Monthly Archives: February 2014

Fascia, Keeping it Healthy (Pt 2)

By Josh Betteridge

Welcome back,

 

Hopefully we’ve absorbed a little bit about fascial structure and the importance of it for everyday function. Today we are going to discuss how we make our fascia healthy again and how to maintain its function.

There are many factors influencing fascial structure. Before we dive into that, lets recap some key points from part one:

 

1) Our fascial system is like a network of rivers, which transport mechanical stress throughout the body.
2) It’s essential for our river (ECM) to stay fresh and flowing
3) Fascia is innovated with lots of sensory detectors
4) A weak link in fascia can produce pain elsewhere due to large connections between muscles
5) Structural shape is guaranteed by a 3D tensional model, not compression or stacking.

Is my fascia ‘bad’?
There are many contributing factors that result in a structural change of fascia. Using our river analogy we can understand this in a much easier way, instead of talking to you about the role of glycosaminoglycans (If you want to impress someone, do a bit of research about GAGs).

If our river dries out, stops flowing, or the riverbank becomes weak; the transportation system is disrupted as much as the M25 in rush-hour. There is no FLOW!

The essentials to keep fascia flowing are:

A) HYDRATION

B) ALIGNED COLLAGEN

Simple. The end…

A) Unfortunately, it’s not as simple as drinking water and thinking everything’s going to work itself out. The majority of us do not consume enough water daily for fascial rehydration. It can even take up to eight weeks for your hypothalamus to secrete antidiuretic hormone (ADH) efficiently once water intake has been increased. A general rule – drink water (and only water) until your urine is clear. Even if we are drinking enough water and produce sufficient ADH, our pathways are blocked. We’ll cover this later on.

 

B) Furthermore, increased viscosity of the ECM not only occurs from lack of hydration but through ‘bad’ movements, emotional stress and poor diet. ‘Bad’ movements range from sedentary positions (refer to our sitting down article for a recap) to over-exertion in the gym – we need to find the balance of ‘correct’, varied movements.

Lets review a bit of human biology. Successful repair of a muscle is a balance between collagen synthesis and progressive exercise. We have an abundance of cells called fibroblasts which blast collagen into areas of the body where we think we need it and usually they’re right. Fibroblasts sporadically lay collagen down in certain areas and we must exercise appropriately to realign the collagen (riverbank).

 

If we DO NOT help align the collagen, our rivers become stagnant and blocked. Imagine sticks building up in a river, slowly creating a damn. This is similar to a build up in the ECM through excess collagen.

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I made note of the word ‘think’ because even when we are sedentary and seated for long periods of time, our bodies are in myofascial contraction – producing excess collagen, most notable in areas of shortening such as hip flexors and pec major.

 

On the other hand, if we exercise too much with lots of repetitive movements and high-load, cellular fibroblasts are going to be spraying collagen around like no tomorrow!

 

Remember your myofascial system will reinforce your daily patterns with increased collagen synthesis.

 

The photo on the right is our dehydrated, viscous, excess-collagenous, stagnant myofascial system we see in office workers right through to high-level athletes!

 

How to Hydrate your Myofascia

Drink!

Drink plenty of pure filtered water, anything else containing water such as juices, coffee and fizzy drinks will not hydrate you! Alcohol inhibits the release of ADH meaning all water goes straight through the pipes and out the other end, so when a client questioned me believing they are ‘hydrated because of the clear urine after five beers’ I felt obliged to tell them otherwise….

As your body takes in water, it distributes it around the body with certain structures prioritising absorption over others. Take our river network and apply it into a 3D structure like a sponge. If our sponge and rivers are dried out it becomes very turgid and brittle with minimal ability to absorb forces without fraying or breaking. However, if we hydrate our network of rivers within our sponge, the pliability of our sponge increases. It is able to withstand torsion, squeezing and force! (NB: A compression model would not work in this way).

Dr Guy Voyer sums up pain in relation to myofascial restrictions: “Without water there is friction between structures. Where there’s friction; there’s fire”

 

Move! 

