The Human Experience of Fascia
Fascia has been overlooked in the medical field until recently. The first International Fascia Research Congress took place at Harvard in 2007. The leading researchers around the globe gathered together to solidify Fascia’s standing in the history of science and medicine. I have an intuitive gift of palpating the restrictions in fascia. My understanding and passion for this tissue needs to be shared and understood as simply as the muscle and bone are understood by every person who has a body.
Why has fascia been overlooked? It was always cut away or removed from anatomy books. The superficial fascia before 2007 was not illustrated in one anatomy text book. These books displayed the proud muscle and the sturdy bone. The quiet fascia, with such a prominent role in function of every bone and muscle was always cut silently and thrown away. In the past my therapy has met with much resistance, because fascia did not exist to most people. How can I be a specialist in something no one had heard about. The MDs and the PHd’s I met were brilliant people, but were dumbfounded and condescending when I talked about the Fascia? People sought out treatments after they had tried every other traditional path. Like the fascia I sat quietly and waited until the muscle and the bone approach was exhausted. Of course this dismissal was frustrating and still is, but it did not weaken my passion and my belief in the work. I stayed the course for 12 years and now Fascia is starting to have its day in the sun. The Sun is shining brightly.
What is fascia? It is a fibrous band of innervative connective tissue made of collagenous fibers and elastic fibers. What does this mean to you? Those words mean nothing unless you are a scientist.
Let’s start by telling you what fascia is not. It is not the skin. The skin is a type of connective tissue and is an organ. The superficial fascia lies underneath the dermis and similar to the skin, has no beginning and no end. The lymph system, fat and water live in the superficial fascia. Fascia release and lymphatic drainage treatments complement each other, as the systems cannot be separated. The skin should not be adhered to the superficial fascia, but this happens often when there is trauma, a simple test of skin rolling can demonstrate this, if the skin does not roll painlessly and effortlessly, it is adhered. Trauma in the fascia creates this stickiness and can become rigid. This rigidity reduces blood flow and range of motion. I would like to mention the body does not differentiate between physical trauma and emotional stress/trauma. A sticky and rigid web like tissue forms and starts to restrict movement. The history of the body is remembered in this tissue. All injuries and traumas leave an imprint on connective tissue, and one day the pain will be felt, but it is an accumulation of events, you don’t just wake up one day and can’t move. It takes years for dysfunction and pain to develop. Life experiences are continually changing the shape of our bodies and our emotions.
Fascia made up of multiple bundles of collagen fibers and elastin is a form of connective tissue, a stand alone, unique it is not a tendon, a ligament nor is it cartilage. It does surround these specific connective tissues and often attaches onto them, and lies over top of them. When a muscles, tendon, ligament, cartilage contracts so does the fascia, the fascia responds to the pressure, tension and glides seamlessly maintaining structure and integrity for the system. The fascia is analogous to a pulley system. Muscle acts to move the joints, the joints are the fulcrum and the fascia is the rope. The force of the rope (fascia) always trumps the action of muscle or bone, it is stronger than steel. A great example is slouching, when we consciously sit up straight and contract our back muscles we can bring the shoulder blades back, but this is often tiring and temporary. Only when the fascia has been released through stretching therapy, will the slouching stop and the shoulders remain back with ease. Muscles alone cannot maintain a contraction indefinitely; the fascia must do the work if it is to be done without effort.
The picture below illustrates how the tiny ropes (fascia) support and suspend larger structures (muscles, organs, bone). When in balance the pulley system operates smoothly with effortless fluidity. Any pull on the rope (fascia) in one direction affects the whole system which is pulled out of alignment. Similar to pulling a loose thread in a sweater, the integrity of the sweater is altered, and shifts in the direction of the pull. It is extremely difficult to put the thread back into the sweater, but how you put it back is to stretch the rest of the sweater until the loose thread is retracted. Unfortunately, the form and shape of the sweater has been altered forever, and so is the body. The muscle provides an internal force on the rope; external forces can also be acting on the ropes. This force on the rope( fascia) can alter the entire function of the body, thus changing the shape. This change in shape usually causes pain.
The presence of nerves endings in the Fascia supports its proprioceptor function, one of balance. When the fascia is restricted and is being stretched these nerves are activated and it may give the sensation of burning. It feels very different than muscle pain; the fascial pain originates deep in the body and works its way to the surface, contrary to normal muscle pain. Where external pressure is applied to a muscle, the pain originates in the pain receptors in the skin and from the restriction of the muscles compressing on the nerve. Pain follows the pattern from the surface, this signal of pain is relayed to the brain. The continuous matrix serves an important function for the body. It is imperative to maintain a pressure system that generates structural support without it we would not have power to contract or have integrated smooth movement that only a closed system can produce. A pull on the fascia in the foot can pull on the fascia located in the shoulder. Fascia surrounds all organs, bones, cells and nerves; it is the micro component of the body and plays a major role in joint stability, general movement, balance, coordination and posture. Superficial fascia is more than a nylon stocking covering the body; it is what makes the body operate smoothly and without effort.
