SO WHAT IS FASCIA?

Fascia is a connective tissue whose role is to support our bodies. It attaches to, surrounds, and links our muscles, nerves, bones, blood vessels, and organs. It can be superficial (directly under your skin) or deep, and its fibers blend with your skin, muscles, bones… It is made of collagen fibers, which are tough and hard to stretch, as well as elastin fibers, which are much more stretchable. It runs from the top of your head to the tip of your toes, which is why a restriction in one area can create tension on the fascia in another. You can picture it as a wool sweater: if you pull on one side of the sweater toward the waist, you will be feeling a lot of pulling and tension around your neck on the opposite side.

At FlowState Seattle Massage, we have therapists trained in this field with experience working with this system.

The majority of people suffering from pain and lack of motion could have fascial restrictions and are not diagnosed at all, often accepting the dreaded “you are gonna have to live with this”.

The fascial restrictions dilemma

Part of the problem is that myofascial restrictions are not picked up and don’t show on imaging tests such as X-ray, MRI, and CAT scan, and the patient is being left with no diagnosis/cause for their pain and symptoms. Most physical and massage therapists are also not trained in assessing the myofascial system and often, fascial restrictions remain even after a round of physical therapy treatments.

The myofascial system plays an important role in supporting and defining the shape of your body. There exists a high concentration of fascial tissue around your diaphragm (your breathing muscle), your pelvis, the base of your skull, and at the top of your thoracic cavity, which is the top of your rib cage, base of your neck, around your collarbone, and your top ribs.

Normally, your fascia can move and stretch without restrictions, and create room for your nerves, blood, and lymphatic vessels to run through your body to go from one point to another. Fascia is innervated, therefore a possible pain generator, and a large number of mechanoreceptors are also found in myofascial tissue, which proves the fascial system has an important sensory role.

Patients often describe a dull, aching and deep pain that can go from low grade to severe, and they often feel that their pain is affected by different part of their body.

WHAT HAPPENS WHEN FASCIA IS RESTRICTED?

With injury (big or small), mental or physical trauma, mental and/or physical stress, or inflammation, or even improper hydration, restrictions in the fascia occur.

Scar tissue is formed, hardens, and creates tension and pressure on the fascia and the structures it attaches to. These restrictions can be local to the site of injury or exert tension and pressure on areas further in the body that might not seem related at all to the location of the trauma.

For example, I have treated multiple patients with complaints of back pain that did not improve until myofascial release was performed over their abdominal cavities. These patients all had one thing in common: abdominal surgeries, or cumulative mental stress that has become chronic. Often affecting or pulling on organs and sometimes creating systemic tensions as the fascia tries to keep the body together, holding for dear life.

Issues like surgery create scarring, which promotes the formation of disorganized fibrous tissue, aka fascia, which then starts to pull the joints; often the low back, neck, and IT bands are the joints that feel the tension first, as these are areas with the most fascia.

Accumulative stress increases cortisol, which creates congestion in the lymph system and thus tension over the myofascial structure. Anytime there is congestion anywhere in the body, the fascia feels the effects first, as it has an incredible number of nerve endings compared to muscle.

These are a few examples of how chronic pain-suffering patients could be misdiagnosed and go for years with their symptoms and complaints with no one addressing the real source of their problem.

MYOFASCIAL RELEASE AS TREATMENT

Myofascial release is the treatment of choice for fascial restrictions. Even though the practitioner uses both hands in a skin to skin contact manner, it is very different than a standard massage: it uses slow, sustained light pressure and stretching techniques to release these restrictions. You may also be treated in areas that seem unrelated to where you feel the primary symptom.

Many clients notice a difference after just one session. Others need a series of treatments to unwind years of accumulated tension — both are completely normal.

I would encourage any new or returning client to seek care from a practitioner trained in myofascial release—especially if you have been treated elsewhere and your symptoms have not fully resolved.