Fascia – we’re better connected
The Cinderella of soft tissue
Fascia – Gywneth Paltrow referred to it at the end of last year as “the secret organ” and although it is well known of within the manual therapy world, in some ways she’s right. For years, because it was everywhere, it was considered superfluous. Anatomists would scrape it all off and throw it away so they could get a better view of the ‘important’ stuff (muscles, organs, arteries, nerves etc), and so cadavers would more closely resemble the neat and defined pictures found in anatomy texts. Even in fairly modern anatomy textbooks there is minimal mention of fascia and the pictures still show the musculoskeletal system as being made up of separate ‘parts’ that each has its own attachment points and its own action. Now while I’m not suggesting that that isn’t true, the bicep for example when contracted does indeed flex the elbow (among other things), but the body and how it moves is just not as simple as that. You are not a machine, you are not the sum of your parts, you are a dynamic moving organism that needs to be looked at and treated as a whole.
Last year I attended a dissection day run by Caroline Barrow (College of Body Science) and the thing that stuck me the most about that day was how utterly and completely intertwined our muscles are. This idea of defined and separate muscles with separate attachment points that we learn in school is completely farcical. Thomas Myers (Anatomy Trains) describes the musculoskeletal system as one ‘muscle’ tacked down in different places by fascia and from what I’ve seen I think he may very well be right.
What is fascia?
Essentially fascia is connective tissue, it is made up of collagen, elastic and a ‘snot like’ ground substance (which is 70% water). Fascia comes in a wide range of densities, a spectrum that ranges from fascia that resembles candy floss to thick fibrous fascia like the IT band. Tendons, ligaments, periosteum (surrounds bones), epimysium (surrounds entire muscles), perimysium (surrounds groups of muscles fibres into bundles or fascicles), endomysium (surrounds individual muscle fibres), joint capsules and the membranes that surround organs, nerves, spinal cord and the brain all fall within the fascial system. It has been described as a 3 dimensional body stocking that surrounds every structure of the body. John Upledger explains that fascia is “a maze which allows travel from any one place in the body to any other without ever leaving the fascia.” The individual names we give these structures suggest they are different but in fact they are all part of the same connected system that Thomas Myers calls our system of biomechanical regulation. Therefore a restriction in one part of the fascial system will affect every other part to a greater or lesser extent. A simple way of demonstrating this is to twist a bit of fabric, like your t’shirt and see how the twist extends lines (pain) in all different directions, away from the restriction itself.
Why is fascia important?
Fascia is the fabric that holds us together and helps to transmit forces throughout the body as a whole. An idea called Tensegrity (or biotensegrity) which comes from the phrase ‘tension integrity’ explains how lightweight materials can be used to create great stability when tightly integrated. We grow up with this idea that our bones hold us up and it kinda makes sense, they are the hard, tough bit, but try and stand a load of bones on top of each other and they’ll just fall down. A good visual to explain tensegrity is to think of a tent, if the guy ropes (connective tissue) aren’t creating the right amount of tension, the poles (bones) and in fact the entire tent falls down. Tension is therefore spread throughout the system, but if too much tension is exerted the structure will break at it’s weakest point. In non-specific low back pain for example one theory is that there is not necessarily a problem with the structures that make up the back, it’s just that that is the weakest point and that’s why the pain is felt there.
There are 10 times more sensory nerve endings in your fascia than in your muscles, so it plays a massive part in proprioception (how we know where and how are body is positioned without looking) and it has been suggested that most soft tissue injuries are in fact connective tissues injuries and not muscular injuries.
Just as your muscles will change and grow if you train them, your fascia responds to mechanical forces:- postural holding patterns, emotional holding patterns and injury. In it’s ‘normal’, hydrated healthy state, fascia has the ability to move and slide without restrictions. However, in it’s unhappy state restrictions in the movement of the fascia can lead to pain and loss of range of movement. The body is very adaptable, and one way your body adapts is to lay down more fascia. Sit in a slouched, head forward posture staring at a computer long enough and your body will ‘help’ out by laying down more fascia to support this position, more fascia = more stiffness, more stiffness = less movement, less movement = more fascia. I think you get where I’m going with that one! Modern imaging technology has shown that there is a thickening of the thoracolumbar fascia (the fascia of the lower back) in people who have non-specific low back pain which may possibly be a casual factor in their pain.
Love your fascia
I’m not talking about hitting the gym or ‘working out’, just simple moving your body and as much as possible! We all have lives/jobs/commitments so fit movement in wherever you can. Take a walk during your lunch break, stand up and walk around when you’re on the phone, make everyday things a little less convenient for yourself – get off the bus a stop earlier/park the car further away from the entrance, even something as simple as fidgeting when sitting down helps.
You’re a human being that has evolved over thousands of years to stand upright, walk, run, hop, skip, climb, hang from things and carry stuff. Get in touch with your inner child, play with movement and have fun rolling around.
Get a massage
As always I’m going to suggest manual therapy!
There are several theories as to how manual therapy helps to release restrictions in fascia. My personal favourite is one put forwards by Robert Schleip that focuses on the mechano receptors found in the fascia and how the fascial system and the autonomic nervous system are closely linked leading to changes in fascial tonus and ground substance viscosity. If fascial restrictions can lead to pain and dysfunction, then the release of these restrictions should lead to a return to function.
Essentially I’m talking about yoga. Gliding slowly into a stretch, holding the position for up to a few minutes and gliding slowly out is fascial stretching.
“Movement, harmonious activity, unimpeded flow of bodily fluids, unimpaired nerve transmission, and the free range of motion of muscles and joints are all connected to health and life. When movement ceases, life ceases.”
Finando & Finando
Mega BIG thanks to the awesome Rachel Fairweather and Meghan Mari (Jing Advanced Massage Training) my teachers, for sharing their wealth of knowledge and passion for anything and everything related to the body with me. All the theories in the above blog have come to me through them. I will be forever grateful to them for introducing me to this fabulous and fascinating world of fascia.
If anyone reading this is interested in developing their skills or indeed have ambitions of becoming a massage therapist details of their outstanding courses can be found HERE or if you would like to talk about the best place to start, call the office on 01273 628942 and have a chat with Nina (Director of Student Development).
Jemma Fordham is a clinical massage therapist who specialises in the treatment of chronic pain conditions based in Brighton. She works with her clients to help facilitate their bodies own healing through bodywork, exercise and education.
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