Fat cells, called adipocytes, are an essential part of human physiology. They are important for energy storage, but they also create the nervous system's insulating myelin sheath and form the cell membrane of every one of the trillions of cells in our body.
Fat cells are also involved in critical metabolic processes such as food intake, insulin sensitivity, and insulin secretion. Because of this, fat tissue has been redefined as an endocrine organ and a central player in human metabolism and energy homeostasis.
In humans, there are two major areas of adipose tissue: subcutaneous fat (under the skin) and visceral fat (around the organs). In this post, the subcutaneous fat layer is discussed. It is innervated and highly vascularized, and provides extensive pathways to lymph vessels. It has two distinct layers (deep and superficial) that are loosely divided by a fibrous membrane of superficial fascia.
Subcutaneous fat also serves as a major communication hub, talking with the rest of the body via the nervous system. The type of nerves in this fat tissue are from the sympathetic nervous system - the system that controls the flight or fight stress response. In addition, there are sensory nerves that respond to temperature and mechanical stimulation, suggesting that the superficial fascia and subcutaneous fat may play a role in nociception (the act of certain receptors in the nervous system carrying a signal to the brain that could then be translated as a potential danger to the body).
Furthermore, in the healing process, recent evidence indicates that wounds that go deeper than the dermis layer of our skin use fibroblasts from the superficial fascia found in the subcutaneous fat layer to heal. In other words, the process of healing and scarring, and ultimately, the perception of pain, may be driven by the subcutaneous fat layer.
The bottom line? The subcutaneous fat layer is not inert, nor should it be considered unnecessary to the human body. Even if this layer of soft tissue is not the target of a massage treatment or other pain management technique, it is important to know that sensory information may be coming from it, and therefore should be considered as a part of a pain management protocol.
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