Fascial Health and Medical Massage Therapy

How Massage Therapy can treat this (almost) invisible component of musculoskeletal pain.

Fascia is an (almost) invisible source of either strength or restriction.

When we think of Massage, most of us think of muscles. Some may even think of nerves and bones. But seldom do we think of fascia, and yet it is one of the most extensively networked tissues in our bodies. Surely something so prolific must have some effect on either our wellbeing or our dysfunction. Below, we will take a closer look at both the nature and function of Fascia in the body, and the tools of Massage Therapy for treating it.

The Nature of Fascia

Imagine taking a bunch of grapes from your refrigerator and wrapping each grape in plastic wrap. Then imagine wrapping the whole cluster. Then imagine wrapping the grapes up along with the rest of the fruits (each also individually wrapped), and imagine wrapping the bundle of fruits together with the bundle of like-wrapped veggies and the bundle of condiment jars. Then imagine wrapping the whole fridge.

This is what Fascia (also known as Myofascia) is like inside your body. This special type of connective tissue wraps each individual muscle fiber within a muscle. It wraps groups of fibers. It wraps the whole muscle. It wraps groups of muscles, organs, bones, blood vessels and nerves. And finally, a layer of it sits just beneath the skin.

While Fascia acts in many ways like plastic wrap, clinging to and supporting other tissues throughout the body, it looks more like a dryer sheet. Thousands of tiny fibers run every which way, creating a sturdy mesh. These fibers are suspended in a gel-like material known as “ground substance”.

Like a sweater, your fascia can be "snagged" or pulled in one area, affecting another area.

Although Fascia is organized predictably into identifiable ligaments and tendons and specific sheets in the body, it also runs throughout, forming an interactive web. Pulling on one end of the web will effect the other end. This concept forms the basis of the Sweater Theory of Fascia. If someone pulls on the lower right hem of your sweater, it will stretch up into the left shoulder, changing the tension throughout the whole garment. If someone pulls on the front middle of your sweater, all of its interwoven threads will strain towards that area. One area cannot

become adhered or restricted without effecting every other part of the vast Fascial network.

Considering Fascia’s entanglement with other body tissues, its pliability is crucial to allow the other structures full range of motion. When fascial tissue becomes restricted, it binds up the tissues around it, impairing proper movement and function, not unlike you trying to move your arms while wearing a tight-fitting blazer. Exploring some of the reasons for fascial restriction will help us intuit ways to maintain and improve our fascial health.

Reasons for Fascial Restriction

Injury is a major factor in fascial pliability. “Scar tissue” consists, in part, of disorganized layers of fascia that the body aggressively builds up as an injury heals. While scar tissue is initially helpful in preventing a repeat injury, over the long term it can become restrictive and cause other injuries or compensations to occur. As in the sweater analogy above, scar tissue acts as a “stuck point” or anchor that pulls on the rest of your fascial “sweater”, distorting it and creating strain throughout the body.

Injuries have a big effect on fascial pliability or restriction.

Lack of movement and chronic patterns are also factors. The body is like a smart device, trying to learn from your habits and get better at the movements and routines your brain practices often. If you play golf, your body will be looser in some areas and tighter in others in ways that enhance your swing. If you have a

condition such as cerebral palsy, you might have forearm contractures that help you use your motorized wheelchair. While this may be beneficial for high level athletes or someone with a special need, it doesn’t tend to have great effects on those of us with 9 to 5 desk jobs. If you spend most of your time at a desk, your fascia will literally start to reconfigure to brace you into this position, which isn’t helpful if you’re at the park trying to throw a football with your teen. You’ll feel stiff and clumsy and will be at higher risk of injury.

Age is also a component of Fascial mobility. Ground substance is softer and more pliable when we are younger, but with age (and lack of movement), it begins to set. It seems that as in other tissues, like our skin and vertebral discs, fascia begins to dehydrate as time passes. While some wear and tear as we age is natural and normal, additional factors linked closely to age, such as brain function (affecting balance and mental health) also contributes to physical decline. Some of these factors combine with age to produce a snowball effect: The fear of falling or of getting lost, for instance, may stop the aging from going out or staying active, creating the perfect conditions for a lack of mobility and stiff Fascia.

Getting Relief

Fascial health wiThere are things you can do NOW to improve fascial health!

