More on Fascia
Fascia is a three dimensional sheet of firm tissue, that spreads throughout the body from head to toe.
It has numerous forms, and essentially envelops the body beneath the skin, enclosing muscles, tendons, ligaments, bones, nerves, arteries and organs.
Fascia has the consistency of a trash bag or mesh, with both elastic and plastic properties. It can stretch, load and unload. It can also contract, but not the same way that muscles do.
Muscle contractions are initiated by neurotransmitters and electrical stimulation. Fascia is thought to contract by the release of histamine.
Fascia is influenced by numerous factors:
- Our environment
Fascia is a dynamic fluid transport network, feeding adjacent tissues with oxygen, hormones, minerals and nutrients and respectively removing waste products.
Because of the it’s interconnections, injuries to the fascia will lead to disrupted fluid flow to the network of fascia above and below
Besides the lesions caused by injuries to the fascial system itself, fascia can also be affected by viral or bacterial infections, clogging its fluid transportation.
Dysfunction of the fascial system due to injury, inflammation or posture may lead to an abnormal high pressure on the respectively fed structures. This can result in pain and dysfunction as well as strange symptoms which often confuse conventional physicians.
There are 6 different Fascial Distortions, each with distinct characteristics:
- Triggerbands– Injuries in which the fibers have become distorted (i.e., twisted, separated, torn, or wrinkled). These are usually described as a “burning” or “pulling” pain. The goal of the treatment is to physically break the adhesions, untwist the distorted bands and re-approximate the torn fibers. This is accomplished by “ironing” out the wrinkled fascia.
- Herniated trigger points– The underlying tissue has protruded through an adjacent fascial plane and become entrapped. These are responsible for a wide range of painful complaints such as sore shoulders, neck aches, abdominal pain, renal colic pain and lumbar strains. The patient pushes their fingers directly deep into the painful area for relief. Treatment involves doing the same, i.e. it forces the protruded and entrapped tissue back through the herniated fascial plane.
- Continuum Distortion– A lesion at the transitional area between ligament, tendon, capsule and bone. This imbalance in the transition zone disrupts the mechanical function of the ligament and alters its proprioception (position sense). The continuum distortion results in uneven mechanical information being transmitted to the brain. This uneven information is interpreted as pain located at very spot of the transition. Pressure through the therapist’s thumb firmly and continuously applied directly in the continuum distortion, forces the transition zone to shift. Thrust manipulation, similar to chiropractic manipulation can also be performed.
- Folding distortions– When fascia in or around a joint becomes distorted from either traction or compression forces. Patients typically feel a pain deep inside, and have the desire to be stretched or compressed. Patients might try pushing their fist into the area (e.g. lower back) while they are extending or bending their spine. These are treated with thrust manipulation or traction.
- Cylinder distortions– Exhibit symptoms resembling neurological conditions such as tingling, numbness or muscle cramps. Patients feel the need to repeatedly squeeze the affected tissue. To treat cylinder distortions, the affected tissue is stretched or compressed. Stretching plus rotating the affected area i.e. “Squeegee-technique” is effective, as is cupping (an acupuncture technique).
- Tectonic fixation- The fascial surface loses its ability to properly glide, due to the loss of fluid between two structures. The two layers of fascia stick together like magnets. This distortion is common in joints throughout of the body. The patient affected by tectonic fixation will express that their back needs to be cracked. These are treated with thrust manipulation.
Assessing Fascial Distortions is done through:
- Range of motion
- Muscle testing
Fascia is probably one of the least understood tissues in the body, whose clinical significance is often ignored.
Treating Fascial Distortions can often yield dramatic results in a minimal amount of time. It is effective for both acute and chronic injuries and can be an effective tool for helping athletes return to play quicker than conventional rehabilitation.