Fascia

Fascia is one of my favorite things to talk about – and for good reason! The term itself is becoming more and more well-known, but there’s still confusion as to what it actually is and what it does. Hopefully this will help clear that up:

 

What is it?

Simply put, fascia is connective tissue. It’s made up primarily of collagen (think ligaments and tendons), but instead of only connecting bones or muscles to each other, it acts as a complex, interwoven web throughout the body. While tendons and ligaments are thick bands of collagen, fascia is much thinner and more widespread, like the white “fuzz” that holds together an orange (see pic below). It wraps all throughout the body – around muscles, nerves and organs, keeping them connected, but also stabilized and separated.

 

 

What does it do?

Fascia has a few different roles, many of which are still being identified. Some of the more established functions include:

1. Transmitting mechanical tension – it helps to brace the body during physical stress by diffusing external force along itself.
2. Reducing friction from movements – it acts as a barrier between areas of the body that can be harmed from direct and repetitive rubbing (like between muscles and nerves).

Since fascia is so omnipresent, has a background role in many functions, and because it is also rich in sensory nerve innervation and blood vessel presence, it’s currently being investigated for numerous other functions, such as:

1. Offering proprioceptive input – helping to provide the body with spatial awareness
2. Providing nociceptive input – transmitting pain throughout the body

What can go wrong?

As mentioned earlier, the main component of facia is collagen. Now, problems arise when this collagen starts to have altered properties, such as:

1. Becoming too stiff: As in cases of fibrosis where excess is deposited and thickened tissues form (as is commonly seen in a lot of tendonitis/osis cases)
2. Forming adhesions: Like after a surgery, where scars develop. One important characteristic of the collagen fibers in fascia is that it is oriented along the direction of force. When adhesions form it can inhibit smooth fascial gliding.
3. Becoming too loose: As in collagen disorders, such as Ehlers-Danlos Syndrome, where the supporting and stabilizing function is lost.

How can you fix it?

Improving fascial health can come from several ways. For example:

1. Since the collagen of fascia is made from fibroblasts, one treatment goal is to try and increase the presence of them (thereby stimulating collagen deposition). This is commonly done using instrument-assisted soft-tissue mobilization AKA Scraping (such as Graston, Smart Tools, Gua Sha, etc).
2. Another goal can be to break up any adhesions that have formed, which can be done manually using a number of soft-tissue techniques (massage, cupping, dry needling, trigger-point therapy).
3. Exercise is always king when it comes to maintaining fascial health. Movement keeps the tissue active and fresh.

 

 

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Written by Dr. Brandon Buchla, DC, CSCS

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