WHAT IS FASCIA?
Fascia is highly innervated connective tissue, which spreads throughout your body in a 3-dimensional web from your head to your feet without interruption. Trauma, posture, or inflammation can create a binding down of the fascia resulting in excessive pressure on nerves, muscles, blood vessels, osseous (bony) structures, and/or organs.
Standard tests such as x-rays, myelograms, CT scans, EMG, etc., do not assess the fascial systems. It is the invisible system in a medical workup. It can only be assessed during a hands-on clinical evaluation. The viscoelastic quality of the fascial system causes it to resist a suddenly applied force. The myofascial release approach consists of the gentle application of sustained pressure into the fascial restrictions. This essential time element has to do with the viscous flow and the piezoelectric phenomenon. A low order (gentle pressure) applied slowly will allow a viscoelastic medium (i.e. fascia) to elongate (stretch).
If you visualize a spider web, although delicate in appearance, the spider web is versatile, extremely strong, and vital not only because of its structural design, but to the survival of the spider itself. When a fly gets trapped within a web, that fly not only affects the area of the web that binds it, but changes the tensile forces throughout the entire design, therefore, acting as a form of communication to the spider. The same thing happens in our body with fascia.
What Is Fascia Made Of?
Fascia is made up of 3 main components: Collagen, Elastin, and Ground Substance. Collagen is the silk thread of the spider web, except these threads are hollow. Elastin are the fibers that are just like the elastic thread of the stretchy fabric found in our skinny jeans. It provides ease of movement during the lengthening compression stretch of the fascial fibers. Finally, the Ground Substance is the environment where the fascia resides. Ground Substance when unrestricted is a liquid that flows inside and out of the hollow collagen threads preventing their hollow design from collapsing, as well as, lubricating the threads to assist in its movement of glide, slide, and pull. Like Johnny Cash said, fascia is “everywhere man”. When looking at fascia from a less cellular viewpoint it can be described as sheets, bands, or mesh. It surrounds every nerve, blood vessel, ligament, tendon, muscle, organ and bone in one form or another, and in doing so provides for an interior network that not only provides structure to our body, but it helps absorb shock, and works as a transmission system signaling throughout the body.
Why Is Fascia Important?
When increased demands are placed on the fascia (repetitive stress, immobility, poor posture, injury, lack of hydration), the structure can be changed. This change causes the ground substance to harden and that hardening causes fascial restriction. The fascial restrictions then cause the body to prevent its structural integrity by limiting tissue restriction/motion normally available from the fascia, and stiffening it as a secondary method of strength by limiting the motion available from the fascia. This is why fascial restriction can play a major role in pain and movement dysfunction. Therefore, even after a bone or muscle heals after an injury, the fascia will not spontaneously release, which may have an effect on the surrounding structure. Again, our fascial system is like a spider web, and a tug on one end can cause a change of structure on the other.
How We Treat Fascial Restriction At North Jersey Physical Therapy
Through our holistic approach to physical therapy, we understand the patient’s symptoms, but treat the root cause. This is done by performing a movement examination, and pain neuroscience evaluation. We then treat the patient utilizing various manual therapies including:
- Myofascial Release
- Dry Needling
- Functional and specific exercises to meet the patient’s needs.