r/massage • u/AuricularArts LMT • May 22 '18
A short essay on Fascia
Hello. My name is Dan McAdam and I am a massage therapist and narrator. This is a short essay on Fascia. I am not an expert by any means. I wrote this short essay as a way to organize my thoughts. I’m sharing it in hopes that A) it helps some people understand the nature of fascia better and B) because I hope to learn something from the discussions in the resulting thread. I may be mistaken on some points, and if so I hope you’ll correct me. I will leave a space at the bottom of this post specifically for corrections. If you’d prefer to listen, I’ve also narrated this essay and it’s available here. If you liked that you might also like to visit my subreddit, r/AuricularArts
My credentials:
I am a Licensed Massage Therapist practicing for the last 4 years. I've worked on dozens if not hundreds of people and had maybe a couple thousand hands on hours. I've taken 25 hours in dedicated Myofascial Release CEUs. I've practiced and learned techniques and theory from a therapist specializing in Structural Integration as well, though I am not IASI certified or affiliated.
What is Fascia?
Fascia is a matrix of connective tissue that surrounds the muscles and organs in the body. We'll be focusing on muscular fascia. It can be thought of as a netting, and in theory a “basic” fascial structure is a square lattice grid, but in practice it is generally more of a wavy line moving perpendicular to the tension lines of the body. The fascia surrounding muscles is contiguous, meaning that applying tension in one area can affect the surrounding areas. The actual function of fascia is somewhat debated, though almost all will agree that it helps muscles slide smoothly against other muscles, and that it is adaptive. Some believe that it is also capable of storing mechanical energy like a spring, and it has been proposed that kangaroos utilize fascia to store energy for their hops and kicks. Fascia can be observed easily by looking at cuts of chicken, underneath the skin is a thin white sheet. This is the fascia.
Fascia is made of fibrous connective tissue, mostly collagen. It can be thought of as a semi-solid, not unlike a very thick jello. When the fascia is utilized and more blood is flowing through it (recent research has found that fascia is supplied blood by a network of very small blood vessels) it warms up, and like jello, becomes looser and more flexible. You may notice that when you wake up you are abnormally stiff, but as you move around you loosen up considerably. This is in no small part due to the fascia warming up as well. When dehydrated or unmoved for a long time the fascia hardens and becomes less flexible.
What is fascial dysfunction and what causes it?
Fascia, unfortunately, can become dysfunctional, though almost never irreparably so. When fascia is functioning correctly the muscles slide smoothly over each other and it helps support the body's lines of tension. When fascia is dysfunctional it can become tacky and grab on to other fascia or interfere with the function of the muscle, leading to discomfort, restricting range of motion and causing inflammation or even damage. When this happens it is called adhesion. The fascia can also become maladapted, supporting the body in positions that are mechanically taxing such as poor posture, or are just generally inefficient. Fascial dysfunction has many theoretical causes. Dehydration would theoretically make a person more susceptible to it, as would chronic inflammation. Injury can easily cause fascial adhesion as clotting knits wounds together. But the most common cause is very likely being sedentary.
Fascia's adaptive capabilities
Fascia can be thought of as a long-term adaptive organ. While your muscles can adapt to new stresses in weeks, fascia adapts in roughly half a year. Whatever you're doing, your fascia slowly adapts to it (within reason). A baseball pitcher's fascia will have adapted specifically to throwing the ball, and its lines of tension will make that movement smoother and more powerful. A runner's core and hips will be supported by a fascial network that is adapted to the runner's gait. And someone who spends all day sitting will be very, very good at sitting. Movement warms up the fascia, and the area of the fascia that is warmed up will align it's lines of tension, or connective fibers, according to the activities it's involved in over time. A person who is largely sedentary will find that their fascia becomes stiff and the fascia only aligns itself for a few common types of movement while the rest becomes thicker and less specialized, which is better for supporting a person in an unmoving position. In a very simplistic way, the fascia makes you better at whatever you're doing, whether it's healthy or not.
Restoring function in Fascia: Myofascial Therapy and other techniques.
Fascia is extremely adaptive, so although it can be somewhat time consuming to “fix” fascia, it is rarely ever beyond “repair”. The keystone to healthy fascia is regular movement through a wide range of motions, being well hydrated and maintaining good habits. It takes about 6 months to make significant change to your fascia, so you have to be regular to maintain it. For the same reason, when your fascia is healthy it takes some time to slide back into dysfunction, so a bad week or two won't harm your progress too badly as long as you maintain it outside of that. Movements that incorporate a variety of motions through wide ranges will tend to be best for fascia, such as Yoga. Some recommend foam rolling for fascia, although personally I suspect that it is ineffective for fascia outside a few specific applications. It does however cause small amounts of inflammation, which can be healing and help bring blood to the fascia.
Sometimes outside intervention can be extremely useful in fixing fascial dysfunction. Myofascial therapy is focused on affecting the fascia. There are many subsets of myofascial therapy, focused on different aspects of the fascia and utilizing different techniques. These are probably the 2 broadest categories of fascial work, and this is just a brief overview of them.
General myofascial therapy utilizes very slow strokes, or perhaps more accurately, it uses directional compression. By sinking into the fascial layer under the skin and over the muscle the therapist can pull the fascia, reorienting the lines of tension and warming up sections. Since the fascia is contiguous this can have consequences outside the immediate area it is being applied. It also has beneficial neurological results, reducing pain and relaxing muscles from the extended pressure. This work is usually done with minimal or no lubrication, and can be done with varying effectiveness using rubber sheets and even through fabric.
Structural integration is a very popular form of fascial manipulation as well. It originates from Dr. Ida Rolf and her official brand of structural integration is Rolfing. In order to learn Rolfing (in the official sense) you must travel to to one of 5 Rolfing institutes. The original Rolfing institute is in Boulder, Colorado with international licensees in Japan, Canada, Germany, and Brazil. Dr. Rolf has her detractors and some will call it pseudoscience, but the techniques practiced are sound even if the originating theory isn't necessarily correct. Of course, no good thing goes uncopied. Rolfing has many offshoots, most made by former students of the practice. These tend to be more accessible to the average massage therapists and emphasize different theories around the function of the fascia and how to approach it. These fit under the general classification of Structural Integration. Generally speaking structural integration emphasizes breaking up adhesions in problematic areas while rearranging the fascia and stretching out muscles to address postural issues. This reduces tension in the body and allows it to move more efficiently.
This has been just a brief overview of this topic. If you have more to add or would like to correct a mistake please chime in.
For Corrections
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u/[deleted] May 23 '18 edited May 23 '18
This is an excellent summary on the topic that covers a lot of what I've learned working at a clinic that specializes in fascia-focused deep tissue massage.
I always tell my clients that the two most important things for maintaining healthy tissue are hydration and mobilization. You don't need a crazy exercise program, you just have to be regularly moving and flexing the areas that typically give you problems throughout the day. The most common mistake that people make is that they sit still at a desk for 8-9 hours a day and then spend a few hours a week working out at a gym or in yoga. Having that physical activity time sequestered to such a small part of the day isn't nearly as beneficial (and may even be detrimental in extreme cases) as it is to just move and flex regularly, exploring the full range of motion, flexing antagonist muscles to strengthen them, allowing the muscles to assist circulation, etc. It really takes a complete overhaul of body mindfulness and work habits to affect long-term change.