Without movement, excess collagen will not be aligned and the pure water will not be distributed evenly through your fascial network. Fascial is a hydrodynamic tissue. Hydrodynamics is the study of liquids in motion and it’s the motion that is key to spread of hydration through tissue. Movement actually squeezes water out of our tissues (refer back to the sponge) and is then able to reabsorb fresher water (slowly removing stagnant water and replacing it with a more nutrient-dense form). Through movement, our stagnant rivers with dams are eliminated providing we have enough fluid in our system and we move correctly.

 

If our myofascia moves in only particular ways, such as isolated gym-based movement, we drive fluid out of some structures and into others, dehydrating certain parts of the myofascial chain. This predisposes us to higher levels of pain and injury.

 

Ideally, we want to produce full body movements using full myofascia links progressing to bouncing, springing and multiplanar movements such as:

Yoga, Kettlebells, Plyometrics and Olympic Lifting.

(NB. Stagnancy in myofascia leads to further chronic issues such as increased toxin levels, we’ll cover this at a later date)

Release!

I’m sure we’ve all had a sports massage at some point feeling pretty sore before, during and even after in some cases. There has been a huge increase in fascial release techniques which have greater benefits than generic sports massages. Before eating an orange, you’ll notice you roll it around in your hand and suddenly it’s easier to peel. When you’re rolling it around you’re breaking down small fascicles in the orange and allowing fluid to move around as well as increasing heat and pliability. Fascial release produces the same effect on the human body and our rivers of myofascia. Good fascial release should feel refreshing, deep and not too painful. You can even conduct this on your own using a foam roller and golf ball.

(NB: There are recent discussion’s suggesting fascial ‘release’ is not an applicable term due to high shear forces needed to ‘release’ fascia. Until more research is proven it’s a debate for another time)

 

Conclusion

 

The majority of us reading this will have some areas of discomfort and pain somewhere in the body, the good thing to know is its possible to create an entirely rehydrated fascial system over a few months with consistent movement and treatment if needed.

 

Drink well, move functionally and release! All three of these contribute hugely to reducing the viscosity of your ECM, providing a healthy environment for mechanical stress, and aligning strong, uniformed collagen.

 

Thomas Myers sums up the importance of our ECM:
“The ECM has evolved to distribute the stresses of movement and gravity while at the same time maintaining the shape of the different components of the body. It also provides the physico-chemical environments of the cells imbedded in it, forming a framework to which they adhere and on which they can move.”

So we’ve just been told that gravity, movement and chemical secretions influences ECM function. There’s no escaping those three things. Ever.

 

Cheers,

 

Josh

 

 

 

 

Buckminster-Fuller, R (1982) Synergetics: Explorations in the Geometry of Thinking (Macmillan)

Laycock, JF (2010) Perspectives on Vasopressin. Imperial College

Maffulli, N. Renstrom, P. Leadbetter, WB. (2005) Tendon Injuries. Springer

Myers, TW (2009) Anatomy Trains: Myofascial Meridians for Manual and Movement Therapists. Churchill Livingstone.

Schleip, R. (2012) Fascia: The Tensional Network of the Human Body. Elsevier.

Fascia – A Brief Introduction..

By Josh Betteridge

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I’m sure everyone is thinking “Great, another article on how cool and amazing fascia is.” It’s so cool it’s uncool, the hipster of therapy and rehab.

The great debate today ranges from whether fascia has any relevance to our movement, to can we even produce enough force to make any changes to our fascial structure and even whether fascial restrictions influences pregnancy complications. Today we’re going to investigate a little further into the role fascia plays on our body…

What is Fascia?
Everything. Our whole body is one fascial system which surrounds our muscles like a big envelope. It surrounds your vital organs, assists your vertebrae with padding and has a thin cling film like layer around your bones.

Remember, three key points:

A) All of our structures are made from the same material
B) When we label and analyse structures (tendons, ligaments, etc) as individual, we disregard the connections between them.
C) Fascia is our biomechanical regulation system and not a series of parts like a machine.

To put this simply, we must analyse and rehabilitate the body as a functional being! The lack of quality research in the past using cadavers and dissection methods failed to recognise the importance fascia has on human movement resulting in those boring textbook definitions of muscle, nerve innervation, fibre type, next muscle, nerve innervation, fibre type, zzzzz… Unfortunately, this translates to a lot of professional practice, assessing injury to an isolated area. With fascia extending from our head to toe, we should be assessing the human body from head to toe regardless of where the injury site is.

