Fascia
I tweeted a story and mentioned fascial health the other day and had a few requests to go into more detail. I also made a little joke about it being kind of funny that no one in the holistically deranged community has created a grift related to fascial health yet, any day now that I have said this a thread will pop up (LOL). “Fascia” is Latin for a band or bandage. In the past fascia has been regarded as inconsequential compared to the tissues which they encompass. New research is demonstrating this assumption is wrong. Fascia is very important to surgeons, physiotherapists, orthopedists, osteopaths, podiatrists, massage therapists, acupuncturists etc. Professor Frederic Wood Jones, coined the term “ectoskeleton” to describe the fascial system finding it serves as a soft tissue skeleton in its role as significant site of muscle attachment.
Fascia is a thin casing of connective tissue, made mostly of collagen that surrounds and holds every organ, blood vessel, bone, nerve fiber and muscle in place. It’s part of why our organs aren’t jostling around as we move. Fascia is innervated making it almost as sensitive as skin. Fascia is involved in the containment of infections and pus, edema and effusions, compartment syndromes, plantar fasciitis and many other conditions. Healthy fascia is shiny, smooth, slippery and flexible. Unhealthy fascia is gummy and crinkles easily. During surgery fascia is dissected and when fascia is injured it can form adhesions. Fascia takes 6-24 months to heal. During surgery the fascia is carefully sutured back together its integrity is crucial to incisional stability and preventing incisional dehiscence. Fascia is made up of multiple layers with liquid in between called hyaluronan. It’s made to stretch as you move. When it thickens, is dry and stiffens around muscles, it limits mobility and causes pain. The continuum of fascia throughout the body, the mechanical role of fascia coordinating with the musculoskeletal system, the ability of fibroblasts that are in fascia and throughout the body to communicate with each other demonstrates that fascia may act as a body wide mechanosensitive signaling system with an assimilating function like the nervous systems.
There is fascia located around your muscles, viscera, and spine and they are all connected. Current research is demonstrating that most diseases have a fascial component. Fascia is important as it is crucial to biomechanics, coordinating the body’s movements, proprioception, and fluid flow through the body. Fascia is very important in understanding muscles and musculoskeletal pain, and acupuncture. Studies have shown that the way acupuncture needles are manipulated can change how fascial cells respond.
There is superficial and deep fascia. Superficial fascia is layer of areolar connective immediately beneath the skin, deep fascia is a tougher, dense connective tissue. Deep fascia is arranged as sheets forming a stocking around the muscles and tendons. Dense connective is found in superficial fascia enclosing the saphenous veins as well. Fascia also forms a protective tunnel for the vessels in hands and nerves as well. The role of fascia in the limbs is defined as an integrating “bone–fascia–tendon system.” The layer of fat in the superficial fascia is distinctly a human trait serving as insulation due to our scant body hair. The superficial fascia supports blood vessels and nerves to and from the skin and promotes movement between the skin and underlying structures. Deep fascia elsewhere in the limbs and body like the face is often not tightly bound to the skin, however ligaments extending from deep fascia to anchor the skin are widespread and serve to resist a wide variety of dynamics, including gravitational force. Therefore, collagen retention is important in combating facial aging and sagging. The dominant cells in deep fascia are fibroblasts which are integral to mechanotransduction, which is their process of communicating with each other via gap junctions and responding to tissue stretch. All forms of fascia contain collagen and elastic fibers. Fascia is abundantly innervated. Deep fascia contains and separates groups of muscles into compartments. It integrates the compartments and transmits load between them.
Exercise and especially weight bearing exercise helps to stimulate collagen remodeling in fascial tissues. Oral contraceptives have been found to have a depressing effect on collagen remodeling. Aging also effects fascia causing fibrosis (stiffness) and laxity, kind of like an old, deflated balloon that has been in the sun too long. These changes contribute to pain related and age-related reductions in muscle strength and range of motion, that isn’t entirely explained by the loss of muscle mass. Connective tissue and the extra cellular matrix (ECM) are the primary site of inflammatory responses in tissues, the ECM interacts with immune cells to change their function, which is important for growth and regeneration of tissues. Early inflammation after tissue damage due to physical exercise or injury is crucial for tissue remodeling, stem cell activity and collagen synthesis/remodeling these processes can be inhibited by the chronic intake of non-steroidal anti-inflammatory drugs. Non-steroidal anti-inflammatory drugs are not recommended after breaking a bone by most orthopedic surgeons for their interference in the early stage of inflammation that aids in repair.
Limited daily physical activity can weaken your fascia as well as repetitive movements that overwork isolated parts of the body. Injuries and surgery also impair the integrity of fascia. Dehydration, stress induced chronic inflammation, poor sleep all negatively impact your fascial health. Structural integration is a form of physiotherapy that works by manipulating and stretching your fascia to relieve pain and improve physical mobility. Structural integration works by use of slow, deep, fascial and myofascial manipulation. Consistent and varied daily exercise helps fascia stay supple. Regular stretching promotes fascial health. Poor posture causes fascia to tighten, so focusing on maintaining good posture is important. Heat therapy like sauna, steam and red-light therapy have all been shown be beneficial for fascial health. Vitamin C and Sulphur are both important for fascia as they booth boost and support collagen production. Foods rich in antioxidants to lower oxidative stress and chronic inflammation are also important in supporting fascia. B12 and folic acid have been found to help with myofascial pain. Healthy fascia improves body symmetry, alignment, blood flow, reduces risk of injury and improves sports performance. Try to stretch a minimum of 10 minutes per day focusing on every part of your body. I think classic calisthenics exercises are great for fascia and should be incorporated into exercise routines. Of course, drink plenty of water…