I spend a lot of time these days talking about fascia. I study fascia, I work with fascia, I am a big ol’ fascia geek, and I could make the argument that your fascia is the most important system in your body. Yet four years ago I had never heard of the stuff, and even three years ago – when I was about to enter massage school, and had already been seeing a myofascial release (MFR) therapist for six months – I had only the vaguest understanding of it. So I can empathize with those who find my fascia fixation confusing.
The challenge in explaining fascia is that it is so utterly omnipresent in our anatomy, intertwined and interacting with absolutely everything, that it’s almost simpler to consider the question, “What isn’t fascia?” (Answer: not much.) But I do get asked this a lot, so here is my best effort at summing up what fascia is, what it does, and why it gets so much of my attention.
To begin with, fascia is connective tissue in the most literal sense, in that it connects every cell of your body to all the surrounding cells. A layer of fascia wraps around every structure in your body (every bone, every muscle, every organ, every blood vessel, etc.) and anchors it to the neighboring structures. Taken all together, fascia forms a continuous three-dimensional web throughout the entire body, that gives the body its structural integrity. Perhaps you’ve seen an illustration of human musculature, showing the body without skin? Remove fascia from that diagram and you’d be looking at a pile of goo. In utero, fascia is the very first body system to develop; at only two weeks of gestation, when what will eventually be a baby is still just a cluster of cells, fascia forms and effectively casts a net around and through those cells, providing a flexible scaffolding within which other physical structures will take shape.
And although it can be microscopically small, fascia is strong stuff. It has a tensile strength of about 2000 pounds per square inch, similar to that of a radial tire. That statistic still sort of blows my mind, but when you consider that fascia is really what keeps us in one piece, well, let’s just be thankful it’s so strong.
Fascia can tense and relax like muscles can, and responds to both physical and emotional stimuli. (Ever noticed how your body tenses up when you’re under emotional stress? This is largely why. You might think a sentiment like “I have to hold it together!” is metaphorical, but your fascia interprets it literally and tightens in response.) In healthy tissue, the fascia is constantly in motion, rearranging itself as needed to allow body structures to slip and slide against each other. But when fascial restrictions form, that motion gets arrested, and parts that should slide against each other freely instead get stuck together. If you’ve ever felt a muscle knot, that’s an adhesion between separate layers of fascia that have temporarily become fused.
The reason this can happen – as well as the reason MFR is effective – is that fascia is thixotropic. Which is to say, healthy fascia has a gel-like consistency, but when it’s traumatized, or gets too cold or dehydrated, it will solidify and become very sticky. When heat or pressure are applied, it will gradually liquefy again and regain its ability to move. Those who have experienced MFR know that the work progresses very slowly, using long, sustained holds and pulls. Thixotropy is what that’s all about; heat and pressure from the therapist’s hands can, bit by bit, soften stuck fascia, allowing it to unstick itself. Which is lucky, because given the tensile strength I mentioned earlier, a therapist can’t force her way through restricted fascia without doing considerable damage. But I can warm and gently stretch the fascia, and over time it will release itself.
In the term “myofascial release,” that “myo-” root means the fascia associated with muscles. Every individual muscle cell is surrounded by fascia. The cells are bundled together into fascicles, and every fascicle is wrapped in a layer of fascia. The fascicles are bundled into the muscle as a whole, which in turn is wrapped in another layer of fascia, which then fuses into the tendon attaching the muscle to bone. So your myofascia encompasses the entirety of your muscles, from outermost sheath down to every tiny cell, and it’s impossible to work on muscles in any way without also working on the fascia. The thixotropy of fascia and its presence throughout the musculature can also explain a lot of phenomena you’ve probably noticed about your muscles, such as why you feel stiff when you get very cold, and why muscles loosen with heat.
As a massage therapist, then, while it is of course important for me to know which muscles are responsible for which movements and where those muscles attach, it’s arguably more important that I understand fascia. How fascia behaves, how to soften it, and where it tends to be thickest, factor into almost every decision I make while putting my hands on a client, whether that client has come to me for simple relaxation or for relief from serious pain. From the bodyworker’s perspective, fascia is everywhere and everything.