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.

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