Biomechanical effects of fascial hydrorelease: A cadaveric study

Biomechanical effects of fascial hydrorelease: A cadaveric study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Biomechanical effects of fascial hydrorelease: A cadaveric study Kousuke Shiwaku, Hidenori Otsubo, Daisuke Suzuki, Pirri Calmero, and 6 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-4619915/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 28 Mar, 2025 Read the published version in BMC Musculoskeletal Disorders → Version 1 posted 4 You are reading this latest preprint version Abstract Background We aimed to investigate the influence of hydrorelease (HR) on the gliding resistance force between the aponeurotic fascia and epimysial fascia and between two epimysial fasciae using a biomechanical testing system. Methods In this cadaveric comparative study, 12 paired legs amputated above the knee joint from six fresh-frozen specimens were divided into two groups. The distal insertions of the target tendons of the tibialis anterior and posterior were detached and sutured to a force gauge for tension measurement during tendon pull. These tendons were representatives of the layer between the aponeurotic and epimysial fasciae of the tibialis anterior and between the epimysial fasciae of the tibialis posterior and flexor digitorum longus. For the baseline, the position where the tension of the target tendon was approximately 15 N was determined to eliminate creep. In the HR group, the baseline test position was replicated, and force was measured. The intervention was an HR injection between the specified fascial layers. The main outcome was the gliding resistance force between the aponeurotic and epimysial fasciae and between two epimysial fasciae. Results The resistance force between the aponeurotic and epimysial fasciae in the HR group was 6.4% lower than that in the control group ( P = 0.02). The resistance force between two epimysial fasciae in the HR group was 4.2% lower than that in the control group ( P < 0.01). Conclusions The gliding resistance force significantly decreased after HR in the layer between the aponeurotic and epimysial fasciae and between two epimysial fasciae in this cadaveric study. fascia myofascial pain syndrome biomechanics cadaver tendon Figures Figure 1 Figure 2 Figure 3 Figure 4 Background Hydrorelease (HR), or hydrodissection, is the ultrasound (US)-guided injection of a solution into the fascia without anesthesia [ 1 , 2 ]. HR is indicated for nerve disorders and myofascial pain syndrome (MPS) [ 1 , 2 ]. Physical findings of MPS include tenderness and localized hyperirritable nodules within palpable taut bands of skeletal muscle fibers and fascia [ 3 , 4 ]; these are the targets of HR. Recently, US has been utilized to confirm MPS findings, such as thickening or stacking of the fascia or densification [ 5 ]. Furthermore, the solution can be injected into the inter-fascia layers, inside the aponeurotic fascia (APF), or intramuscularly using US [ 3 , 6 – 8 ]. Several reports discuss the clinical outcomes related to pain relief after HR for MPS and fascia-related disorders [ 3 , 6 – 10 ]. A study revealed an improvement in the shoulder range of motion (ROM) after HR of the coracohumeral ligament in patients with a global limitation of shoulder ROM [ 10 ]. However, the mechanisms of pain relief or ROM improvement remain to be thoroughly investigated. Speculated mechanisms underlying HR in patients with MPS include improved hydration and gliding between fascial layers, as well as the release of entrapment of small nerve fibers of both A- and C-fibers [ 11 ]. However, the biomechanical effects of HR on intra-APF and between the APF and epimysium (EPI) have not been investigated. Only one cadaveric study has revealed improved gliding around the median nerve at the carpal tunnel after HR (74002). Therefore, this study aimed to investigate the influence of HR on the gliding resistance force between the APF and EPI and between two EPIs using fresh-frozen cadavers and a biomechanical testing system. We hypothesized that the resistance force would decrease after HR. Methods Specimen preparation The Ethics Committee of our institution approved the study protocol for obtaining, utilizing, and disposing of fresh frozen human cadaveric legs (No. 1-2-68). Twelve paired legs from six fresh-frozen specimens (mean age at death, 82.5 years; range, 72–90 years) with no apparent scars from previous surgery or leg trauma were obtained through donations to the university anatomy program. All individuals provided informed consent before death. The specimens were thawed at room temperature for at least 24 h before testing. Each specimen was positioned supine and moistened to preserve tissue integrity during the test. The legs were amputated 20 cm above the knee joint line. The proximal end of the femoral bone was exposed for 15 cm, fixed using acrylic resin (Ostron II; GC), and poured into a cylindrical mold. The femoral cylinder was secured with an aluminum clamp, connected to the manipulator (Technology Service), and fixed to the clamp (Fig. 1 a). The knee was fixed at 30° flexion using wires, and the ankle was similarly fixed in a neutral position. The distal insertions of the target tendons of the tibialis anterior and posterior were detached and sutured to a force gauge to measure the tension in real time; these tendons were selected as representatives of the layer between the APF and EPI and between two EPIs, respectively (Fig. 1 b). US-guided injection A 10–2 MHz linear transducer (Aixplorer v12 and SL10-2; Supersonic Imagine, Aix-en-Provence, France) was used in this study, and a US-trained orthopedic specialist conducted the examination. Injections were performed under a short-axis view using a 25 G needle and the in-plane technique (Fig. 2 ). The target points were between the APF and EPI of the tibialis anterior and between EPIs of the tibialis posterior and flexor digitorum longus (Fig. 1 b). Four injections were administered for each target (Fig. 1 a). The first injection, HR1, was administered in the middle third of the leg; this was followed by injections HR2, HR3, and HR4, each performed 2.5 cm distal to the previous one. All injections comprised 2.5 mL of 0.9% saline with blue ink. Testing protocol One side of the paired leg was assigned to the HR group and the other to the control group. First, for