When I took anatomy in college, my professor warned us that he was going to ruin food for us forever. He spent the semester comparing nerves to linguini noodles, and muscles to steak. It’s amazing how so much of the body can be compared to food. Most days, I left class to immediately head to the cafeteria for lunch, because I was starving!
It wasn’t until massage school that I learned of a lesser known food comparison to the body: the pith of an orange is comparable to fascia. Immediately intrigued, I spent a good amount of time researching this new structure. In the multiple anatomy classes and cadaver labs I’ve taken, this was the first time I had heard of fascia. Of course I’ve heard the term used in words such as Plantar Fasciitis, but never fascia.
So exactly what is this relatively unknown structure? What does it do and what does it have to do with chronic pain?
What is Fascia and what does it do?
The first thing I ask my patients when I’m describing fascia is if they eat meat. (Yes, another food analogy.) Fascia is the stringy stuff between the meat when you shred beef or pork. It is what is referred to as the “silverskin” when you prepare a rack of ribs. In short, fascia is a fibrous connective tissue that forms a complex web and permeates every corner of our bodies. Like ligaments and tendons, fascia is made up of closely packed bundles of collagen fibers that are oriented to the direction of pull.
Let’s return to our original comparison of fascia to an orange. The rind of the orange is comparable to our skin, and the fruit inside represents our muscles and internal organs. The stringy white pith that connects the rind to the fruit? That would be your fascia!
Just like the white pith extends down between the sections of fruit, so does fascia extend down between segments of muscles and encircle the entirety of our blood vessels, bones, nerve fibers, muscles, organs and organ systems together. Without fascia, both the orange and our bodies would completely fall apart!
What role does fascia play in pain?
Let’s try an activity. Sit in a chair with your knees bent and flex your ankle up and down. Now, take that leg and, with the knee straight, put in on the table in front of you and do the same thing. Notice how the foot moves less. Now, bend your trunk forwards. Even less motion. Now drop your head. You can really feel the tightness in your calf. This demonstrates just one simple fascial connection: the back line. But the fascial connections throughout the body are far more complex.
In a healthy person, fascia is tough, but pliable, allowing for smooth and unrestricted movement of each muscle group. Restrictions in the fascia cause restrictions in the muscles and are where pain and injury can happen. But, thanks to these fascial connections as described above, the restriction could come from either muscle or fascia, and possibly in another part of the body. Tight fascia is every bit as painful as a tight muscle.
In my six years practicing myofascial release, I’ve seen many patients come to see me after breaking a foot or rolling their ankle complaining that suddenly their hip hurts, or they are getting headaches more frequently. Looking at their symptoms with the knowledge of fascial pathways, suddenly, their symptoms make sense! The body might be composed of different parts, but everything is connected through fascia!
When injuries and dysfunction happen in one area, the body adapts and compensates to keep the body upright and without pain, and as a result, fascia will shorten or tighten in areas because the muscles cannot hold the extra tension alone.
So how can you maintain healthy fascia?
The number one thing I tell my patients when they are experiencing fascial pain is to focus on their posture. Our bodies are in a constant fight against gravity. Fascia can hold its shape, but it can’t support weight. We need to help support it.
Here is a simple shoulder resetting exercise you can do when sitting at work or stopped at a stop light:
1. Straighten your spine
2. Squeeze your shoulders up to your ears
3. Pull your shoulders back
4. Let your shoulders drop
Do you feel how much more open your chest feels? This position takes the stress off your shoulders and neck and will help reduce headaches, upper back pain, and even numbness and tingling in your hands.
Another thing you can do is stretch regularly. Stretching increases the flexibility and mobility of your joints, and prevents fascia from becoming stuck in one position.
And, of course, regular self-massage or professional massage therapy. If you don’t have the money for regular professional massage, a tennis ball or a lacrosse ball can be used to work through sore areas in your body. Get creative! Kneel on the floor with the ball sandwiched between your hamstrings and calves to work both muscles, lay on your side with it under your hips. Press the ball into tight areas until you feel a “hurt so good” pressure and hold that pressure without moving for 15-30 seconds before moving it to another area.
If you have any further questions about fascia, or want to find out what professional myofascial release is like, come see me!
References:
https://www.treehugger.com/dont-throw-away-best-part-your-citrus-fruits-4854768 https://www.marquettept.com/2018/11/27/what-is-fascia-and-how-does-it-contribute-to-pain/ https://experiencelife.lifetime.life/article/the-web-of-life/
https://theyogalunchbox.co.nz/an-interview-with-tom-myers-of-anatomy-trains-on-the-new-anato my-of-interconnectedness/
https://en.wikipedia.org/wiki/Fascia#:~:text=Like%20ligaments%2C%20aponeuroses%2C%20a nd%20tendons,to%20the%20direction%20of%20pull.
https://www.hopkinsmedicine.org/health/wellness-and-prevention/muscle-pain-it-may-actually-be -your-fascia#:~:text=Fascia%20is%20a%20thin%20casing,When%20stressed%2C%20it%20tig htens%20up.
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