Is fascia causing your back or neck pain …or just improving our vocabulary?

Although Fascia may sound more like word from a Mike Myer’s movie or a cooking show, it seems to be a major contributor to our posture, performance and pain.

FUN FASCIA FACTOIDS:

• Fascia accounts for 20% of your body mass. This is equivalent to 25-40+ lbs! (Note: Fascia-ectomy (removal) is NOT recommended for weight loss. You will essentially ‘melt’ into a fascia-less puddle on the floor.
• Fascia is a fibrous connective tissue that acts somewhat like the casing around sausage links. Fascia transmits force quickly from muscle to muscle, tendon to tendon, joint to joint.
• Overly tight, fibrotic or ‘stuck’ fascia can compress nerves and muscles, resulting in pain.
• Fascia stores water, carries electrical (voltage) signals and can contract and relax. Fascia acts to move fluid around the body for healing and hydration like a hydraulic pump.
• Fascia is made of fibroblasts (regeneration cells than can expand and contract) held together by a surrounding matrix.

Recently, we have discovered that the structures of our spines and joints have a lot less correlation with our pain levels that we thought! Our fascia may be the culprit we have been looking for to explain this inconsistency.
Fascial restrictions or thickenings are caused by inactivity, stress, overuse, biomechanics or alignment issues, injury, trauma, inflammation and lack of blood flow (hypoxia).

POSTURE AND PERFORMANCE

How and when do these connective tissues lay down new fascial tissue? For example, if you sit all day with your knee flexed, the fascia surrounding your knee will be replaced within a smaller and smaller range each day/week/month.
Your fascia determines what positions are necessary based on the demand that you place on your body. So if your ‘fascial demand’ over time is sitting mostly (vs. doing the splits – within limits of joint depth and shape), then the fibroblasts will gradually thicken or stiffen the fascial matrix into a tighter position to support this limited range of motion.
If, on the other hand, you are running, twisting, swinging, jumping or gently stretching in all different directions throughout the week, this language of ‘force’ with maintain mobility and ‘strength’ within the entire fascial network. Since the language of fascia is force, forces from all different angles will help strengthen and re-enforce fascial lines in more dynamic and bigger patterns. Conversely, more simple repetitive movements only such typical cardio and gym/machine exercises, will decrease the fascia’s ability to expand and tolerate more range of motion over time.

With regards to posture, a person with a history of back pain who ALWAYS maintains ‘neutral spine’ under all circumstances (even in a safe and unloaded way) will gradually lose the simple ability to move his/her spine due to fascial organization. Without exploring safe, pain-free segmental motion of the spine regularly, the fascial will solidify and create more pain and problems.
For example, when returning to a sport after a break of a few years (or even weeks/months), fascial stiffness can create a much higher cost of effort leading to excessive soreness and/or acute or chronic injury.

FASCIAL HEALTH RECOMMENDATIONS

Ideally explore larger ranges of motion each day with your neck, shoulders, back and hips.
Here is good video to help start mobilizing your fascia (and joints).

1) Movement: move every 30-60 minutes and include ‘micro-break’ (5 seconds) stretching. Gentle stretches (shoulders, neck, back and hips) can increase the fibroblasts size up to 200%, leading to relaxation of the entire fascia tissue and matrix. For the legs, lunging or squatting and even walking can help.

2) Exercise: With regular exercise, the fibroblasts increase their ability to produce fresh mobile collagen. You can actually improve the quality of your fascia in as little as three days of active movement.
As you exercise, small tears in the fascia will occur, just as micro tears in your muscle occur during strength training. To allow the fascia to regenerate and heal, you’ll want to recuperate for two to three days after vigorous exercise.
Since fascia is positioned in all different directions, try to train your muscles at all different directions, positions and at different speeds (safely), including some plyometrics (hopping, jumping, dynamic movements).

3) Stretching: Longer held stretching (1-2+ minutes) can have a more profound effect on the fascia (fibroblasts). Higher temperatures (warm environment) can help release the fascia more quickly but increase risk of over stretching the muscles and tendons.

4) Release: Using a (foam) roller, lacrosse, tennis or golf ball etc. for 1-2 minutes on tight or symptomatic areas can help with more surface/superficial fascial changes or improvements.

5) Hydration: hydrate to keep fascia mobile and pliable

6) Nutrition: Sorry but sugar leads to an increase inflammation (as well as most processed vegetable oils (especially PUFAs) and processed food in general).

Severely agglutinated fascia can take up to one year to regenerate and often require treatments** to remodel and repair.

**Treatment Options for Fascia

Since fascia covers vast areas of our muscles and surrounds almost everything in our bodies, including organs, almost all treatment have some effect on the fascia. How much and how useful a ‘fascia’ treatment is depending on a few general components.

Sufficient force, depth of treatment and time under tension all seem to be key components to treating and releasing fascia.

Treatments I use for fascia release include:

1. Graston Instruments (link to my page): Target thickened, tightened and fibrotic fascia
2. Active Release Techniques: Targets fascial thickening (fibrosis/adhesions) between muscle layers and fibers.
3. Class 4 Laser: Targets inflammation, nerve irritation, blood flow and cellular metabolism within fascia
4. Shockwave Therapy: Can target more significant fascia thickenings that Active Release or Graston Instruments may not be able to access.
5. Chiropractic: Attempts to reduce tension around a joint and help signal a decrease in neurological tone and/or inflammation in and around the fascia near the joints.
6. Orthotics: Occasionally, orthotics can help relieve stress on certain areas of the fascial system to help decrease overproduction of fascial tissue leading to restriction or pain. Typically, orthotics should be a last resort if the fasica itself needs to be specifically stretched, released or re-enforced (strengthened).

Other potentially helpful options for fascia treatment include Needling and Rolfing.

So, if you feel like your fascia is holding your back or holding you back in general, hopefully this article will help you re-organize your fascial priorities!
Good luck.