Chiropractic News from Dr M Buna

Is your fascia causing your (muscle) pain?

Fascia is an interconnected web of collagen sheets, chords and bags present throughout your body. These fibres wrap around, divide and connect every one of your muscles, bones, nerves, blood vessels and organs. Fascia protects you, connects you together and keeps you upright! fascia surrounds each muscle fibre and group

Strangely, for something so large, the medical, sport and rehab communities do not talk about fascia in relation to injury or repair. This is something we can probably blame on Leonardo leonard da vinciDa Vinci. His early drawings of the human body led to the modern understanding that "bones are the framework and that muscles moved the body." This didn't leave any room for fascia.

If fascia is everywhere, why wasn't it thought to be important?

Because it is everywhere.

The network of fascia is so large and interconnected in the human body that it is impossible to assign it a singular function. No one could believe that something present everywhere in the body could have multiple functions. In fact, in chiropractic school, we cut through the fascia in the cadavers to get to the "important stuff!"
Fascia is demanding it's due attention now. In fact, 2007 saw the first International Fascia Research Congress, held at Harvard Medical School. Researchers realized that fascia was involved in every movement and therefore every injury in the body. Rather than being a bystander of no importance, fascia was involved in moving our bodies (mechano-transduction) and the contractile properties of muscles. This was a great revelation, given that no one paid any attention to fascia before this!

 

What does fascia do?

abdomnial fasciaIn the abdominal cavity, for example, fascia wraps around each of individual internal part, keeping them separate and allowing them to slide easily with your movements. It's strong, slippery and wet. Fascia creates a sheath around each muscle; because it's stiffer, it resists over-stretching and acts like an anatomical emergency break. It connects your organs to your ribs to your muscles and all your bones to each other. It structures your insides in a feat of engineering, balancing stressors and counter-stressors to create a mobile, flexible and resilient body unit. It generally keeps you from being a big, bone-filled blob.

"Fascia is the missing element in the movement/stability equation," says Tom Myers, author of the acclaimed book Anatomy Trains.

Myers was among the first medical professionals to challenge the field's ignorance of fascia in the human body. He has long argued for a more holistic treatment, with a focus on the fascia as an unappreciated overseer.
"While every anatomy book lists around 600 separate muscles, it is more accurate to say that there is one muscle poured into six hundred pockets of the fascial webbing.The 'illusion' of separate muscles is created by the anatomist's scalpel, dividing tissues along the planes of fascia. This reductive process should not blind us to the reality of the unifying whole."

Why are athletes, medical and sports trainers interested in fascia now?

While there is a temptation to think of fascia as the body's version of plastic wrap, this is too simplified. Fascia can contract, feel contraction and impact and respond to determine the way you move. Hmmmm.
Second only to the skin, it is the richest sense organ of the body. It contracts independently of the muscles it surrounds and responds to stress without your conscious command. That's a big deal. It means that fascia affects your movements, for better or worse. It also means that this stuff massage therapists and physical therapists and orthopedists have right at their fingertips is the missing variable, the one they've been looking for.

What does fascia mean to you?

Let's try an experiment.
Grab hold of the collar area of your shirt or the shirt of someone beside you. Tug on the collar in an upward motion. What happens to the shirt?
The whole shirt moves upward, in response to a tug at the collar. Your collar pulls into the back of your neck. The tail of your shirt inches up the small of your back. Your sleeves move up your forearms.
When you let go of the collar, the shirt falls back into place.
That's a bit like fascia. It fits like a giant, body-hugging T-shirt over your whole body, from the top of your head to the tips of your toes and crisscrossing back and forth and through and back again. You can't move just one piece of it, and you can't make a move without bringing it along.
Let's try a second experiment.
Pull the collar of your shirt, or someone beside you. Hold onto it for 8 hours. That's about the length of time many people spend leaning forward over a desk or computer or steering wheel.
Let's try a third experiment.
Pull on the collar of the shirt 2,500 times. That's approximately the number of steps you'd take on a half-hour run.
Your shirt probably isn't looking too good at this point.
Fascia – Stronger than your shirt and self-repairing!
Fortunately, though your fascia is tougher than your shirt and it has self-healing properties.
In its healthy state fascia is smooth and supple and slides easily, allowing you to move and stretch to your full length in any direction, always returning back to its normal state.

