Where is the Inflammation Trapped? The Interstitium, Inflammation, and Interstitial Inflammatory Stasis – Fascia is not Alone

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Article 3 of 6 of "That Was Not A Muscle" companion series

If only the late Marvin Minsky could see how his confocal microscope would evolve since its invention in 1957. Thanks to its latest rendition as confocal laser endomicroscopy, it can get real-time, high-resolution images of living tissue, thus opening new dimensions in medical procedures and research.

This is what made possible the histological breakthrough of 2018, where researchers accidentally identified pathways forming a complex network of collagen bundles filled with clear fluid that preceded the lymphatic networks. Up to that point, these networks had only been seen as dense connective tissue, or even microtears.

This complex collective of microscopic channels and vessels forming a microvascular system is known as the Interstitium and its anatomical distribution includes the dermis, vascular adventitia, submucosa of the viscera, bronchi, adipose tissue, and all fascial tissues including musculoskeletal fascia. This is where the inflammation and its proinflammatory mediators get trapped, thus compromising our microvasculature and tissue function and health. The illustrations in the video will help you understand this crucial concept.

Inflammation is a normal component of our physiological balance as it’s essential for tissue repair. The other component of this balance is the production of anti-inflammatory mediators, which the presence of inflammation triggers. The harmonious flow of these two responses is what keeps our physiology healthy and in homeostasis.

Theoretically, the lymphatic system and vascular perfusion would clear all inflammation during the repair process. However, the nature of the interstitium as a pre-lymphatic layer means that any chemical or mechanical disruptions to the vascular perfusion mechanisms—whether from trauma, infections, or stress—could trap proinflammatory mediators. This entrapment is known as Interstitial Inflammatory Stasis (IIS) and it’s from here that trapped inflammation travels to the spinal cord via the fascial sensory neurons.

Recall from our previous installment that type III and IV pain sensory neurons or nociceptors, are the most abundant sensory neurons in all fascial expressions. Recall also that neurons are bidirectional channels or tubes, where chemicals and signals are sent to and received from the spinal cord. Once an injured or affected structure starts producing inflammation, it will send this source inflammation toward the spine via these sensory neurons, where it will first affect their bodies and nuclei at the Dorsal Root Ganglion (DRG).

The neuronal cell bodies at the DRG react to the presence of inflammation by increasing their reactivity and eliciting the Dorsal Root Reflexes (DRR). The DRR, in turn, reduce the production of anti-inflammatory mediators and produce additional inflammation, which then reaches the dorsal horn of the spine. Not only does this reaction sensitize the affected neuron, making it more sensitive to fire, but it also starts an inflammatory cycle that can only be understood by examining neural convergence.

And neural convergence is what will cover in the next installment.

Until next time, I wish you a joyous and pain-free life.

Certified Counterstrain Therapist - CSC I

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The topics in this series are covered in-depth in the book That Was Not A Muscle, available now at your favorite online book retailer.

All photographs, illustrations, graphics, videos, and other media contained in or associated with this publication are the intellectual property of Izzy Sanchez, Integrated Healing and Strength Systems, Inc., and Mar en Hoguera Media, LLC, and are protected under United States and international copyright laws. Unauthorized reproduction, distribution, display, modification, publication, or use of these materials in any form is strictly prohibited. Any infringement of these rights may result in civil and/or criminal penalties, and violators may be subject to prosecution to the fullest extent permitted by law.

All biomedical illustrations created with BioRender.