Research over the years
In the 70’s, Harry Farfan proposed the idea that fascia was needed to transfer forces from muscle to muscle however it was questioned at the time. As Serge Gracovetsky discussed, it’s easy to say fascia transmits force between muscles, it’s harder to explain how (we’ll leave that for another day). Bartelink’s theory, despite the evidence proving otherwise, suggests muscles in the lower back are responsible for lifting. It came under scrutiny when his relationship between muscle strength and abdominal pressure to lift heavy loads was calculated to create a force so strong in an individual, an explosion would occur! After more research, It was from here the fascia in our lower back was understood to assist heavily in movements!

Thomas Myers has consistently argued fascia’s role in human function has a large influence on musculoskeletal aches and pains. If we were to view an individual’s skeletal system, we would be able to notice wider hips on females. If we viewed their muscular system, we’d probably be able to see whether the individual went to the gym or not. If we viewed their fascial system however, facial expression, organ location, posture, previous trauma are only a few of the many discrepancies we would be able to conclude. You would essentially be a recognisable 3D figure!

Following on from this, Robert Schleip’s research suggests the number of sensory nerve endings in fascia is up to 6 times(!) more than that of muscle proving it to be the most influential proprioceptive system in our body.

Today we have a better understanding of fascia and it’s is remarkable ability to process sensory and proprioceptive information!

A bit more boring science…
Sorry, one final important boring bit. The assumption our body is a stack of compressed bones (like brickwork in a building) must be disregarded to appreciate body movement. You’ve probably noticed skeletons in your classrooms/clinics are supported by wire. Unfortunately it’s pretty tricky to replicate a skeleton with a 3D fascial tensegrity model surrounding it. Picture the human body as a balloon, not a building. As the layers expand, stress is distributed evenly to support the growing structure. Where there is imbalance and weakness, the structure will fail (balloon bursts), a compression-based model will not expose this.

Structure of Fascia
What makes fascia quite fascia-nating (wahaaayyy!), is the collagen which makes it strong and the extra-cellular matrix (ECM) which creates the fluid-like consistency. Picture a fresh-water river with strong banks, our collagen is the river bank and the fresh-water is our ECM, providing a healthy environment for movement of life.

If our collagen isn’t aligned well and our fresh, flowing river becomes slow and stagnant = INJURY

Our fresh-water river can become stagnant, viscous and dry or it can maintain it’s flowing quality. If the former, how are we able to transmit forces appropriately through the body? Simply, we don’t. If our muscles cannot transmit forces between fascial connections to other parts of the body – injury occurs!

Healthy Fascia?
We’re probably all wondering this is all well and good but how do you maintain a healthy fascial system. Before we get onto that we need to tie all these points together:
A) Fascia connects everything to everything!
B) We have fascial connections from our head down to our toes.
C) Fascia assist heavily in transferring load when moving the body.
D) The ECM must be fluid and flowing to transfer load!
E) Tensegrity not compression!

Hopefully we have a little understanding about fascia’s role in human movement. Part two will discuss how we maintain a healthy fascial system!

Josh

(To see a network of fascial rivers, follow this link:

1. Schleip, R. et al. (2012) Fascia: The Tensional Network of the Human Body. Elsevier

2. Myers, TW. (2009) Anatomy Trains: Myofascial Meridians for Manual and Movement Therapists. Churchill Livingstone.

3. Gracovetsky, S. (2008) Is the lumbo-dorsal fascia necessary? Journal of Bodywork and Movement Therapies 12, 194-197.

4. Farfan, H. (1975) Muscular mechanism of the lumbar spine and the position of power and efficiency. Orthopedic Clinics of North America 6, 135–144.

Is sitting the new smoking?

By Josh Betteridge

Hello,
 
Are you sitting comfortably? Great, we’ll get started. Most of us reading this will be either relaxing on the sofa, tucked into their work station or on the daily public transport commute. Lets dive a little further into why this can be causing you unsuspecting problems…
 
I’m sure we’ve all picked up on something in the media recently suggesting how sitting down for long periods of time increases your chances of disease and muscular pain? Fear not, there are a few key ways to assist you in preventing and curing such issues.
 