the HR group, as a baseline test, the position where the tension of the anterior or posterior tibialis equaled approximately 15 N (named “force 0h” [Table 1 ]) was determined for each leg. During the creep removal process, the baseline test position was adjusted to maintain a force of approximately 15 N through 10 repetitions of pulling from the relaxation to the baseline test position. HR1 was exclusively performed in the HR group. In Test 1, the position of the baseline test was reproduced, and “force 1h” was acquired. This process was repeated four times, and the values “force 1h–4h” were documented (Table 1 ). Second, for the control group, all procedures were performed except for the HR intervention, resulting in the acquisition of “force 0c–4c.” For instance, the reduction in gliding resistance due to HR1 was calculated as force 1c divided by force 0c. Confirmation by dissection Within 1 min of the biomechanical tests, dissection was promptly commenced and completed in approximately 10 min. The needle insertion point was confirmed, along with the saline injection point. A large U-shaped skin incision, 5 cm from the injected point, was created. The superficial fascia, APF, and EPI were carefully exposed to confirm the presence of saline in the intended layer as directed by the operator (Fig. 3 a). The loose connective tissue between the APF and EPI of the tibialis anterior was visualized using 0.9% saline solution with ink. Additionally, some property changes may have occurred in the loose connective tissue of the fascia between the APF and EPI (Fig. 3 b). We named this status “lubricated fascia.” Statistical analysis First, a two-factor repeated analysis of variance was performed. Subsequently, as a post hoc test, an unpaired t-test was conducted to compare the differences between two groups of equivalent tests; for instance, comparisons were performed between “force 1h” divided by “force 0h” and “force 1c” divided by “force 0c” (Table 1 ). Additionally, a paired t-test was conducted to compare the changes from the previous test within each group, such as “force 1h” divided by “force 0h” versus “force 2h” divided by “force 0h” (Table 1 ). All statistical analyses were performed using IBM SPSS Statistics for Windows, version 28.0 (IBM Corp., Armonk, NY, USA). Statistical significance was set at P < 0.05. A post hoc power analysis was performed to determine the study’s power, which ranged from 0.982 to 0.997. Results Results for the tibialis anterior Figure 4 a shows the test results for the tibialis anterior. In test sequences 1–4, the force in the HR group was significantly lower than that in the control group ( P < 0.01, P = 0.01, P = 0.02, and P = 0.02, respectively). After the four HRs, the force decreased by 6.4%. In the HR group, after HR1, HR2, and HR4, the force decreased significantly compared with that in the previous test ( P < 0.01, P = 0.01, and 0.03, respectively). No significant differences were observed in the other comparisons. Results for the tibialis posterior Figure 4 b shows the results of the tests for the tibialis posterior. In test sequences 1–4, the force in the HR group was significantly lower than that in the control group ( P < 0.01, P = 0.01, P < 0.01, and P < 0.01, respectively). After the four HRs, the force decreased by 4.2%. In the HR group, after HR1, HR3, and HR4, the force decreased significantly less than that in the previous test ( P < 0.01, P = 0.04, and P < 0.01, respectively). No significant differences were observed in the other comparisons. Discussion This study revealed that the gliding resistance force between the selected fasciae significantly decreased after HR. The force decreased by 6.4% after HR between the APF and EPI and by 4.2% after HR between the two EPIs. Interpretations of the results of the resistance force When a tendon is pulled for a certain distance, the resistance force can be divided into the force pulling it and the gliding resistance between the tendon and its surrounding structures. Because HR was performed outside the EPI, the force change of the muscle fibers inside the EPI during the test was assumed to be approximately equal between the HR and control groups. Therefore, the force change may be mainly attributable to the change in the force of the gliding resistance between the APF and EPI or between two EPIs. Considering this, the reason the force decreased after HR should be discussed, focusing on the loose connective tissue between the APF and EPI or between two EPIs. Although we could not investigate this thoroughly, some property changes may have occurred in the loose connective tissue between the APF and EPI (Fig. 3 ). We speculated that these property changes probably occurred due to the solution and may be an important reason for the decrease in the force after HR. Additionally, another important reason is the physical separation between the APF and EPI or between two EPIs following needle insertion and injection of a certain volume of saline solution. However, the reasons for this decrease in force are speculative. Therefore, future studies are necessary to investigate the reason for the decrease in the resistance force caused by HR. Although we have only investigated the change in force, we speculate that the decrease in the force in this study (believed to be due to the change in the gliding between the two fasciae) is one of the main reasons why HR relieves pain in MPS and similar disorders. Therefore, future studies should investigate why force decrease is related to pain relief by HR. Clinical implications Thickening or stacking of the fascia on US [ 10 ], densification [ 5 ], and the associated laydown of extracellular content can be observed in MPS [ 12 – 14 ]. The myofascial trigger point is a key factor in the pathophysiology of MPS [ 4 ]. Therefore, thickened fascia on US imaging and observations of tenderness should be regarded as important findings for considering HR as a treatment option [ 3 ]. In this cadaveric study, the HR areas were normal without thickened fascia or obvious MPS. This study investigated the decrease in the force in human cadavers without specific fascial alterations. Because the resistance force is expected to be higher in patients with MPS or similar pathologies, future experiments on HR using animal models with such pathologies are necessary. Study limitations The two