In conditions such as muscular dystrophy, fibrosis or other neuromuscular disorders, the spindle capsule is often affected, with a notable thickening/ stiffness of the capsule due to excess deposition of ECM which leads to impaired proprioception.6,190,191 Additionally, capsule cells contribute to the production of ECM proteins, including versican (VCAN), elastin, collagen IV and matrix metalloproteinases (MMPs), as well as signalling molecules in the extracellular space,17,192,193 where collagen IV has been recognised as a marker for spindle ECM. This evidence concerns the gene VCAN and muscular dystrophy.