors, including their danger-oriented cortical processing. However, the described central nervous system tends to respond to fascial nociception—in contrast to muscular nociception—with a particularly sensitive pain-associated responsiveness. Manual practitioners who completed their basic training in neurophysiology in the last century often use the "gait control theory" as an explanatory model for the pain-reducing effect of their work. Recent advances in pain sciences have shown this to be only partially correct. Proprioceptive signaling can provide a pain-inhibiting effect, particularly to their specific innervation region at the spinal cord. However, for this effect, the speed of the incoming neural stimulation is apparently not a decisive factor. Instead, novel investigations revealed threshold for nociceptive stimulation, which may then lead to myofascial pain. In addition, they may actively give off cytokines that sensitize polymodal neurons in their peripheral innervation region and predispose these areas to a nociceptive function. FASCIAL INTEROCEPTION The term interoception to describe body perceptions that are less concerned with where our body is in space and in relation to gravity, and more with However, for this effect, the speed of the incoming neural stimulation is apparently stimulation leads to pain perception in a specific client depends on many additional factors, including their danger-oriented cortical processing. However, the described findings indicate that the tissue origin often makes a substantial difference, since the central nervous system tends to respond to fascial nociception—in contrast to muscular nociception—with a particularly sensitive pain-associated responsiveness. Manual practitioners who completed their basic training in neurophysiology in the last century often use the "gait control theory" as an explanatory model for the pain-reducing effect of their work. Recent advances in pain sciences have shown this to be only partially correct. Proprioceptive signaling can provide a pain-inhibiting effect, particularly to their specific innervation region at the spinal cord. However, for this effect, the speed of the incoming neural stimulation is apparently The term to describe body perceptions that are less concerned with where our body is in space factors, including their danger-oriented cortical processing. However, the described findings indicate that the tissue origin often regions via these polymodal receptors. However, when the connective tissue matrix surrounding the respective sensory receptors is altered, these interstitial neurons tend to actively lower their tissues and constitute an essential part of what is frequently referred to as the enteric brain. In addition, other interoceptive interstitial receptors are located within perimysial and endomysial intramuscular their basic training in neurophysiology in the last century often use the "gait control theory" as an explanatory model for the pain-reducing effect of their work. Recent advances in pain sciences have shown this to be only partially correct. to describe body perceptions that are less concerned with where our body is in space and in relation to gravity, and more with how it is doing in its constant search for homeostasis related to our physiological needs. Interoceptive signaling is therefore associated with somatic perceptions, such as temperature changes, hunger, thirst, nausea, tingling, soreness, oxygen interoception are all free nerve endings— they are interstitial receptors. Most of those receptors are located in visceral connective tissues and constitute an essential part of what is frequently referred to as the enteric brain. In addition, other interoceptive interstitial receptors are located within perimysial and endomysial intramuscular The neural stimulation from those interoceptive nerve endings does not follow the usual afferent pathways toward the somatomotor cortex in the brain; rather, these neurons project to the so- called insular cortex, an area of cortical gray matter that is not located on the brain's outer surface but is folded down or internally into the depth of the forebrain. In this walnut-sized brain area, perceptions about internal somatic sensations are associated with emotional preferences, expectations, and feelings. Patients with disturbed functioning of the insula may still have full biomechanical functioning and achieve high IQ levels in respective cognitive tests, but they are usually impaired Several health-related impairments, such as low-back pain, scoliosis, or complex regional pain syndrome, are associated with homeostasis related to our physiological needs. Interoceptive signaling is therefore brain's outer surface but is folded down or internally into the depth of the forebrain. In this walnut-sized brain area, perceptions about internal somatic sensations are associated with emotional preferences, expectations, and feelings. Patients with disturbed functioning of the insula may still have full biomechanical functioning and achieve high IQ levels in respective cognitive tests, but they are usually impaired in their social skills and are unable to make Several health-related impairments, such as low-back pain, scoliosis, or complex about internal somatic sensations are associated with emotional preferences, expectations, and feelings. Patients with disturbed functioning of the insula may still have full biomechanical functioning and achieve high IQ levels in respective cognitive tests, but they are usually impaired in their social skills and are unable to make reasonable decisions in complex social disturbed functioning of the insula may still have full biomechanical functioning and achieve high IQ levels in respective cognitive tests, but they are usually impaired matrix surrounding the respective sensory receptors is altered, these interstitial neurons tend to actively lower their threshold for nociceptive stimulation, which may then lead to myofascial pain. In addition, they may actively give off cytokines that sensitize polymodal neurons in their peripheral innervation region and predispose these areas to a nociceptive A seemingly miniscule mechanical stimulation, such as a leg-length difference of only 1 mm, can then lead to a nociceptive response within the intricate network of these intrafascial polymodal FASCIAL INTEROCEPTION interoception to describe body perceptions that are less concerned with where our body is in space and in relation to gravity, and more with how it is doing in its constant search for homeostasis related to our physiological needs. Interoceptive signaling is therefore associated with somatic perceptions, such as temperature changes, hunger, is usually applied to describe body perceptions that are less concerned with where our body is in space and in relation to gravity, and more with how it is doing in its constant search for homeostasis related to our physiological needs. Interoceptive signaling is therefore associated with somatic perceptions, such as temperature changes, hunger, thirst, nausea, tingling, soreness, oxygen supply, and muscular effort, as well as rather, these neurons project to the so- called insular cortex, an area of cortical gray matter that is not located on the brain's outer surface but is folded down or internally into the depth of the forebrain. m a s s a g e & b o d y wo r k s e p te m b e r/o c to b e r 2 0 2 2 a sense of belonging (versus alienation) The peripheral sensory receptors related to interoception are all free nerve endings— they are interstitial receptors. Most of those receptors are located in visceral connective they are interstitial receptors. Most of those peripheral sensory receptors related to interoception are all free nerve endings— they are interstitial receptors. Most of those PROPRIOCEPTIVE IMPAIRMENT INTEROCEPTIVE DYSREGULATION Low-back pain Eating disorders Irritable bowel syndrome Whiplash Posttraumatic stress disorder Complex regional pain syndrome (CRPS) Substance-use disorders Attention deficit hyperactivity disorder (ADHD) Depression Panic disorder Generalized anxiety disorder Scoliosis diagonal chain Autism spectrum disorders Depersonalization/derealization disorder Systemic hypermobility Somatic symptom disorders Functional disorders Other myofascial pain syndromes Fibromyalgia Chronic fatigue syndrome 2