main limitations of this study are as follows: First, the specimens were fresh frozen cadavers; some reactions that occur in living patients do not occur in cadavers. Thus, the behavior of the solution after injection would also be different [ 15 ]. Second, in patients with clinical MPS, some conditions, including the resistance force, would be different from those in the normal fresh-frozen cadavers used in this study. Despite these limitations, this study is the first to quantitatively evaluate the resistance force on the fascia after HR using a biomechanical testing system. Conclusions In this cadaveric study, the gliding resistance force significantly decreased after HR in the layer between the APF and EPI or between two EPIs. Further studies on living animals and humans are necessary. Abbreviations APF aponeurotic fascia EPI epimysium HR hydrorelease HR1, 2, 3, and 4 first, second, third, and fourth hydrorelease injections, respectively MPS myofascial pain syndrome ROM range of motion US ultrasound Declarations Ethics approval and consent to participate The study was approved by the Sapporo Medical University Ethics Board (number 1-2-68).All participants provided written informed consent. Consent for publication All participants provided written informed consent. Competing interests The authors declare that they have no competing interests. Funding This work was partially funded by MEXT/JSPS KAKENHI (grant number JP 20K18035) Authors’ contributions KS wrote the initial draft of the manuscript. HO, TK, and AT designed the study. HO, PC, IO, and CS contributed to data analysis and interpretation and assisted in manuscript preparation. KS, HO, and DS contributed to data collection. All other authors participated in the interpretation and critically reviewed the manuscript. All authors read and approved the final version of the manuscript and agreed to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. Acknowledgments Not applicable. References Fukui S, Rokutanda R, Kawaai S, Suda M, Iwata F, Okada M, et al. Current evidence and practical knowledge for ultrasound-guided procedures in rheumatology: joint aspiration, injection, and other applications. Best Pract Res Clin Rheumatol. 2023;37:101832. Neo EJR, Shan NT, Tay SS. Hydrodissection for carpal tunnel syndrome: a systematic review. Am J Phys Med Rehabil. 2022;101:530–9. Courseault J, Kessler E, Moran A, Labbe A. Fascial hydrodissection for chronic hamstring injury. Curr Sports Med Rep. 2019;18:416–20. Simons DG. New aspects of myofascial trigger points: etiological and clinical. J Musculoskelet Pain. 2004;12:15–21. Giamberardino MA, Tafuri E, Savini A, Fabrizio A, Affaitati G, Lerza R, et al. Contribution of myofascial trigger points to migraine symptoms. J Pain. 2007;8:869–78. Wang T, Vahdatinia R, Humbert S, Stecco A. Myofascial injection using fascial layer-specific hydromanipulation technique (FLuSH) and the delineation of multifactorial myofascial pain. Med (Kaunas). 2020;56:717. Kongsagul S, Vitoonpong T, Kitisomprayoonkul W, Tantisiriwat N. Ultrasound-guided physiological saline injection for patients with myofascial pain. J Med Ultrasound. 2020;28:99–103. Kanamoto H, Orita S, Inage K, Shiga Y, Abe K, Eguchi Y, et al. Effect of ultrasound-guided hydrorelease of the multifidus muscle on acute low back pain. J Ultrasound Med. 2021;40:981–7. Tantanatip A, Patisumpitawong W, Lee S. Comparison of the effects of physiologic saline interfascial and lidocaine trigger point injections in treatment of myofascial pain syndrome: a double-blind randomized controlled trial. Arch Rehabil Res Clin Transl. 2021;3:100119. Kimura H, Suda M, Kobayashi T, Suzuki S, Fukui S, Obata H. Effectiveness of ultrasound-guided fascia hydrorelease on the coracohumeral ligament in patients with global limitation of the shoulder range of motion: a pilot study. Sci Rep. 2022;12:19782. Willard FH, Vleeming A, Schuenke MD, Danneels L, Schleip R. The thoracolumbar fascia: anatomy, function and clinical considerations. J Anat. 2012;221:507–36. Stecco A, Meneghini A, Stern R, Stecco C, Imamura M. Ultrasonography in myofascial neck pain: randomized clinical trial for diagnosis and follow-up. Surg Radiol Anat. 2014;36:243–53. Hoheisel U, Rosner J, Mense S. Innervation changes induced by inflammation of the rat thoracolumbar fascia. Neuroscience. 2015;300:351–9. Stecco C, Stern R, Porzionato A, Macchi V, Masiero S, Stecco A, et al. Hyaluronan within fascia in the etiology of myofascial pain. Surg Radiol Anat. 2011;33:891–6. Behr AU, Chan VWS, Stecco C. Living versus cadaver fascial plane injection. Reg Anesth Pain Med. 2019. 10.1136/rapm-2019-100893 . rapm-2019-100893. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Published Journal Publication published 28 Mar, 2025 Read the published version in BMC Musculoskeletal Disorders → Version 1 posted Editorial decision: Revision requested 10 Jul, 2024 Editor assigned by journal 08 Jul, 2024 Submission checks completed at journal 08 Jul, 2024 First submitted to journal 22 Jun, 2024 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-4619915","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":325075563,"identity":"ddd26ee8-e1f6-4870-8abb-8699bc08385d","order_by":0,"name":"Kousuke Shiwaku","email":"","orcid":"","institution":"Sapporo Medical University School of Medicine","correspondingAuthor":false,"prefix":"","firstName":"Kousuke","middleName":"","lastName":"Shiwaku","suffix":""},{"id":325075564,"identity":"561f5b6a-cd9f-4f1d-b85a-922bed0fa0bb","order_by":1,"name":"Hidenori Otsubo","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA5ElEQVRIiWNgGAWjYBACA2YGAwhLgoHxAZDi4SNSiwFICzOIxcNGUAsDQgubBEiEoBZzduaNDxgq/tgb3G4+Vvk1x06GjYH54aMbeLRYNrMVGzCcMUjccOdY2m3ZbclAh7EZG+fgc9hhHjMJxjaDBIMbOWa3JbcxA7XwsEkT0GL+A6jFHqSlWHJbPVFazBiAWhg3ALUwftx2mBgtbMUSCWeME2feOZYszbjtOA8bMyG/nD+88cOHCjl7vtvNBz/+3FZtz8/e/PAxPi1gkAClmXnAJCHlyIDxBymqR8EoGAWjYMQAAFTQQnHUgdNvAAAAAElFTkSuQmCC","orcid":"","institution":"Sapporo Sports Clinic","correspondingAuthor":true,"prefix":"","firstName":"Hidenori","middleName":"","lastName":"Otsubo","suffix":""},{"id":325075565,"identity":"44434f98-63bd-47c7-b997-bd4e32e41edb","order_by":2,"name":"Daisuke Suzuki","email":"","orcid":"","institution":"Hokkaido Chitose Collage of Rehabilitation","correspondingAuthor":false,"prefix":"","firstName":"Daisuke","middleName":"","lastName":"Suzuki","suffix":""},{"id":325075566,"identity":"0d00139c-3b0f-476c-8109-8b5dd14c5724","order_by":3,"name":"Pirri