Fascia and its relationship with pain

Apr 8th, 2011

Comments: 17
Category: Massage Therapy

Fascia and its relationship with pain

What is Fascia?

Fascia is a continuous web of connective tissue that exists throughout your body. Your muscles, tendons, ligaments, bones, and organs are connected through this web, binding these structures together and creating a three-dimensional matrix that connects you from the top of your head to the tips of your toes. It consists of several layers: a superficial fascia, a deep fascia, and a subserous fascia. For the purpose of this discussion, I will talk about deep fascia.

Deep fasciae are tough, dense connective tissues surrounding individual muscle fibers, muscle bundles, and groups of muscles. Fascia shares many of the same properties as muscle, allowing it to contract, relax, and hold tension, just like muscle tissue. Fascial tissues are full of nerves — including sensory receptors to detect pain — and also play an important role in movement derived from muscles, tendons, and joints (proprioception).

Imagine plastic wrap. Your muscles are wrapped tightly in multiple directions by these fasciae. The interconnected nature of fasciae means tightness in one area of your body can be directly connected to painful areas in a completely different area.

What is fascial pain?

Healthy fasciae are relaxed, pliable, elastic and flexible. When you are healthy, your fasciae can absorb the forces that are created when you move.

With trauma or repetitive use injury, adhesions and scar tissue form in the fasciae. When you experience trauma — from a fall or accident or through repetitive strain — the surrounding areas become tight and restricted, affecting range of motion and stability throughout the body. Points of restriction in the fasciae place pressure on nerves, bones, muscles, and adjacent fasciae, causing chronic pain.

Fascial pain is probably the most common cause of musculoskeletal pain (Imamura et al 1997 as cited by Starlanyl and Copeland 1996, Starlanyl 2003, and Javaid 2010). If you are experiencing acute or chronic pain, fascial dysfunction may be the underlying cause of your symptoms.

Deep Tissue Fascial Massage

Deep tissue fascial massage therapy is a form of soft tissue therapy used to treat pain and restore range of motion. This is accomplished using traction, stretching or direct pressure; relaxing contracted muscles; increasing circulation; increasing venous and lymphatic drainage; and stimulating the stretch reflex of muscles and overlying fasciae.

The end result is fasciae that are softened and stretched, with the release of painful knots.

References

Imamura, S.T., T.Y. Lin, M.J. Yriyrits, S.S. Fischer, R.J. Azze, L. A. Rosgano and R. Mahar. 1997. The importance of myofascial pain syndrome in reflex sympathetic dystrophy.” Physical Medicine and Rehabitation Clinics of North America. 8:207-211.

Javaid, Ahmad. Myofascial pain: Understanding the Injury Process. 2010. http://ahmadjavaid.com/myofascial%20pain.htm

Starlanyi, Devin J., and Mary Ellen Copeland, Fibromyalgia and Chronic Myofascial Pain Syndrome: A Survival Manual. 2001. Fibromyalgia and Chronic Myofascial Pain Syndrome: A Survival Manual. http://www.friendswithfibro.org/mps.html

Starlanyi, Devin. 2003. Fibromyalgia and Chronic Myofascial Pain: Keys to Diagnosis and Treatment. http://homepages.sover.net/~devstar/physinfo.htm

Ward, Patrick. 2010. Notes on Fascia. http://optimumsportsperformance.com/blog/?p=133
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DISCUSSION 17 Comments

  1. Self Treatment For Plantar Fasciitis - The Art of Fitness | The Art of Fitness - Austin Deep Tissue Massage Therapy July 28, 2011 at 7:21 am

    [...] fasciitis is caused by stress to the soft tissue that supports the arch of the foot. It is possible to develop plantar fasciitis from an acute [...]

  2. Free Your Feet By Jesse James Retherford | The Art of Fitness - Austin Deep Tissue Massage Therapy August 10, 2011 at 10:33 pm

    [...] conditions of the knees, hips, low back, shoulders, and neck can all be traced through the fascial tissue down to the feet. I believe that foot health is one of, if not the biggest, determining factor of [...]

  3. Heel Strike Compared To Forefoot Strike Gait Pattern And How It Relates To Pain By Jesse James Retherford | The Art of Fitness - Austin Deep Tissue Massage Therapy August 18, 2011 at 2:23 pm

    [...] the local area of a client’s complaint; I address the structure of the whole body. I look for dysfunctional fascial tissue and assess the underlying postural movement patterns that cause them. By addressing the underlying [...]

  4. An Exploration of Barefoot Walking and Running Gait By Jesse James Retherford | The Art of Fitness - Austin Deep Tissue Massage Therapy August 25, 2011 at 6:57 pm

    [...] of running in shoes with a heel strike leads to dysfunctional gait patterns — and ultimately chronic pain and injury — what does it do when walking, such as speed walking or walking with a [...]

  5. What is Posture | The Art of Fitness - Austin Deep Tissue Massage Therapy August 31, 2011 at 6:55 pm

    [...] What provides that shape is a highly complex system of bones, muscles, tendons, ligaments, and fascia that provides stability, strength and coordination to the [...]