To begin, let’s rewind back to our ancestors 50,000 years ago who would run, walk and jump around all day keeping their musculoskeletal systems active and switched on. They would climb trees to hunt food and sprint after prey day after day using their body through full range of movements. Our bodies were designed for this sole reason! Compare this against the 21st century human who sit, inactive for long periods of the day whether it be at work, in the car or on the sofa.
 
Sitting is an activity which does not involve much energy expenditure (obviously). Thus, our bodies increase glucose levels in the blood and decrease the good cholesterols. This occurs because our body believes we are in a storage phase due to the low-level activity which ultimately makes us resistant to insulin. There are numerous studies being concluded with these findings and more empirical evidence is being produced too!
 
As soon as we sit down…
1. Our calorie burning reduces to 1 per minute
2. Enzymes which break down fat decrease by 90%
3. Electrical stimulation in our legs (essential for muscular contraction) switches off.
 
At this point most of us are now having a bit of a panic and get out for a run only to return 10 minutes later with potentially what feels like a torn calf or sciatica or a groin pull and so on….. and most importantly, a reason to discontinue exercise.
 
The reason why we feel this pain is due to the muscular imbalances which have derived from a poor postural foundation due to long periods of sitting. Once we decide to chuck the skins on and jog around Hyde park, our bodies are not balanced well enough to deal with the stresses which are placed on the muscular system. We are quite literally running before we can walk.
 
Jump up for a moment and stand up straight. Take your hand and feel one of your hip flexors (the muscles at the front which cross the hip joint). Don’t be shy to get stuck in a little bit – I’m sure you feel that ropey and tight muscular band? The tight muscle you are feeling is pulling your hips forward and creating this muscular imbalance.
 
This can be applied to many areas of the body. For example, if you press into where your pectorals insert in the front of the shoulder you’ll also feel plenty of tension.
 
With our hips constantly flexed and our arms always outstretched forward in a seated position, our brain recognises this as your ‘normal’ position. As our brain is a clever piece of equipment it remembers what we do day after day. So, to help us be really really good at sitting down, it tries to put our body in a nice seated posture producing very tight, overactive hip flexors and shoulder internal rotators.
 
What this means for the body when we exert ourselves is some muscles are working too hard and others are not working enough. 
 
All we need to do is restore balance and alter the load correctly through the musculoskeletal system! This simply results in pain-free exercise.
 
Get those hips and arms moving! We see many people with chronic pain due to long periods of sitting. With a few pro-active lifestyle changes you can prevent such problems:
 
1) Tissue Release
Targeting restricted myo-fascia reduces pain and increases range of movement to assist in reaffirming muscular balances and symmetry through your body.
 
2) Corrective Exercise
Once you have restored range of movement to a joint it’s imperative to build your body back up in a balanced, strong fashion to keep you fit and healthy for life even if you’re desk-bound!
 
3) Move!
Don’t email Claire downstairs about lunch. Get up from your seat, use the stairs and start activating those muscles more regularly. Get a few jumping jacks on the go or march on the spot. Activation of joints and muscles prevent them from becoming dominant, stiff and glued together.
 
4) Get off the sofa!
Those who sit for more than 3 hours a day watching TV are 64% more likely to die from heart disease. We sit down enough at work, don’t add to the problem away from the office.
 
5) Dynamic Stretching
Put your body into positions it’s not been for a long time. How many of you could squat down and get your ass to grass without falling over?
 
So, are you sitting comfortably?

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Welcome

Hello,

After recently returning to the UK after two years working overseas I have jumped on the bandwagon for blogging. Despite a huge number of rehabilitative blogs available, I feel I could still spam your news feed with how to better yourself as a human…

After graduating in Sports Therapy & Rehabilitation, I moved to Melbourne, Aus for two years practicing in a musculoskeletal rehab clinic. Currently located in a unique London exercise and therapy clinic.

Feel free to share, discuss and even disagree with whatever I am discussing here!