Credit: Richard Harty, PT


FASCIA

Credit: Dr. Guimberteau, MD

Credit: Dr. Guimberteau, MD

Fascia (also called connective tissue) is a tissue system of the body to which relatively little attention has been given in the past. Fascia is composed of two types of fibers: 

A. Collagenous fibers which are very tough and have little stretchability;

B. Elastic fibers which are stretchable.

From the functional point of view, the body fascia may be regarded as a continuous laminated sheet of connective tissue that extends without interruption from head to toe, front to back. It surrounds and permeates every other tissue and organ of the body, including cells, nerves, vessels, muscle and bone. Fascia is more dense in some areas than others. Dense fascia is easily recognizable (for example, the tough white membrane that we often find surrounding and permeating butchered meat).


WHEN FASCIA IS INJURED

Credit: Myofascial Releease

Credit: Myofascial Releease

Because fascia permeates all regions of the body and is all interconnected, when it scars and hardens in one area (following injury, inflammation, disease, surgery, etc.), it can put tension on adjacent pain- sensitive structures as well as on structures in far-away areas. Some patients have bizarre pain symptoms that appear to be unrelated to the original or primary complaint. These bizarre symptoms can now often be understood in relationship to our understanding of the fascial system.


ANATOMY OF FASCIA

Credit: Myofascial Release

Credit: Myofascial Release

The majority of the fascia of the body is oriented vertically. There are, however, four major planes of fascia in the body that are oriented in more of a crosswise (or transverse) plane. These four transverse planes are extremely dense. They are called the pelvic diaphragm, respiratory diaphragm, thoracic inlet and cranial base. Frequently, all four of these transverse planes will become restricted when fascial adhesions occur in just about any part of the body. This is because this fascia of the body is all interconnected, and a restriction in one region can theoretically put a “drag” on the fascia in any other direction.


TREATING FASCIAL
RESTRICTIONS

Nerve cell surrounded by fascial tissue

Nerve cell surrounded by fascial tissue

The point of all the above information is to help you understand that during myofascial release treatments, you may be treated in areas that you may not think are related to your condition. The trained therapist has a thorough understanding of the fascial system and will “release” the fascia in areas that have a strong “drag” on your area of injury. This is, therefore, a whole body approach to treatment.

A good example is the chronic low back pain patient; although the low back is primarily involved, the patient may also have significant discomfort in the neck. This is due to the gradual tightening of the muscles and especially of the fascia, as this tightness has crept its way up the back, eventually creating neck and head pain.

The collagenous fibers of fascia are extremely tough and resistant to stretch. In fact, it is estimated that fascia has a tensile strength of as much as 2000 pounds per square inch. (No wonder when it tightens, it can cause pain.) 

However, it has been shown that with sustained pressure (applied by a therapist's hands) fascia will soften and begin to release.