More than 1 in 5 adults in the US experience chronic pain daily. I’m guessing you probably know someone included in that statistic. Maybe it’s even you and your own body. There is in fact a lot we do know about pain including the pathophysiological mechanisms and contributing factors, however, most of the time we only think about muscles and nerves when it comes to pain. But what about your living, breathing, full bodysuit called fascia? Didn’t think about that one, huh? Don’t worry you’re not the only one ;)
What is fascia?
Fascia is the connective tissue that surrounds our muscles, nerves, and blood vessels to help keep everything in place. Although the fascial network is an incredibly efficient container system for the body, it is not static. You can think of your fascia more like long thin socks or women’s tights than a Tupperware container. It is thin and flexible and moves with your muscles, joints, and nerves. This fibrous tissue is made of collagen fibers that can withstand unidirectional pressure and force (ie. stretching your arm overhead). The interesting thing about fascia is that it is filled with sensory nerve fibers. Our sensitive fascia is home to many tiny receptors that are constantly sending information to the brain and spinal cord. Given the information that the brain receives, your brain will interpret that information to help you understand where your body is in space and how it should move and react to certain environmental factors. Sometimes, however, when there is fascial dysfunction that same information gets interpreted as pain. Yes, you read that right. The pain you feel is actually your brains interpretation of something going wrong inside of the body. And sometimes the thing that is wrong is coming directly from your fascia.
Why are you experiencing pain from your fascia?
Healthy fascia is able to slide and glide with our muscles and joints during movement. When our fascia moves freely with the rest of the body, the brain picks up that information and interprets it as “normal”, so we don’t feel any pain. However, sometimes fascia gets sticky and tight, like clear nail polish on women’s tights (ladies you know what I’m talking about!). Physically, fascia can become tight for many reasons including: sitting in one position for a long period of time, poor posture, physical or emotional trauma, chronic inflammation, connective tissue disorders etc. This thickening or shortening of the fascia is called fascial dysfunction and is a common contributing factor to pain.
Ways to manage fascial dysfunction & pain:
· One of the best ways to soften fascia and bring it back to its normal pliable self is through myofascial release. Myofascial release is a specific massage technique performed by your physical therapist that specifically targets the fascia rather than muscles. This can be done anywhere in the body including the abdomen and pelvic floor!
· Ok, as a former dancer, this one’s my favorite. Foam rolling! Simple foam rolling or massage balls are excellent ways to release fascial tension and promote healthy sliding and gliding of the fascial tissue in the body. This is a quick and easy method you can perform on yourself at home to directly target your fascia.
· More specific techniques that soften fascia and can be offered by your physical therapist are cupping and instrument assisted soft tissue mobilization. Both techniques are excellent tools used to target fascial restrictions and can help reduce pain.
·Exercise. Yes, moving our body actually helps to stretch and contract fascial tissue which can loosen any tight spots and promote blood flow to the restricted area. All forms of exercise work great as long as they do not cause any pain.
Although fascial release techniques are helpful tools to relieve pain, there is very little scientific evidence that supports the use of these techniques for chronic pain. From what I’ve read and researched, there is greater evidence for active exercise to relieve pain as compared to passive treatments like myofascial release.
My clinical opinion: If you are experiencing pain, it’s important to remember your fascia. A well-rounded therapy session should be comprised of both active exercises and passive treatments like foam rolling, cupping etc. From my experience, each body requires a specific combination of exercise and manual therapy to feel better from pain. Some people do get better from treatments with 75% passive and 25% active treatments, where others are the complete opposite and require much more activity built into their program. Either way, a moderate combination of the two can help relieve pain and your therapist should determine the right recipe for your body.
Thanks for reading! Leave a comment with any questions or thoughts.
With light,
Dana
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