Ever feel tight or stiff? It may not be your muscles, but your fascia!
Fascia (pronounced FASH-a) is thin, strong connective tissue surrounding all structures within the body. It consists of several layers – superficial fascia is situated under the skin whilst the deeper tissue surrounds muscles and connects the whole body.
Close up view of the fascia
Deep fascia covers the muscles in 14 distinctive patterns and is further divided into epimysium, which cover the muscles, perimysium, covering muscle bundles, and endomysium, covering individual muscle fibres. Its structure allows it to support other inter-connected parts (such as muscle, bone and organs), resulting in proper alignment:
(a) As it connects the whole body, there is co-ordinated movement throughout the body, with smooth motion between muscles;
(c) The fascia protects the bodily structures against external forces; and
(d) It also has sensory properties, contributing to the way pain is perceived and your body’s awareness of its position in space.
How does this vital tissue get damaged?
Fascia can degenerate and become problematic for various reasons. These causes can include mechanical injuries, both acute and chronic.
- Acute injuries can include sprains, fractures and direct trauma.
- Chronic injuries can include overuse injuries or poor posture.
- Physical causes include extreme temperatures or mental strain.
- Chemical causes include nutritional imbalances or hormonal changes.
- Infection or metabolic issues can result in fascial dysfunction.
- Insufficient movement or exercise can result in abnormal fascial lines.
- Fascial gliding can also be restricted by muscle overuse or sustained muscle contraction.
How can physiotherapists treat fascia?
Physiotherapists treat fascia with the aim of reducing pain and improving mobility, as well as function. They use techniques such as Myofascial release (MFR) and Fascial manipulation (FM) to achieve these goals.
MFR is a direct technique where the physiotherapist gives gentle sustained pressure and stretching to fascia to release restrictions within the fibres. It results in the fascial fibres unravelling and restoring the muscular/fascial balance. This improves tissue mobility and flexibility.
During FM, physiotherapists target specific areas along the fascial lines and apply deep pressure to the areas to restore the glide of the tissue.
Physiotherapists can also make use of other techniques to restore normal movement and minimise pain. These include techniques such as:
- Trigger point therapy, focusing on “knots” causing local or referred pain;
- Dry needling, where a thin needle is inserted into trigger points;
- Stretching and movement therapy, such as static and dynamic stretches; and
- Kinesiology taping, where fascia is supported without restricting movement.
References
Takei, H. Manual Physiotherapy of Fascia-Introduction to Myofascial Release and Fascial Manipulation.