The interplay between fascia, skeletal muscle, nerves, adipose tissue, inflammation and mechanical stress in musculo-fascial regeneration

Muscle and connective tissues are structures that provide stability and movement to organisms belonging to the animal kingdom. Fascia and muscle tissues structurally and functionally integrate to form a musculofas-cial system with exceptional biomechanical properties, which allow animals to accomplish complex tasks. Mechanical overload through intense exercise or injury, however, may damage these tissues over the course of a lifetime. Although mammalian skeletal muscle and fascia both retain a good regenerative potential in the adulthood, regeneration is very sensitive to alterations in the biochemical and physical environment. In this review, the reciprocal role of fascial tissue and skeletal muscle in their regeneration processes are explored. The involvement of adipose and nervous tissue in the regulation of muscle and fascia regeneration are also revised. It is hypothesised, for the first time, that for effective regeneration of skeletal muscle, both muscle and fascial tissues are necessary, and that nervous and adipose tissues contribute and deeply influence this process.