As far as I’m concerned, everyone with a body needs to know about fascia – especially everyone with a body who has pain.
Fascia can be a complicated thing to conceptualize, so I’ll start with the basics and go from there.
Fascia is a connective tissue that is comprised of mostly collagen. The fibers of the fascia form dense bands and sheets that wrap around our muscles and organs to keep everything in neat, little packages. Essentially, fascia is like a plastic wrap for our body. In addition to being plastic wrap, fascia also serves as a mechanism to distribute forces of muscles and external stresses and reduce friction in our bodies.
For many years, fascia was thought of as fairly unimportant to how our bodies mechanically function; muscles and bones took the lead in mechanical functioning, fascia just supported the body in a passive way and held stuff together in bits and pieces. In fact, anyone in health sciences who has completed a cadaver dissection in the past will tell you that his or her professor might have said to “just cut through that white stuff, the important structures are under all of that”. However in more recent years and with the help of physical therapist, John Barnes and researcher, Dr. Jean-Claude Guimberteau, fascia is thought of in a whole new light. It is now realized that fascia is a completely continuous system of a liquid-crystalline matrix, not just a band of tissue here and a sheet of tissue there. In other words, the fascia in the head is continuous with the fascia in the foot is continuous with the fascia in the liver is continuous with the fascia in the eye, etc. It has also been noted that when the body undergoes some sort of stress or trauma, the fascia develops adhesions.
Stay with me here… picture a tablecloth on a table… you can pull it in any which direction and it moves and flows and adapts over the edges and corners of the table. This is like fascia in our body; if you move your arm, your fascia adapts to the movement and flows nicely to allow for that movement to occur. Back to the table cloth… I just hammered a nail through the table cloth into the table… now when you pull the tablecloth, it only goes so far and has to manage and move around the nail as much as possible. That nail is like an adhesion in our fascial system. If the fascia in your hip flexor region is tight from the stress of sitting all day, an adhesion forms there. Now, if you try to stand up straight or move your arm way over your head, your fascia has to negotiate around that adhesion as best as it possibly can. The result of this is pain. If your pelvic fascia is binding you down, but you are continuously raising your arm and forcing those muscles in your shoulder to work in over drive in order to fight the abdominal adhesion, the result is shoulder pain.
For years, shoulder injuries have been treated at the shoulder, knee issues at the knee, hip issues at the hip… but what if your shoulder pain is coming from your abdominal fascia adhesion? If you have ever had a nagging pain that keeps coming back even after repeated physical therapy stints, year after year, then you better get your fascia checked.
Now you find a myofascial release therapist. John Barnes has developed a method of myofascial release (MFR) that is steadily infiltrating the system of traditional therapy and making great changes to treatment and outcomes. There are people (therapists) out there, myself included, who are trained to find your fascial restrictions and help you rehab through them. I’m not going to lie, it’s pretty amazing stuff.
I encourage all of you in pain to try and focus on your body a bit, notice your aches and pains, take note of where you feel restricted, try and establish relationships between your pains… that ankle pain you’ve had for years that you think is unrelated to your neck pain may not be. If you have access to a MFR therapist, I highly recommend going for at least one session to see what is truly going on with your body and identify any imbalances you might have that never knew about.
Peace and love,
Alix Terpos PT, DPT