Myofascial Mania

Fascia- what is this ‘mystery’ tissue that is getting Musculoskeletal Geeks talking?

Traditionally, it has been assumed that the main players prone to ‘going wrong’ and causing pain and injury in the human body are the skeleton, the muscles and the nerves. It was assumed that Fascia was merely packaging, an inert cling-film wrap surrounding the main players, one to be stripped away and discarded during dissection, its’ role in the body massively underestimated. Until more recently…

Practitioners of Musculoskeltal medicine are hugely excited by this tissue; what we now know to be a living, communicative matrix of connective tissue, (made mostly of densely packed collagen fibres) surrounding and linking every single cell in our bodies to that of its neighbours, from brain, to blood vessels and intestines to calf muscle. Fascia is best illustrated by visualising the film of tissue that you see when you pull the skin off a piece of chicken breast. Here, it is thin and opaque but this is a tissue that varies throughout the body according to function; in places it will be thicker, whiter (such as the Illiotibial band running from hip to knee) others more transparent and thinner. Under the microscope it looks a bit like an intricate cob-web of tiny interconnecting tubules, or the veins left behind on the skeletal dead leaf of a tree.

Fascia not only surrounds muscle, it permeates it, giving it form and structure. It provides the casing for every fibre; take it away and you’d be left with a substance a bit like pâté.

The reason that we are so excited by Fascia is that previously, the anatomical model of muscles and joints producing separate movements, was hard to reconcile with what we actually see. Our bodies produce a fluid chain reaction of movement, each influencing another. We now know that the fascia facilities this fluidity, connecting each part, allowing it to communicate with the other. It is the missing link within our practice and has opened up a whole new world of treatment and opportunity for change.

Bundle the bottom left hand corner of your jumper or shirt into your left hand. Now lift your right arm right up above your head. See the creases running from your left hand, diagonally across your body? That’s how Fascia connects one part of you to another, and if it’s become bound or thickened in one area (the bundled material in your left hand) it influences and tensions through to another. If your shirt is not too stretchy, you’ll even feel the restriction of the ‘fascia’ on raising your right arm.

Every injury, every niggle, tension, ache and pain you’ve ever experienced, muscular, bony, nervy or otherwise, will have been influenced by Fascia. Fascia is mobile but incredibly tough. It provides resistance to overstretching, feedback to muscles to regulate activity through tensioning and allows each body part to know what the other is doing. Generally, if held in one position (imagine a teenager slumped at their desk) or exposed to repetitive forces (practicing a tennis serve over and over) it is very resilient and will bounce back to form. However, if loaded too far or for too long (the slumped teenager becomes a slumped adult- still spending long hours at a desk) it can become thickened, deformed or bound down. This adversely affects normal movement and can result in a chain reaction of compensation and problems.

Thankfully, Fascia is incredibly plastic. When we influence it through treatment techniques, it responds and changes immediately. Real-time imaging has shown that the tubules will detach from one connection and immediately form another, new connection. Amazing. We can test a movement, identify its fault or dysfunction, treat the corresponding area of fascia and watch that movement change. And that’s what’s got us so excited, the ability to undo through our fingertips, to influence the entire body through manipulating a tissue that we can access just 1-2mm under our skin. 

If you'd like to explore how your Fascia could be affecting your body, please do visit us in Richmond or Chelsea or give us a call.