Calmero","email":"","orcid":"","institution":"University of Padova","correspondingAuthor":false,"prefix":"","firstName":"Pirri","middleName":"","lastName":"Calmero","suffix":""},{"id":325075567,"identity":"32d49a41-0404-4af0-a125-8c198f95f737","order_by":4,"name":"Izaya Ogon¹","email":"","orcid":"","institution":"Sapporo Medical University","correspondingAuthor":false,"prefix":"","firstName":"Izaya","middleName":"","lastName":"Ogon¹","suffix":""},{"id":325075568,"identity":"deee944e-73db-4ab9-8e5a-e77d51e42376","order_by":5,"name":"Taiki Kodesyo","email":"","orcid":"","institution":"Sapporo Medical University School of Medicine","correspondingAuthor":false,"prefix":"","firstName":"Taiki","middleName":"","lastName":"Kodesyo","suffix":""},{"id":325075569,"identity":"d3671ec0-9e17-4267-8776-23d089f8bacc","order_by":6,"name":"Tomoaki Kamiya","email":"","orcid":"","institution":"Sapporo Medical University School of Medicine","correspondingAuthor":false,"prefix":"","firstName":"Tomoaki","middleName":"","lastName":"Kamiya","suffix":""},{"id":325075570,"identity":"0881bb01-b022-4159-9235-b1d040344e07","order_by":7,"name":"Keigo Taniguchi⁵","email":"","orcid":"","institution":"Sapporo Medical University School of Medicine","correspondingAuthor":false,"prefix":"","firstName":"Keigo","middleName":"","lastName":"Taniguchi⁵","suffix":""},{"id":325075571,"identity":"25c967b2-27e3-4b3c-8576-e59438e30726","order_by":8,"name":"Atsushi Teramoto","email":"","orcid":"","institution":"Sapporo Medical University School of Medicine","correspondingAuthor":false,"prefix":"","firstName":"Atsushi","middleName":"","lastName":"Teramoto","suffix":""},{"id":325075572,"identity":"4e31bba9-8f09-40d2-824b-2479a834db5c","order_by":9,"name":"Carla Stecco","email":"","orcid":"","institution":"University of Padova","correspondingAuthor":false,"prefix":"","firstName":"Carla","middleName":"","lastName":"Stecco","suffix":""}],"badges":[],"createdAt":"2024-06-22 04:08:24","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-4619915/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-4619915/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1186/s12891-025-08533-y","type":"published","date":"2025-03-28T15:57:48+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":61570786,"identity":"216cd1e6-5880-4b44-96b8-21a2ed3d1835","added_by":"auto","created_at":"2024-08-01 10:50:28","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":129101,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003e(a) Experimental setup with a clamp, manipulator, and force gauge.\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eDownward arrow: target point for (1) the layer between the APF and EPI for the tibialis anterior. Upward arrow: target point for (2) the layer between two EPIs of the tibialis posterior and flexor digitorum longus.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e(b) Schemas of the layer (1) between the APF and EPI and (2) between two EPIs\u003c/strong\u003e.\u003c/p\u003e\n\u003cp\u003eSmaller arrow: target point for (1) the layer between the APF and EPI of the tibialis anterior. Larger arrow: target point for (2) the layer between two EPIs of the tibialis posterior and flexor digitorum longus.\u003c/p\u003e\n\u003cp\u003eAPF: aponeurotic fascia; EPI: epimysium; HR: hydrorelease; SF: superficial fascia.\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-4619915/v1/a9b7bb0dfba7dd5eea90fd3c.png"},{"id":61570785,"identity":"e7bc8bfb-aa48-444c-b526-a57f494a4b13","added_by":"auto","created_at":"2024-08-01 10:50:28","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":768889,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eShort-axis ultrasound images of ultrasound-guided injection.\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"2.png","url":"https://assets-eu.researchsquare.com/files/rs-4619915/v1/445aad3bba3753d3360568cc.png"},{"id":61570783,"identity":"3866e1cd-e9e4-48c4-b42d-6f30bb03c464","added_by":"auto","created_at":"2024-08-01 10:50:28","extension":"png","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":895472,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eDissection after injection between the APF and EPI of the tibialis anterior.\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e(a) Before separation from the leg. (b, c) After separation from the leg.\u003c/p\u003e\n\u003cp\u003eThe loose connective tissue of the fascia between the APF and EPI, termed “lubricated fascia,” is found.\u003c/p\u003e\n\u003cp\u003eAPF: aponeurotic fascia; EPI: epimysium.\u003c/p\u003e","description":"","filename":"3.png","url":"https://assets-eu.researchsquare.com/files/rs-4619915/v1/a337f200907bfe74299af361.png"},{"id":61570784,"identity":"49b575d2-e23b-407e-b7d3-17660410f92f","added_by":"auto","created_at":"2024-08-01 10:50:28","extension":"png","order_by":4,"title":"Figure 4","display":"","copyAsset":false,"role":"figure","size":189712,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eResults of the tests for (a) tibialis anterior and (b) tibialis posterior.\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eEach result is presented as a percentage of the baseline test.\u003c/p\u003e\n\u003cp\u003eF: force.\u003c/p\u003e","description":"","filename":"4.png","url":"https://assets-eu.researchsquare.com/files/rs-4619915/v1/fb1b3a2b9738d0b9f150e05d.png"},{"id":79605020,"identity":"66757362-e650-45af-bc49-9843c6c02eb1","added_by":"auto","created_at":"2025-03-31 16:10:21","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":3025146,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-4619915/v1/e1793b75-0330-48c4-b0e1-edc266cd9beb.