La pennation musculaire (sarcomères, fibres, fascicules musculaires et aponévroses) (1ère partie)
François Bonnel
Kinésithér Scient 2013,0542:25-33 - 10/04/2013
Pendant des décennies, l'enseignement de la myologie a été traditionnel. La description classique d'un muscle faisait état d'un corps musculaire qui se poursuivait par un tendon. La présentation académique au tableau noir et dans tous les livres d'anatomie se décomposait en origine, trajet direction et terminaison. Le corps musculaire était colorisé en rouge sans autre détail. Il en découle que ces descriptions étaient négatives et ne permettaient pas de comprendre son fonctionnement intrinsèque. À la suite de microdissections, il nous est apparu que l'on devait introduire trois notions essentielles avec : le fascicule musculaire, l'aponévrose et la pennation. La connaissance des structures anatomiques intrinsèques doit être à l'origine d'une nouvelle pratique de rééducation de l'appareil locomoteur. La notion d'étirement maximal est à reconsidérer car risque de léser les sarcomères. La raideur musculaire est un concept qui n'a pas encore été élucidé et qui nécessite des travaux de recherche fondamentale et d'observation sur le terrain dans la pratique de kinésithérapie.
For many decades myology teaching was traditional. The classical description of a muscle was of its belly followed by its tendon. The academic presentation on the blackboard and in all of the anatomy books consisted of the muscles origin, its direction and its insertion. The muscle belly was colored in red without any other details. It seems that these descriptions were negative and didn't allow one to understand the muscles intrinsic function. Micro-dissection has showed us that there are three essential notions which should be introduced: the muscle fascicle, the aponeurosis and the pennation. A new rehabilitation program for the musculoskeletal system must be based on knowledge of intrinsic anatomical structures. The notion of maximal stretching should be reconsidered due to the risk of sarcomere lesion. Muscle still ness is a concept that has not yet been elucidated and requires further research and clinical observation in physiotherapy practice.
For many decades myology teaching was traditional. The classical description of a muscle was of its belly followed by its tendon. The academic presentation on the blackboard and in all of the anatomy books consisted of the muscles origin, its direction and its insertion. The muscle belly was colored in red without any other details. It seems that these descriptions were negative and didn't allow one to understand the muscles intrinsic function. Micro-dissection has showed us that there are three essential notions which should be introduced: the muscle fascicle, the aponeurosis and the pennation. A new rehabilitation program for the musculoskeletal system must be based on knowledge of intrinsic anatomical structures. The notion of maximal stretching should be reconsidered due to the risk of sarcomere lesion. Muscle still ness is a concept that has not yet been elucidated and requires further research and clinical observation in physiotherapy practice.