  6. The Foundation of Your Posture | Injury Prevention Begins at Your Foot | The Art of Fitness - Austin Deep Tissue Massage Therapy September 12, 2011 at 2:37 pm

    [...] fitness. The program I use with my clients involves deep tissue massage therapy with a focus on the fascial system, self-massage using a foam roller, flexibility training, corrective exercise, functional strength [...]

  7. You Cannot Control Your Posture - The Art of Fitness | The Art of Fitness - Austin Deep Tissue Massage Therapy September 16, 2011 at 8:42 am

    [...] How did we get here? The human body is awe-inspiring. It is capable of moving with speed, power, agility, stamina, and grace — in an amazingly wide range of motions. It is also capable of adapting to the demands that are placed upon it. Unfortunately, most of us no longer move the way our body was designed to move.  We weren’t trained to.  The training grounds that once shaped The Human Body no longer exist. What we have instead are cars, couches, computers and ergonomic chairs. These are the new “training grounds” and our body has adapted to them well.  For many, it has adapted too well. In this training we sit for long hours each day. We do not utilize movement that engages our postural system the way it was designed to be engaged. Over time, these muscles become weak. They atrophy. They fall asleep and quit functioning. They no longer provide the essential stabilization that is so important to movement. In time, our body adapts to this new environment and develops bad habits.  The most prominent example is the recruitment of mobile muscles to provide stability. Let’s revisit the analogy of driving your car with the brakes and the gas pedals pressed down at the same time. How well would your car move? Not well at all.  Driving like this is extremely damaging to the car.  The same is true for your body.  The pain you feel in your body is the indicator light telling you “stop driving and visit a mechanic.” A mechanic in this sense would be a “body” mechanic, a deep tissue massage therapist, postural movement coach, or physical therapist. I recommend somebody with advanced knowledge and experience with the fascial system and how it relates to pain. [...]

  8. La Scapulara: The Mast and Sails of the Body | The Art of Fitness - Austin Deep Tissue Massage Therapy September 26, 2011 at 12:05 pm

    [...] most important step to increasing the functional range of motion of the shoulder joint is through myofascial massage therapy. And deep tissue massage therapy (such as myofascial release and self-myofascial release), when [...]

  9. Not Just Any Movement, You Need Functional Movement | The Art of Fitness - Austin Deep Tissue Massage Therapy October 9, 2011 at 8:38 pm

    [...] you lose it One of the reasons your body is so special is its ability to heal itself. Within your fascial tissue are cells that create fascial adhesions around an injury to provide extra stability and restrict [...]

  10. Looking Back and Looking Forward to the New Year - By Maria | The Art of Fitness - Austin Deep Tissue Massage Therapy January 2, 2012 at 8:56 am

    [...] to be able to do squats and knee bends but that I didn’t think that was possible.  He explained myofascial massage, scar tissue formation, and that humans did in fact lose muscle as they aged, but that muscle can be regained. Family [...]

  11. Six Week Walking Program – Transition to Running | The Art of Fitness - Austin Deep Tissue Massage Therapy January 9, 2012 at 1:32 pm

    [...] takes eight weeks for your muscles to adapt to a new conditioning program. It takes years for your fascia to adapt. By incorporating self massage using a foam roller, deep tissue massage therapy, [...]

  12. Twelve Week Running Program For An Injury Free Barefoot/Minimalist Transition | The Art of Fitness - Austin Deep Tissue Massage Therapy January 15, 2012 at 9:56 pm

    [...] takes eight weeks for your muscles to adapt to a new conditioning program. It takes years for your fascia to adapt. By incorporating self massage using a foam roller, deep tissue massage therapy, [...]

  13. My Personal Story of Pain | The Art of Fitness - Austin Deep Tissue Massage Therapy February 19, 2012 at 1:02 pm

    [...] of deeper issues.  They reflect how we feel on the inside. This is why I specialize in the treatment of chronic pain. I focus my massage and personal training that I might help my clients feel better. I teach them a [...]

  14. Five Steps to Choosing a Massage Professional | The Art of Fitness - Austin Deep Tissue Massage Therapy February 25, 2012 at 9:47 am

    [...] specialize in deep tissue massage with a focus on improving posture by working on the fascial system. I have had success with the majority of my clients. Yet from time to time there are the occasional [...]

  15. The Hips - The Body's Ballast - The Art of Fitness | The Art of Fitness - Austin Deep Tissue Massage Therapy February 25, 2012 at 9:50 am

    [...] This can be accomplished through the use of deep tissue massage therapy with a focus on the fascial system, self-massage using a foam roller, flexibility training, corrective exercise, functional strength [...]

  16. Jesse James Retherford Interview- Barefoot Running | Barefoot Running Reviews April 16, 2012 at 6:18 pm

    [...] Painful conditions of the knees, hips, low back, shoulders, and neck can all be traced through the fascial tissue down to weakness and instability in the feet.  I believe that a lack of foot health is one of, if [...]

  17. A Common Cause of Low Back and Sciatic Pain - The Piriformis | Tao Fit July 8, 2014 at 4:35 pm

    [...]  most common characteristic I find are aggravated myofascial trigger points (TrPs) in the piriformis muscle.  Piriformis trigger points are often confused for [...]

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