What happens to fascia?

Fascia loses flexibility for a number of reasons:

  • lack of activity - cements the supple fibers into place
  • muscles held tight – (stress) thickening in the fibres as they try to protect the underlying muscle
  • overuse – e.g. poor posture, lack of flexibility, repetitive movements. Pulls the fascia into repetitive patterns of movement and holds
  • injury – damaged tissue

Eventually adhesions form within the stuck and damaged fibers, like snags in a sweater. Once snags form in fascia they are difficult to remove.

Remember, it's everywhere

Fascial webbing is continuous and integral to the body, such that a true representation of human anatomy would show it completely covered in fascia. It is all you would see, as it covers back fasciaand connects everything in the body. Thick and white in places like your IT band and plantar fascia, less than 1mm and nearly transparent on your eyelids. And within all that fascia you have adhesions and areas of rigidity. Everyone has adhesions – even you!

Damage is reversible

But, this isn't bad news.

Every bit of the damage in your fascia is reversible, and every one of the problems caused by fascia can be avoided!
By now everyone knows to take of your muscles with stretching, foam rolling and massage. We take care of our bones with diet and restraint.

Now you also know to take care of your fascia. With the right work, you can shake that nagging injury.

How to Care for Your Fascia

Educate yourself about fascia

See a movement therapist, such as a pilates instructor. Pilates is one of the best known movement therapies. Dancers and gymnasts have long embraced movement therapy. They use verbal cues, light touch and simple exercises to lessen the unconscious destructive movement patterns that may be irritating their fascia.

Use a foam roller

Using a foam roller on your fascia produces a similar effect to stretching your muscles. Be gentle and slow in your movements. When you find an area of tension, hold sustained pressure for three to five minutes. You may practice self-massage with the same rules.

Respect your body

If you're attempting to run through an injury, or returning from one with a limp, beware: Your fascia will respond to your new mechanics and, eventually, even after your injury is gone, you may maintain that same movement pattern. That's a recipe for an injury cycle. It's better to take some extra time than to set yourself up for long-term trouble.
Do a variety of activities instead of Just one: If you just walk your body gets adapts to a certain pattern and this is detrimental to your fascia. Continually do a wide variety of different activites. Walk, stretch, swim and do Pilates.

Stretch your fascia

Once your fascia has tightened up, it doesn't want to let go. Because the fascia can withstand up to 2,000 pounds of pressure per square inch, you're not going to force your way through, so you need to s-t-r-e-t-c-h g-e-n-t-l-y

Fascia also works in slower cycles than muscles do, both contracting and stretching more slowly. To stretch the fascia, hold gentle stretches for three to five minutes, relaxing into a hold.

Stretch your muscles

When you hold your muscles tight, the surrounding fascia tightens along with them. Over time the fascia becomes rigid, compressing the muscles and the nerves.

Move it or lost it

Sticky adhesions form between fascia surfaces that are not moved regularly. Over time these adhesions get strong enough to limit your range of motion. Take a few minutes first thing in the morning to roll around in bed and really stretch out, head to toe, just like a cat after a nap.

Stay lubricated

Just like every other tissue in your body, your fascia is made of water. It works better, moves better and feels better when it's wet. So, drink!

Relax!

If you spend all day tense and tight at a desk, ice baths may not be the best thing for you. Fifteen to 20 minutes in a warm Epsom salt bath can coax tight fascia to loosen up, releasing your muscles from their stranglehold. Make sure to follow it up with 10 minutes of light activity to keep blood from pooling in your muscles.

See a fascial specialist

If you have a nagging injury, or just don't feel right, look for a fascial or myofascial specialist in your area. There are different philosophies and methods, ranging from Rolfing, which is very aggressive, to fascial unwinding, which is very gentle. Some methods are similar to massage, while others concentrate on long assisted stretches. Talk to the therapist to see what you need and want. Some osteopaths, chiropractors, physical therapists and massage therapists are beginning to embrace fascial therapies, so ask around.

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