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Biomechanical effects of fascial hydrorelease: A cadaveric study","fulltext":[{"header":"Background","content":"\u003cp\u003eHydrorelease (HR), or hydrodissection, is the ultrasound (US)-guided injection of a solution into the fascia without anesthesia [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. HR is indicated for nerve disorders and myofascial pain syndrome (MPS) [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. Physical findings of MPS include tenderness and localized hyperirritable nodules within palpable taut bands of skeletal muscle fibers and fascia [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]; these are the targets of HR. Recently, US has been utilized to confirm MPS findings, such as thickening or stacking of the fascia or densification [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. Furthermore, the solution can be injected into the inter-fascia layers, inside the aponeurotic fascia (APF), or intramuscularly using US [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan additionalcitationids=\"CR7\" citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eSeveral reports discuss the clinical outcomes related to pain relief after HR for MPS and fascia-related disorders [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan additionalcitationids=\"CR7 CR8 CR9\" citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]. A study revealed an improvement in the shoulder range of motion (ROM) after HR of the coracohumeral ligament in patients with a global limitation of shoulder ROM [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]. However, the mechanisms of pain relief or ROM improvement remain to be thoroughly investigated. Speculated mechanisms underlying HR in patients with MPS include improved hydration and gliding between fascial layers, as well as the release of entrapment of small nerve fibers of both A- and C-fibers [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]. However, the biomechanical effects of HR on intra-APF and between the APF and epimysium (EPI) have not been investigated. Only one cadaveric study has revealed improved gliding around the median nerve at the carpal tunnel after HR (74002).\u003c/p\u003e \u003cp\u003eTherefore, this study aimed to investigate the influence of HR on the gliding resistance force between the APF and EPI and between two EPIs using fresh-frozen cadavers and a biomechanical testing system. We hypothesized that the resistance force would decrease after HR.\u003c/p\u003e"},{"header":"Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e\n \u003ch2\u003eSpecimen preparation\u003c/h2\u003e\n \u003cp\u003eThe Ethics Committee of our institution approved the study protocol for obtaining, utilizing, and disposing of fresh frozen human cadaveric legs (No. 1-2-68). Twelve paired legs from six fresh-frozen specimens (mean age at death, 82.5 years; range, 72\u0026ndash;90 years) with no apparent scars from previous surgery or leg trauma were obtained through donations to the university anatomy program. All individuals provided informed consent before death. The specimens were thawed at room temperature for at least 24 h before testing. Each specimen was positioned supine and moistened to preserve tissue integrity during the test.\u003c/p\u003e\n \u003cp\u003eThe legs were amputated 20 cm above the knee joint line. The proximal end of the femoral bone was exposed for 15 cm, fixed using acrylic resin (Ostron II; GC), and poured into a cylindrical mold. The femoral cylinder was secured with an aluminum clamp, connected to the manipulator (Technology Service), and fixed to the clamp (Fig. \u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003ea). The knee was fixed at 30\u0026deg; flexion using wires, and the ankle was similarly fixed in a neutral position. The distal insertions of the target tendons of the tibialis anterior and posterior were detached and sutured to a force gauge to measure the tension in real time; these tendons were selected as representatives of the layer between the APF and EPI and between two EPIs, respectively (Fig. \u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003eb).\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec4\" class=\"Section2\"\u003e\n \u003ch2\u003eUS-guided injection\u003c/h2\u003e\n \u003cp\u003eA 10\u0026ndash;2 MHz linear transducer (Aixplorer v12 and SL10-2; Supersonic Imagine, Aix-en-Provence, France) was used in this study, and a US-trained orthopedic specialist conducted the examination. Injections were performed under a short-axis view using a 25 G needle and the in-plane technique (Fig. \u003cspan class=\"InternalRef\"\u003e2\u003c/span\u003e). The target points were between the APF and EPI of the tibialis anterior and between EPIs of the tibialis posterior and flexor digitorum longus (Fig. \u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003eb). Four injections were administered for each target (Fig. \u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003ea). The first injection, HR1, was administered in the middle third of the leg; this was followed by injections HR2, HR3, and HR4, each performed 2.5 cm distal to the previous one. All injections comprised 2.5 mL of 0.9% saline with blue ink.\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec5\" class=\"Section2\"\u003e\n \u003ch2\u003eTesting protocol\u003c/h2\u003e\n \u003cp\u003eOne side of the paired leg was assigned to the HR group and the other to the control group. First, for the HR group, as a baseline test, the position where the tension of the anterior or posterior tibialis equaled approximately 15 N (named \u0026ldquo;force 0h\u0026rdquo; [Table \u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e]) was determined for each leg. During the creep removal process, the baseline test position was adjusted to maintain a force of approximately 15 N through 10 repetitions of pulling from the relaxation to the baseline test position. HR1 was exclusively performed in the HR group. In Test 1, the position of the baseline test was reproduced, and \u0026ldquo;force 1h\u0026rdquo; was acquired. This process was repeated four times, and the values \u0026ldquo;force 1h\u0026ndash;4h\u0026rdquo; were documented (Table \u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e). Second, for the control group, all procedures were performed except for the HR intervention, resulting in the acquisition of \u0026ldquo;force 0c\u0026ndash;4c.\u0026rdquo; For instance, the reduction in gliding resistance due to HR1 was calculated as force 1c divided by force 0c.