Perhaps one of the most remarkable points surrounding our body’s most brilliant tissue (in my opinion anyway) is that few laymen/laywomen are aware of its existence.
I’m of course talking about fascia (pronounced fash-ia). No not the material covering the ends of rafter or other ceiling fittings, but the thin casing of connective tissue that surrounds and holds every organ, blood vessel, bone, nerve fibre and muscle in place throughout our body.
Sure, you may have heard of the more well-known areas of fascia, the Plantar fascia (foot), and if you’re a little more nerdy, the Thoracolumbar fascia (lower back). But did you know that fascia winds and binds its way throughout our entire body, from the base of our toes to the tip of our tongue, across our ribs and deep into our pelvis. Fascia is the most abundant tissue in our body, acting like cling wrap (but without the microplastic)!
What is fascia?
Our fascia is a whole body matrix of support that connects our hardest of tissues (think bones) to our softest of tissues (think muscles and organs). It is essential for transferring forces throughout the body, meaning one of its primary roles is the mitigation of force and tension (a very clever suspension system). It not only encases our muscles, but intertwines its way throughout them.
Fascia is made of collagen fibres and a gel-like substance called ground substance. It’s health and function is significantly influenced by fluid status – dehydrated fascia does not move well and its ability to transmit force (and act as our body’s suspension) is diminished. This is when tissue breakdown, joint pain onset and injury can occur.
Our fascia’s magnificence
As the body’s most abundant tissue, our fascia permeates the entire human body, running in continuous lines from front to back, top to bottom and side to side. In 2001, Anatomist Thomas Myers declared that we as humans have “seamless lines of muscle and fascial tissue that produce and transmit force throughout the entire body.”
Myers was and continues to be a pioneer in discovering the complexity of the fascial system and how it interconnects our entire body. He discovered lines, or meridians of myofascia (myo = muscle) and outlined them as follows:
The fascia acts as a communication superhighway, transporting electrical signals or impulses between muscle groups and nerve endings, also known as mechanoreceptors. It is highly innervated, meaning it is super sensitive and has great proprioceptive qualities (more than 10x that of muscles) thus providing a vast supply of information about where our body is in space and the position/s of our joints.
The highly sensitive nature of fascia points to the importance of considering it in any case of chronic pain. Studies show that people with lower back pain have proprioceptive deficits throughout their Thoracolumbar fascia, which is an area of more densely layered fascia that sits at the base of our lumbar spine and plays a vital role in posture, respiration, and transferring loads.
If you weren’t aware of fascia and its awesomeness yet, you sure are now!
Fascia and its role in movement
As discussed above, fascia responds best to the world around us when it is well hydrated. Dehydrated fascia can lead to adhesions and trigger points, which alters the function of both local and global tissues. If you’ve ever suffered referred pain (for example, tightness or restriction in the tissues of your mid-back that has lead to shoulder or neck pain), this was likely due to dehydrated, bound and/or affected fascia. Because of the global nature of our fascia, pain we experience can spread around the body.
Lack of hydration, poor nutrition, caffeine consumption, repetitive movements, excessive sitting and emotional stress all lead to dehydrated fascia, the result of which can be a cumulative injury cycle.
We often see patients stuck in their own unique cumulative injury cycle. As lifestyle factors affect tissue health, tolerance to the physical rigours of daily life diminishes. Adhesions and trigger points, unless addressed, can lead to dysfunctional movement patterns and greater load distribution and impact to our bones and skeletal system. Over time this can lead to more rapid degenerative changes throughout our joints.
How to care for your fascia
As you may gather from what you’ve already read, hydration is key. When we are adequately hydrated, the fascial matrix is filled with fluid, much like a sponge. If we engage in regular movement, or apply pressure via massage or the use of a foam roller, fluid is pushed out of the tissue. When this pressure is removed, the area refills with new fluid, bringing with it oxygen and nutrients.
Below is an example of dehydrated tissue vs hydrated tissue – which one do you think is more likely to more effectively move and remodel as we encounter activities of daily living? Which will be the more tolerant tissue to stressors, forces and loads?
Regular movement is also necessary to create healthy fascial tissue. When we spend our days sitting, or repeat repetitive motions, our fascia will become dehydrated in certain areas. Spend excessive time sitting, and the fascia atop your thighs will become restricted as your hips remain in a flexed position. As your posture rounds, the fascia sitting below your sternum can become stuck and bound, making it harder to sit tall and extend.
Repeat a movement often enough, and more layers of collagen and fascial tissue will be ‘laid down’ to strengthen against these repeat loads. This is why our bodies are rarely symmetrical – your preferences and work stations can support pre-existing dominant movement patterns and further reinforce tissue restriction.
Can you guess the occupation of the person above based on the scan of their upper trunk (the sternum can be seen running vertically)?
This is reportedly the scan of a New York taxi driver – the additional layers of fascia are in response to continued pressure from the seat belt crossing the torso. This may or may not have affected the person’s ability to for example rotate to one side better than the other.
Movement to support the fascia
Knowing the nature of our fascial tissue and how it acts as our body’s force mitigation system, it is important that we exercise and move in a way that supports the health of our fascia. Full body, integrated movements are key, as opposed to more isolated, typically body-building-esque type exercises. The controlled transmission of load and tension throughout our fascial lines that run from head to toe make detectable improvements in our standing posture, walking pattern, and ability to complete functional tasks in a safe, strong and efficient manner.
We know that isolating smaller parts of the body during exercise does not have such an effect. When we move in isolation, for example performing a bicep curl, we are under-utilising the fascial system and focusing more on the muscle alone. As humans, we are stronger as the sum of our parts, so it is important that we exercise this way. Can we perform a bicep curl in a manner that allows communication of the bicep and it’s surrounding myofascia to the Latissimus myofascia, which we know then connects into the fascia of the core and Gluteus muscles? You bet we can (click the picture below to see 3 examples of how)! As we mitigate the load of the dumbbell and gravity across multiple areas, our elbows and shoulders will be grateful.
Conclusion
The fascial system is an incredible network of tissue that supports our musculoskeletal system, our central nervous system and even our immune system. If we overlook it during exercise, we are likely under-utilising our body’s capacity for effective force transmission, the likely end result being increased degenerative changes through our joints.
If this blog has piqued your interest in the fascial system and you’d like to learn to exercise in a way that better supports the lines of fascia throughout your body, contact Luke today. I personally love to exercise this way and see best results with patients when considering the health of the fascia!
Happy exercising,
Luke
References
- Feel SOMA (Self Osteo-Myofascial Application) handout following Level One Immersion course, October 2023. Created by Ian O’Dwyer.
- Kopeinig, C., Gödl-Purrer, B. & Salchinger, B. Fascia as a Proprioceptive Organ and its Role in Chronic Pain – a Review of Current Literature. Saf Health 1 (Suppl 1), A2 (2015). https://doi.org/10.1186/2056-5917-1-S1-A2
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