Massage & Bodywork

MAY | JUNE 2023

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76 m a s s a g e & b o d y wo r k m ay/ j u n e 2 0 2 3 First, let's all get the pronunciation of this five-syllable word—hyaluronan—down 100 percent: Hi-ah-lu-ROH- nan. More conventionally, it is known as hyaluronic acid (HA). A simple search on the web reveals thousands of videos about the benefits and the hype surrounding HA related to dermatology and skin care. Being a hydrophillic, water- loving molecule, HA is often added to skin care creams to restore and retain moisture. It's also an additive to massage oils and creams. Hyaluronic acid is readily available as a supplement, though there doesn't seem to be any solid evidence about the benefits of taking it orally. Hyaluronan does play a number of other, non-skin care roles in the body. To highlight a few, HA acts as a shock absorber in the synovial f luid, a space filler in the aqueous humor of the eye to provide tissue turgor (elasticity), and as a cushion against vascular compression in the connective tissue of the umbilical cord. What is of most interest to us as manual therapists is its role in lubrication. When two surfaces need to glide—like tendon sheaths, the pleura between the lung tissue and the interior wall of the chest cavity, the pericardium and the heart, or two muscles along each other—HA makes sure everything goes smoothly. Essentially, hyaluronan is the WD-40 of your body. Since HA is found throughout the body, many types of cells are capable of producing it, including fibroblasts, synoviocytes, smooth muscle cells, and the cell we want to focus on: the appropriately named fasciacytes. FASCIACYTES First discovered by a group of researchers including Antonio and Carla Stecco, the fasciacyte was described as being "fibroblast-like." Despite the similarities, it was determined that the fasciacyte differed enough in both structure (it's much plumper) and immunoreactivity to be classified as a new cell type. That's kind of a big deal. This discovery and its relevance was first published in 2011 in Surgical and Radiologic Anatomy. However, this new knowledge did not become more widely known until late 2018, when a follow-up paper titled "The Fasciacytes: A New Cell Devoted to Fascial Gliding Regulation" was published in Clinical Anatomy, which made it a much bigger deal. 1 What's important about fasciacytes is what they do and where they live. What they do is secrete hyaluronan. And where they live is in the outer layer of loose connective tissue that serves as an interface between the deep fascia and the epimysium of the muscle. The fasciacytes produce the HA that allows for smooth sliding and gliding between muscle and fascia, and likewise along the muscle and fascia of its adjacent neighbors. Think of the hamstring or quadriceps groups. It goes deeper than that, allowing the Hyaluronan Makes the Body Glide Multiple Processes Run Smoothly Thanks to Hyaluronic Acid By David Lesondak critical thinking | BODY OF WONDER TAKEAWAY: Whenever two surfaces need to glide—like tendon sheaths, the pericardium and the heart, or two muscles along each other—hyaluronic acid ensures everything goes smoothly.

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