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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