Fascia has been fashionable over the past few years. Whether you heard it from fitness or therapy professionals, fascia is the new catch term, one that must be used in every possible instance. Yet using a term ad-nauseam doesn’t mean it’s properly understood or applied.
Proof of it is the broad belief that fascia is the sole realm of the musculoskeletal world. “Yes, I’ve had my fascia treated before,” many of my new clients often tell me. “I work my muscles with the foam roller,” they say, as I disguise my cringing.
The realm of fascia does apply to the musculoskeletal world, but rarely are muscles the main culprit as it’s popularly preached. You may review this article for an illustrated explanation of a common affliction in active folks: The infamously tight IT-Band. After treating hundreds of such complaints, only twice have I found the actual IT-Band to be the cause. You will soon learn why.
The musculoskeletal fascia may receive the glamour but it seldom is the focus of the Fascial-Counterstrainer. That’s because we acknowledge that the domain of fascia reaches beyond those popular layers.
Fascia connects us from head to toe and vice versa. It attaches nerves and circulatory vessels to organs, muscular structures, and to each other. It anchors organs to each other and to the musculo-skeletal layers. Fascia determines the shape and merging of all structures. Fascia is the largest living organ in our bodies—not the skin.
This was observed by Robert Schleip, MA, of the European Rolfing Association, in his article Fascial plasticity – a new neurobiological explanation: Part 1 (January 2003 Volume 7, Issue 1, Pages 11–19) in the Journal of Bodywork and Movement Therapies. His article is one of many that help us better grasp the depths of the fascial world.
Can you see why it is futile to think of fascia as the inert sheath we peel off and discard to have full view of muscles we’re enamored with?
When Counterstrainers speak of fascia, they mean the tunica adventitia—the fascial layer on the arterial and the venous systems. Or the epineurium/perineurium of the nervous system. Or the dura mater in the dural tube system. Or the periosteum in the connective tissue of joints, ligaments, and tendons, or—as discovered lately—the fibrous connections in the synathroidal joints of the cranium, the Sharpey fibers, erroneously believed to be a rigid structure. Or they could mean the peritoneum, mesenteric root, or other organ anchors in the visceral system.
Arterial Tissue Layers showing the tunica externa (adventitia) – Blausen.com staff. “Blausen gallery 2014”. Wikiversity Journal of Medicine. DOI:10.15347/wjm/2014.010. ISSN 20018762. – Own work
Those are the fascial structures the Fascial-Counterstrainer aims for when performing manual therapy, using muscles and other tissues as conduits for indirect treatment.
And why this obsession with the deeper layers of fascia?
Because these deep layers may cause or contribute to several conditions attributed to the musculoskeletal system. Fascia is alive and reacts to mechanical and chemical stimuli via abundant type III and type IV nerve terminals. The work of Robert Schleip, MA, shows us that the shape of fascia is not capricious. But he wasn’t the only one to make those observations nor was he the first.
In 1996, the article Dissection of the deep fascia of the leg with reference to epi-fascial and intra-fascial nerves (English translation) written by J. Straubesand in the Manuelle Medizin (1996: 34. 196-200) pointed at evidence of smooth muscle cells in the matrix of the collagen fibers of the crural fascia. In 1993, LH Yahia published the article Viscoelastic properties of the human lumbodorsal fascia in the Journal of Biomedical Engineering (J Biomed Eng. 1993 Sep;15(5):425-9) in which she observed the responses of fascia to prolonged tension.
These articles made key revelations. They showed that fascial cells contain myofibroblasts—yes, specialized muscular tissue—connected to a lattice-shaped structure that enables contraction. When sustained as a protective mechanism, this contraction creates dysfunctions that perpetuate conditions.
This contraction reaches past the fascial level. It affects neighboring fascial layers, adjacent nerves and circulatory vessels, organs, and yes, muscular tissue. A good example is how releasing the fascia in the tibial and calcaneal arteries—located in the ankle joint neighborhood—can resolve stubborn issues of tight hips and weak glutes.
This phenomenon is a far cry from the standard train of thought which sees local muscular tightness/hypertonicity as the cause. Here’s some food for thought: Yahia’s work showed that fascia fought stretching! The more elongation it received, the more it contracted to resist it. Does it surprise you I detest stretching as the default modality to address chronically tight structures?
I’m grateful to the scientific researchers whose collaborative efforts created the International Fascia Congress in 2007. They understood the vital role of fascia and their contributions have been invaluable.
Now, before you believe that embracing the role of fascia is a gift of modern medicine, you should analyze this quote:
“I know of no part of the body that equals the fascia as a hunting ground. I believe that more rich golden thoughts will appear in the mind’s eye as the study of the fascia is pursued, more than any other division of the body.”
A.T. Still, DO, MD
Care to guess when it was published? The late 1800s! It’s from the book Philosophy of Osteopathy, by Doctor Andrew Taylor Still. His ideas met resistance but the father of Osteopathic medicine was ahead of his time.
It is your choice how to proceed as a therapist or patient: Acknowledge the role of deep fascia and improve your success rate, or ignore it to focus on the symptoms and meet failure. No treatment can be complete without recognizing the power and beauty of deep fascia.
Fascial contraction is not capricious—it is only a response to the higher commands of reflex arcs. And it is the nature of protective reflex arcs what we address in this article.
Until next time, may you enjoy a fit and pain-free life!