\u003c/p\u003e\n \u003cp\u003e\u003cimg 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\" width=\"670\" height=\"377\"\u003e\u003cbr\u003e\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec6\" class=\"Section2\"\u003e\n \u003ch2\u003eConfirmation by dissection\u003c/h2\u003e\n \u003cp\u003eWithin 1 min of the biomechanical tests, dissection was promptly commenced and completed in approximately 10 min. The needle insertion point was confirmed, along with the saline injection point. A large U-shaped skin incision, 5 cm from the injected point, was created. The superficial fascia, APF, and EPI were carefully exposed to confirm the presence of saline in the intended layer as directed by the operator (Fig. \u003cspan class=\"InternalRef\"\u003e3\u003c/span\u003ea). The loose connective tissue between the APF and EPI of the tibialis anterior was visualized using 0.9% saline solution with ink. Additionally, some property changes may have occurred in the loose connective tissue of the fascia between the APF and EPI (Fig. \u003cspan class=\"InternalRef\"\u003e3\u003c/span\u003eb). We named this status \u0026ldquo;lubricated fascia.\u0026rdquo;\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec7\" class=\"Section2\"\u003e\n \u003ch2\u003eStatistical analysis\u003c/h2\u003e\n \u003cp\u003eFirst, a two-factor repeated analysis of variance was performed. Subsequently, as a post hoc test, an unpaired t-test was conducted to compare the differences between two groups of equivalent tests; for instance, comparisons were performed between \u0026ldquo;force 1h\u0026rdquo; divided by \u0026ldquo;force 0h\u0026rdquo; and \u0026ldquo;force 1c\u0026rdquo; divided by \u0026ldquo;force 0c\u0026rdquo; (Table \u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e). Additionally, a paired t-test was conducted to compare the changes from the previous test within each group, such as \u0026ldquo;force 1h\u0026rdquo; divided by \u0026ldquo;force 0h\u0026rdquo; versus \u0026ldquo;force 2h\u0026rdquo; divided by \u0026ldquo;force 0h\u0026rdquo; (Table \u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e). All statistical analyses were performed using IBM SPSS Statistics for Windows, version 28.0 (IBM Corp., Armonk, NY, USA). Statistical significance was set at \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05. A post hoc power analysis was performed to determine the study\u0026rsquo;s power, which ranged from 0.982 to 0.997.\u003c/p\u003e\n\u003c/div\u003e"},{"header":"Results","content":"\u003cdiv id=\"Sec9\" class=\"Section2\"\u003e \u003ch2\u003eResults for the tibialis anterior\u003c/h2\u003e \u003cp\u003eFigure \u003cspan refid=\"Fig4\" class=\"InternalRef\"\u003e4\u003c/span\u003ea shows the test results for the tibialis anterior. In test sequences 1\u0026ndash;4, the force in the HR group was significantly lower than that in the control group (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.01, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.01, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.02, and \u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.02, respectively). After the four HRs, the force decreased by 6.4%. In the HR group, after HR1, HR2, and HR4, the force decreased significantly compared with that in the previous test (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.01, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.01, and 0.03, respectively). No significant differences were observed in the other comparisons.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec10\" class=\"Section2\"\u003e \u003ch2\u003eResults for the tibialis posterior\u003c/h2\u003e \u003cp\u003eFigure \u003cspan refid=\"Fig4\" class=\"InternalRef\"\u003e4\u003c/span\u003eb shows the results of the tests for the tibialis posterior. In test sequences 1\u0026ndash;4, the force in the HR group was significantly lower than that in the control group (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.01, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.01, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.01, and \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.01, respectively). After the four HRs, the force decreased by 4.2%. In the HR group, after HR1, HR3, and HR4, the force decreased significantly less than that in the previous test (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.01, \u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.04, and \u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.01, respectively). No significant differences were observed in the other comparisons.\u003c/p\u003e \u003c/div\u003e"},{"header":"Discussion","content":"\u003cp\u003eThis study revealed that the gliding resistance force between the selected fasciae significantly decreased after HR. The force decreased by 6.4% after HR between the APF and EPI and by 4.2% after HR between the two EPIs.\u003c/p\u003e \u003cdiv id=\"Sec12\" class=\"Section2\"\u003e \u003ch2\u003eInterpretations of the results of the resistance force\u003c/h2\u003e \u003cp\u003eWhen a tendon is pulled for a certain distance, the resistance force can be divided into the force pulling it and the gliding resistance between the tendon and its surrounding structures. Because HR was performed outside the EPI, the force change of the muscle fibers inside the EPI during the test was assumed to be approximately equal between the HR and control groups. Therefore, the force change may be mainly attributable to the change in the force of the gliding resistance between the APF and EPI or between two EPIs. Considering this, the reason the force decreased after HR should be discussed, focusing on the loose connective tissue between the APF and EPI or between two EPIs. Although we could not investigate this thoroughly, some property changes may have occurred in the loose connective tissue between the APF and EPI (Fig.\u0026nbsp;\u003cspan refid=\"Fig3\" class=\"InternalRef\"\u003e3\u003c/span\u003e). We speculated that these property changes probably occurred due to the solution and may be an important reason for the decrease in the force after HR. Additionally, another important reason is the physical separation between the APF and EPI or between two EPIs following needle insertion and injection of a certain volume of saline solution. However, the reasons for this decrease in force are speculative. Therefore, future studies are necessary to investigate the reason for the decrease in the resistance force caused by HR.\u003c/p\u003e \u003cp\u003eAlthough we have only investigated the change in force, we speculate that the decrease in the force in this study (believed to be due to the change in the gliding between the two fasciae) is one of the main reasons why HR relieves pain in MPS and similar disorders. Therefore, future studies should investigate why force decrease is related to pain relief by HR.