Fascia can adapt to stretching, thanks to collagen fiber bundles and elastic fibers. The capacity of the collagen fibers to slide over each other may vary or be altered because of trauma, surgery or over use. Restrictions or adhesions can cause inappropriate activation of the nerve receptors within the fascia resulting in pain in the area injured or anywhere in the body. Pain will follow lines of tension and weakness often creating trigger points in the connective tissue or muscles. Inflammation and micro calcification of fascia can result in discomfort often leading to decreased range of movement and a feeling that body is extremely heavy. This causes a web of disorganized collagen fibers and an increased vascularization in the injured tissue that resulted in restricted movement patterns. TRAUMA TO FASCIA
Injury, illness, gravity and/or emotional trauma such as stress, depression, and fatigue occur, affects the fascia; in fact it affects every system in the body, the heart, your blood pressure, vertebral spine because every organ tissue is inserted and supported with fascia. When the fascia is subjected to stress, it responds in an identical fashion whether it is a physical stressor or an emotional one. A special type of collagen fiber is laid down in an irregular direction which looks similar to a spider web. As the inflammation heals, the collagen fibers web the injury together. Cross fiber friction or fascial stretching helps orient the fibers in a linear direction, in accordance with the stress lines of the tissue that is to be repaired. If the fibers have this orientation, the tissue can regain normal function. If normal function is not regained range of motion is decreased and trigger points (sensitivity/pain) develop. When tested in the lab a muscle that has scar tissue cannot contract with the same force or power as a muscle without scar tissue has. The body knows the scar is there and tries to adapt using other surrounding tissues to generate the same level of power; this amazing ability creates an imbalance that will be felt in later years.
If the fibers remain irregularly webbed, they will contract and reduce the mobility of the tissue to which they are attached. Fascia at this point can adhere to more fascia, with the collagen coiling in on itself and shortening over time. The contraction will create ischemia (deficient blood supply), trigger points and compress the arteries, veins and lymphatics that run through the contracting tissue. Trigger points maybe resistant to myofascial therapy, suggesting the trigger points are not just in the contracted muscle; instead they are located in the fibrous tissue. SFT (Simone Fortier Technique)and myofascial therapy can induce fibrous tissue to release its pressure on hypersensitized nerves.
CHRONIC STRAIN ON FASCIA
If the fascia is constantly overloaded, myofascial pain syndrome begins to develop stimulating more fibroblasts, a connective tissue cell that secretes protein to produce more collagen. This leads to an accumulation of collagen in the injured area that can begin to feel as hard as bone and maybe exceedingly difficult to relieve.
Immobility
Layered collagen fibers allow transmission of tension according to the lines of force. Active trigger points are points of pain felt all the time. Latent trigger points are often discovered only through treatment and manual pressure. This fibrous tissue prevents an individual from being mobile because of pain as the body unconsciously adapts to maintain a level of functioning. I have seen many individuals who keep certain parts of their bodies guarded by restricting their range of motion altering their gait and posture. This guarding absolutely reduces mobility. If the rope of the pulley system is continually pulled, the system as a whole wears over time weakens and loses it function. Over the years range of motion decreases, because of injury and lack of flexibility not age. This causes problems with walking, golfing and daily living activities.
The fascia can be confusing and contradictory in function; it is extremely pliable and, at the same time, very resistant and almost inextensible. The flexibility is possible, due to the elasticity of corpuscles connected to the collagen and the direction of the fibers. The resistance is there to provide stability and protection to the entire system.
Importance of Fascia
When we understand the functions of our body, it is easier for us to take care of ourselves. The most importance method of maintaining flexibility in our muscles and connective tissue is stretching. It is subtle and the change takes months but the results last a lifetime. Why avoid doing the most important thing you can do for your body, is it too simple? There is no rush of adrenaline or heavy breathing while stretching. According to the human psyche this translates into nothing is happening so why bother? What we do everyday affects our body in future years. Carrying a purse or a wallet on one side for years can create an imbalance which alters the way a person walks and sits, and over years this change creates pain an dysfunction. 10 -20 minutes of stretching a day will help you get out of bed with ease as you age, keep you upright, pain free, younger, more mobile, I think it is a no brainer, but again you are in charge of your health ultimately, and I will be here for therapy.
Videos that help explain Fascia (Copy and paste the links to your browser window)
The Fuzz Speech – Gill Hedley – http://www.youtube.com/watch?v=_FtSP-tkSug
2 Fascial Tensegrity – http://www.youtube.com/watch?v=rOQw-GR8A4o&playnext=1&list=PL3AB19077D889A335&index=1
Strolling Under The Skin (part 2) - http://www.youtube.com/watch?v=01jdrGrp4Fo