What is Fascia?

“Fascia is a thin casing of connective tissue that surrounds and holds every organ, blood vessel, bone, nerve fiber and muscle in place. The tissue does more than provide internal structure; fascia has nerves that make it almost as sensitive as skin. When stressed, it tightens up” (Johns Hopkins Medicine, 2022). You’re likely already familiar with the skeletal system and the muscular system. The skeletal system consists of our bones, and the muscular system consists of our muscles. Together, this is referred to as the musculo-skeletal system. A lesser known system is the fascia system. The fascia system is what connects the muscles and bones together! 

What Does Fascia Do?

Fascia is a layer of connective tissue that contains hyaluronan (hyaluronic acid). This is what helps reduce friction between the skin and your muscles, and it allows your muscles to glide smoothly and for your joints to move freely. Essentially, fascia is what “permeates the body and enables all body systems to operate in an integrated manner” (Zügel et al., 2018). As we age, the proportion of hyaluronan in the body decreases and the connective tissue becomes more immobile (Zullo et al., 2020). One way to think about fascia is to picture a spider web with dew on it in the morning. The dew is similar to the hyaluronan and allows for movement. This is how fascia in a young, healthy, active person would look. Conversely, you can picture a dusty, old spider web in a basement - just dried out and sticky. As we age, our bodies tend to tighten up and get a little stiff - especially the more inactive we are. So this is an example of how tight and stiff everything can feel since it’s not coated with as much “dew” to keep it moving freely.     

Fascia is also highly innervated with sensory nerves and contains four types of sensory nerve endings: the Golgi organs, Ruffini receptors, Pacini corpuscles, and Interstitial receptors. (Schleip, 2017). Because this tissue is so highly innervated with nerve endings, fascia has 6-10 times more sensory nerves than motor fibers within the muscles! Furthermore, when fascia tightens up, it can cause a lot of pain, create all kinds of muscular imbalances, and lead to restrictions in range of motion. Think of how honey or molasses makes everything it touches sticky. Similarly, when the fascia surrounding your muscles and bones tightens up or gets “sticky” due to injuries or just a sedentary lifestyle, it hinders your muscles from gliding easily and instead of having freely moving joints, you feel tight and may even have some jerky, robot-like movements. 

Interestingly, if you feel pain in a certain area, it may not necessarily be the root cause of the pain (especially if it is an older injury) due to secondary compensations. For example, if the fascia surrounding one of your hips is tight, this may eventually show up as low back pain, shoulder pain, neck pain, and potentially reduced range of motion of the shoulder joint due to the anterior and/or lateral tilt depending on where the tightness is. In addition, since everything is integrated and works synergistically, when you move one way, other muscles and joints move along up and down the entire chain to complete the intended motion. An example of this is bending down to touch your toes. The muscles all along your entire posterior chain either allows this to happen or not - depending on your flexibility. This is why it’s so important to move and stretch your ENTIRE body in a variety of ways to reduce stickiness of the fascia tissue and make sure to keep everything loose, gliding freely, and as mobile as possible.     

How Can I Help My Fascia? 

Movement, in a variety of forms, will help prevent your fascia from getting “sticky”! Going out for a walk, run, or bike ride, lifting weights, yoga, foam rolling, massage, or stretching are just some examples to increase blood flow, promote fluid changes, and create space in and around the fascia. It’s even better if you can move your joints through the full pain-free range of motion to maintain and possibly even increase mobility of the joints. Better improvements in motion create better movement or gliding of the fascia! This is why it’s important to stretch or loosen up the affected area(s) and create space between the area(s) of tissue that have become dense. 

Finally, when you stretch and increase the range of motion in your joints, you’re not only allowing the layers of fascia to glide better and create space between the layers of tissue, but you are changing your brain’s perception of what pain is (Støve, 2021). Especially if you have chronic pain, you often feel better after a good workout or a good stretch because any pain during the activity is the counter-irritant from the typical pain. You are changing the interpretation of the pain signals, your perception of pain is changed the more you work and/or stretch your muscles, and because the pain feels different you may even be able to tolerate the typical pain better or even ignore it completely. Therefore, proper hydration, proper sleeping habits, proper nutrition, and proper movement all work together to keep the fascia healthy and gliding well as we age!

The fascia system is a lesser-known system throughout the body, but it is responsible for holding everything in your body in the proper place. It’s important to keep this system healthy because without it working properly or getting too stiff, you wouldn’t be able to move as freely or as easily. Maintaining a healthy fascia system involves keeping the tissue properly hydrated through adequate water intake, getting enough sleep, healthy eating habits, movement or physical activity, and creating space through stretching. All of these healthy habits can help to increase flexibility and mobility and decrease any painful, dense areas of tissue. So make a plan to move and stretch everyday (if you’re not already doing this on your own, definitely reach out and let me help you with a full-body assisted-stretch!) to keep the fascia gliding properly and improve your mobility by allowing your joints to move freely! 

References:

Johns Hopkins Medicine. (2022). Muscle Pain: It May Actually Be Your Fascia. Retrieved from: https://www.hopkinsmedicine.org/health/wellness-and-prevention/muscle-pain-it-may-actually-be-your-fascia#:~:text=Fascia%20is%20a%20thin%20casing,almost%20as%20sensitive%20as%20skin.  

Schleip, Robert. (2017). Fascia as a sensory organ: Clinical Applications. Terra rosa e-mag. 20. 2-7. Retrieved from: https://www.researchgate.net/publication/319182467_FASCIA_AS_A_SENSORY_ORGAN_Clinical_Applications 

Støve, M. P., Hirata, R. P., & Palsson, T. S. (2021). The tolerance to stretch is linked with endogenous modulation of pain. Scandinavian journal of pain, 21(2), 355–363. https://doi.org/10.1515/sjpain-2020-0010 

Zügel, M., Maganaris, C. N., Wilke, J., Jurkat-Rott, K., Klingler, W., Wearing, S. C., Findley, T., Barbe, M. F., Steinacker, J. M., Vleeming, A., Bloch, W., Schleip, R., & Hodges, P. W. (2018). Fascial tissue research in sports medicine: from molecules to tissue adaptation, injury and diagnostics: consensus statement. British journal of sports medicine, 52(23), 1497. https://doi.org/10.1136/bjsports-2018-099308     

Zullo, A., Fleckenstein, J., Schleip, R., Hoppe, K., Wearing, S., & Klingler, W. (2020). Structural and Functional Changes in the Coupling of Fascial Tissue, Skeletal Muscle, and Nerves During Aging. Frontiers in physiology, 11, 592. https://doi.org/10.3389/fphys.2020.00592