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec13\" class=\"Section2\"\u003e \u003ch2\u003eClinical implications\u003c/h2\u003e \u003cp\u003eThickening or stacking of the fascia on US [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e], densification [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e], and the associated laydown of extracellular content can be observed in MPS [\u003cspan additionalcitationids=\"CR13\" citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]. The myofascial trigger point is a key factor in the pathophysiology of MPS [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. Therefore, thickened fascia on US imaging and observations of tenderness should be regarded as important findings for considering HR as a treatment option [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. In this cadaveric study, the HR areas were normal without thickened fascia or obvious MPS. This study investigated the decrease in the force in human cadavers without specific fascial alterations. Because the resistance force is expected to be higher in patients with MPS or similar pathologies, future experiments on HR using animal models with such pathologies are necessary.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec14\" class=\"Section2\"\u003e \u003ch2\u003eStudy limitations\u003c/h2\u003e \u003cp\u003eThe two main limitations of this study are as follows: First, the specimens were fresh frozen cadavers; some reactions that occur in living patients do not occur in cadavers. Thus, the behavior of the solution after injection would also be different [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]. Second, in patients with clinical MPS, some conditions, including the resistance force, would be different from those in the normal fresh-frozen cadavers used in this study. Despite these limitations, this study is the first to quantitatively evaluate the resistance force on the fascia after HR using a biomechanical testing system.\u003c/p\u003e \u003c/div\u003e"},{"header":"Conclusions","content":"\u003cp\u003eIn this cadaveric study, the gliding resistance force significantly decreased after HR in the layer between the APF and EPI or between two EPIs. Further studies on living animals and humans are necessary.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cdiv class=\"DefinitionList\"\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eAPF\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eaponeurotic fascia\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eEPI\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eepimysium\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eHR\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003ehydrorelease\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eHR1, 2, 3, and 4\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003efirst, second, third, and fourth hydrorelease injections, respectively\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eMPS\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003emyofascial pain syndrome\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eROM\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003erange of motion\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eUS\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eultrasound\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003c/div\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cem\u003eEthics approval and consent to participate\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eThe study was approved by the Sapporo Medical University Ethics Board (number 1-2-68).All participants provided written informed consent.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eConsent for publication\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eAll participants provided written informed consent.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eCompeting interests\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eFunding\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eThis work was partially funded by MEXT/JSPS KAKENHI (grant number JP 20K18035)\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eAuthors\u0026rsquo; contributions\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eKS wrote the initial draft of the manuscript. HO, TK, and AT designed the study. HO, PC, IO, and CS contributed to data analysis and interpretation and assisted in manuscript preparation. KS, HO, and DS contributed to data collection. All other authors participated in the interpretation and critically reviewed the manuscript. All authors read and approved the final version of the manuscript and agreed to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eAcknowledgments\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eFukui S, Rokutanda R, Kawaai S, Suda M, Iwata F, Okada M, et al. Current evidence and practical knowledge for ultrasound-guided procedures in rheumatology: joint aspiration, injection, and other applications. Best Pract Res Clin Rheumatol. 2023;37:101832.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eNeo EJR, Shan NT, Tay SS. Hydrodissection for carpal tunnel syndrome: a systematic review. Am J Phys Med Rehabil. 2022;101:530\u0026ndash;9.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eCourseault J, Kessler E, Moran A, Labbe A. Fascial hydrodissection for chronic hamstring injury. Curr Sports Med Rep. 2019;18:416\u0026ndash;20.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSimons DG. New aspects of myofascial trigger points: etiological and clinical. J Musculoskelet Pain. 2004;12:15\u0026ndash;21.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGiamberardino MA, Tafuri E, Savini A, Fabrizio A, Affaitati G, Lerza R, et al. Contribution of myofascial trigger points to migraine symptoms. J Pain. 2007;8:869\u0026ndash;78.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWang T, Vahdatinia R, Humbert S, Stecco A. Myofascial injection using fascial layer-specific hydromanipulation technique (FLuSH) and the delineation of multifactorial myofascial pain. Med (Kaunas). 2020;56:717.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKongsagul S, Vitoonpong T, Kitisomprayoonkul W, Tantisiriwat N. Ultrasound-guided physiological saline injection for patients with myofascial pain. J Med Ultrasound. 