Because of how integral Fascia is, it is affected by everything that goes on in and around your body. However, today we will focus our discussion on the 3 key elements above. Thankfully, they can all be combated to some degree.

Limiting Injury - Here, the adage, “An ounce of prevention is worth a pound of cure” comes to mind. While there is no magic way of preventing injury, we can limit our risk of it by adopting smart practices. Warming up properly before intense activity, wearing protective gear when appropriate, and training before events are simple ways to reduce injuries. And of course, letting old injuries heal fully and receiving treatment for them is one of the biggest ways to prevent repeat offences in the future.

Movement - Moving your body in a variety of ways is a recipe for happier Fascia. Movement can be said to “warm” the ground substance, making the connective tissue layers more “melty” and less restricted. This is a great tool to combat the effect of age. While you can’t unwind the clock, you can help your fascia unwind by regularly moving, and varying that movement. Try walking, swimming, dance or pilates classes, or working with a personal trainer to increase your overall movement. If you have a hobby or sport that involves repetitive movement, such as golf, try to also add another form of exercise with different motions, to prevent the fascia from becoming restricted into that one movement pattern.

Stretching is another way to help your fascia release- but not just any stretching. Muscular stretches tend to involve lengthening a muscle to its limit and then waiting for a release. Self-Fascial stretching is more fluid, involving a flow of movements that allow the fascia to unwind. Fascia releases best with longer hold times of specific stretches, so if you’d like to stretch your fascia, learn the fascia-focused stretches that you can do at home.

Choose to age well or time will choose for you.

Aging Well - Time marches on for all of us, but have you noticed that it seems to have a more dramatic effect on some than on others? You must age; there is no choice in that. What you can choose is whether or not to age well. We know that certain habits help us as we age. Stimulating our brains with mental exercise (think balancing, doing puzzles, reading, or learning a new skill) can help keep us young “at heart” and in body. Factors like maintaining proper sleep and nutrition, as well as mental health also come into play here. Caring for yourself well is like investing with compound interest…the earlier you start, the more you’ll have to show for it when you’re older. And while it might not seem important to invest in your health when you’re 17, take it from the countless retirees that I’ve treated in practice: Life goes fast. Start now and win (now and) later!

Therapeutic Treatment

Fascia responds best to treatments that address both its gel-like and fibrous components. A regular massage may help loosen the Fascia, but is often more focused on treating the muscles. Certain Massage Therapy, Physical Therapy, Chiropractic, and Bodywork techniques specifically target restricted fascia. Myofascial Release, Myofascial Therapy and Rolfing are techniques that specifically treat fascial restrictions, working with the body’s mechanisms to unwind and “melt” the fascia. Myofascial techniques vary in speed and variety, from quick, intense cross fiber frictions (aimed at tendon and ligament restrictions), to slow, steady cross-hands stretching of different Fascial layers.

Massage Therapy is a great way to address Fascial restrictions!

Due to its highly integrated nature, treatment of the Fascia in one area can cause a therapeutic effect in another area. For instance, due to fascial connections from the thumb to the neck, a fascial stretch on the thumb can actually stretch the neck. This is a huge advantage when it comes to treating an area that is sensitive to the touch. Conversely, treatment to injured neck muscles only would neglect this connective tissue connection and possibly hamper recovery efforts in the long run.

Because Fascia is arranged in various forms throughout the body, treatment is performed in various ways. This allows a knowledgeable practitioner to target specific types of Fascia efficiently and effectively. To find out if your practitioner treats Myofascia, ask them directly.

Conclusion:

With Myofascia literally supporting every fiber of your body, it’s no wonder it can have such a profound effect on your health! Caring for your fascia involves limiting injuries, maintaining healthy movement habits, and aging well.

While there are ways to manage fascial health at home, if you have restrictions such as scar tissue or postural patterns from years of misuse or injury, seeking professional treatment is a great option! Medical Massage Therapy is a safe, minimally invasive modality that can address Fascia, Muscles, Nerves, Bones and Joints all in the same session! It’s a great place to start your journey of reduced pain and reclaimed mobility.

~Alanna

BIBLIOGRAPHY

Hayim, Lisa. “MYOFASCIAL RELEASE: Unlocking Pain + Trauma Using the Hands ft. Craig Cohen”. The Truthiest Life, iHeartPodcasts, 10 Mar. 2023. Spotify.