12 Days of Fitness 2020: Day 6 – The Real Science Behind Fascia

(This is part 6 of a 12 part series to provide you with some helpful health and fitness tips over the holiday season)

Most of you have probably never heard of fascia, or if you have, it may be in the context of “blasting” it to treat cellulite. But talking about fascia has become somewhat trendy recently, and not only in the context of looking better in your swimsuit. A Google search returns more than 79 million hits for the term, and there is even a conference that is entirely devoted to fascia research.

What is Fascia?

According to Stedman’s Medical Dictionary, fascia is “a sheet of fibrous tissue that envelops the body beneath the skin; it also encloses muscles and groups of muscles and separates their several layers or groups.” But this definition is incomplete. Fascia can actually be classified into four types, each with different properties, functions and characteristics. The superficial fascia surrounds the body and includes subcutaneous fat; the deep fascia surrounds the musculoskeletal system; the meningeal fascia surrounds the nervous system; the visceral fascia surrounds body cavities and organs. In mainstream medicine, fascia is rarely considered in isolation as the cause of chronic pain disorders. One exception is plantar fasciitis, a painful and relatively common condition in which the fascia that is responsible for maintaining the arch in your foot is inflamed. The inflammation is directly attributed to a stiffening and a decrease in the flexibility of the fascia. Fascia, like most connective tissue in the body, stiffens with age, overuse and injury. The direct role of fascial changes in causing pain and structural changes in conditions such as chronic lower back pain, headaches and cellulite is less clear. Some body work practitioners including massage therapists, osteopaths, Rolfers, craniosacral therapists and physical therapists claim that fascial restrictions (essentially tightening) — caused by injury, inflammation, trauma, disuse, overuse, misuse or abuse — play an important role in contributing to the pain associated with a wide array of conditions including migraines, fibromyalgia, headaches, lower back pain and women’s health issues. Fascia specialists claim that treating these fascial restrictions with a variety of methods, including proprietary bodywork methods and/or specialized tools, is an important aspect of overcoming these chronic and painful conditions. But what does the science say? Is fascia really that important, and if it is, is there anything we can do to “fix” the fascia and get rid of the pain?

Is Fascia Real Science?

Despite the growing interest, the science of fascia, its clinical relevance and how best to treat it (assuming it is clinically relevant) remains controversial, and there is very limited high-quality research to evaluate and support it. There are two major challenges to fascia research and scientific validation. First, there are major issues with the definition of fascia. Many in traditional medicine consider fascia as simply the tough, fibrous connective tissue surrounding muscle tissue and separating soft tissue areas (including fat) throughout the body. But those who focus on treating it have a broader definition that includes a more dynamic component of fascia (not just the less flexible fibrous tissue), called the extracellular matrix, which is made up of fluid, proteins and carbohydrates. Newly discovered features of the fluid filled spaces referred to as interstitium exists within and between all tissues in the body. Many researchers believe that interstitium is a component of fascia, and since it is fluid, it can be manipulated. Though many fascia manipulation advocates claim that lengthening the restricted fascia is the key to successful treatment.

Do Fascia Treatments Work?

Treating fascial restrictions evolved from the work of Ida Rolf, a pioneering female scientist in the 1920s who developed a method of treating fascia called Structural Integration (commonly referred to today as Rolfing.) According to the official Rolfing website, the method works “to release, realign and balance the whole body, thus potentially resolving discomfort, reducing compensations and alleviating pain.” This type of treatment, performed over a number of sessions, improves the movement between layers of fascia surrounding structures including tendons, nerves, muscle and ligaments. The concept of modifying the fluid component of fascia better known as myofascial release is a safe and very effective hands-on technique that involves applying gentle sustained pressure into the myofascial connective tissue restrictions to eliminate pain and restore motion.” The major issue with putting so much emphasis on fascia and how to treat it effectively is that it is highly unlikely that fascia ever works or can be treated in isolation from other tissues. Muscles, tendons, ligaments and nerves play an essential and more clearly established role in many chronic pain conditions. The complex interaction and interconnection of all the tissues involved presents a significant challenge to defining and isolating the relevance of fascia.

The bottom line is if a bodywork practitioner or specialized tool (myoballs, foam rollers, etc.) claim to be treating your fascia to relieve your chronic pain (or help you get rid of cellulite), you may indeed get the hoped-for results, but it’s a lot more complicated than just fixing the fascia.

Til next time, train smart, eat well, and be better.

See you tomorrow for Day 7 of the 12 Days of Fitness

Just in case, here’s what you might have missed:

Day #1 – 7 Ways to Stop Overeating Forever
Day #2Sleep Facts That May Surprise You
Day #3 – Why Losing Weight Through Exercise is Hard
Day #4 – You Are Never Too Old to Exercise
Day #5 – 6 Ways to Adopting a New Habit

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