2020;28:99\u0026ndash;103.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKanamoto H, Orita S, Inage K, Shiga Y, Abe K, Eguchi Y, et al. Effect of ultrasound-guided hydrorelease of the multifidus muscle on acute low back pain. J Ultrasound Med. 2021;40:981\u0026ndash;7.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eTantanatip A, Patisumpitawong W, Lee S. Comparison of the effects of physiologic saline interfascial and lidocaine trigger point injections in treatment of myofascial pain syndrome: a double-blind randomized controlled trial. Arch Rehabil Res Clin Transl. 2021;3:100119.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKimura H, Suda M, Kobayashi T, Suzuki S, Fukui S, Obata H. Effectiveness of ultrasound-guided fascia hydrorelease on the coracohumeral ligament in patients with global limitation of the shoulder range of motion: a pilot study. Sci Rep. 2022;12:19782.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWillard FH, Vleeming A, Schuenke MD, Danneels L, Schleip R. The thoracolumbar fascia: anatomy, function and clinical considerations. J Anat. 2012;221:507\u0026ndash;36.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eStecco A, Meneghini A, Stern R, Stecco C, Imamura M. Ultrasonography in myofascial neck pain: randomized clinical trial for diagnosis and follow-up. Surg Radiol Anat. 2014;36:243\u0026ndash;53.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHoheisel U, Rosner J, Mense S. Innervation changes induced by inflammation of the rat thoracolumbar fascia. Neuroscience. 2015;300:351\u0026ndash;9.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eStecco C, Stern R, Porzionato A, Macchi V, Masiero S, Stecco A, et al. Hyaluronan within fascia in the etiology of myofascial pain. Surg Radiol Anat. 2011;33:891\u0026ndash;6.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBehr AU, Chan VWS, Stecco C. Living versus cadaver fascial plane injection. Reg Anesth Pain Med. 2019. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1136/rapm-2019-100893\u003c/span\u003e\u003cspan address=\"10.1136/rapm-2019-100893\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. rapm-2019-100893.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-musculoskeletal-disorders","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bmsd","sideBox":"Learn more about [BMC Musculoskeletal Disorders](http://bmcmusculoskeletdisord.biomedcentral.com/)","snPcode":"","submissionUrl":"https://author-welcome.nature.com/12891","title":"BMC Musculoskeletal Disorders","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"fascia, myofascial pain syndrome, biomechanics, cadaver, tendon","lastPublishedDoi":"10.21203/rs.3.rs-4619915/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4619915/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eWe aimed to investigate the influence of hydrorelease (HR) on the gliding resistance force between the aponeurotic fascia and epimysial fascia and between two epimysial fasciae using a biomechanical testing system.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eIn this cadaveric comparative study, 12 paired legs amputated above the knee joint from six fresh-frozen specimens were divided into two groups. The distal insertions of the target tendons of the tibialis anterior and posterior were detached and sutured to a force gauge for tension measurement during tendon pull. These tendons were representatives of the layer between the aponeurotic and epimysial fasciae of the tibialis anterior and between the epimysial fasciae of the tibialis posterior and flexor digitorum longus. For the baseline, the position where the tension of the target tendon was approximately 15 N was determined to eliminate creep. In the HR group, the baseline test position was replicated, and force was measured. The intervention was an HR injection between the specified fascial layers. The main outcome was the gliding resistance force between the aponeurotic and epimysial fasciae and between two epimysial fasciae.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eThe resistance force between the aponeurotic and epimysial fasciae in the HR group was 6.4% lower than that in the control group (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.02). The resistance force between two epimysial fasciae in the HR group was 4.2% lower than that in the control group (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.01).\u003c/p\u003e\u003ch2\u003eConclusions\u003c/h2\u003e \u003cp\u003eThe gliding resistance force significantly decreased after HR in the layer between the aponeurotic and epimysial fasciae and between two epimysial fasciae in this cadaveric study.\u003c/p\u003e","manuscriptTitle":"Biomechanical effects of fascial hydrorelease: A cadaveric study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-08-01 10:50:23","doi":"10.21203/rs.3.rs-4619915/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2024-07-10T08:14:02+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2024-07-09T02:43:31+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2024-07-09T02:42:38+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Musculoskeletal Disorders","date":"2024-06-22T04:06:11+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-musculoskeletal-disorders","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bmsd","sideBox":"Learn more about [BMC Musculoskeletal Disorders](http://bmcmusculoskeletdisord.biomedcentral.com/)","snPcode":"","submissionUrl":"https://author-welcome.nature.com/12891","title":"BMC Musculoskeletal Disorders","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"a4b196da-223d-4170-9bc1-bafd2e08fe98","owner":[],"postedDate":"August 1st, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2025-03-31T16:06:03+00:00","versionOfRecord":{"articleIdentity":"rs-4619915","link":"https://doi.org/10.1186/s12891-025-08533-y","journal":{"identity":"bmc-musculoskeletal-disorders","isVorOnly":false,"title":"BMC Musculoskeletal Disorders"},"publishedOn":"2025-03-28 15:57:48","publishedOnDateReadable":"March 28th, 2025"},"versionCreatedAt":"2024-08-01 10:50:23","video":"","vorDoi":"10.1186/s12891-025-08533-y","vorDoiUrl":"https://doi.org/10.1186/s12891-025-08533-y","workflowStages":[]},"version":"v1","identity":"rs-4619915","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4619915","identity":"rs-4619915","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}