Fascia has a lot of explaining to do when it comes to chronic pain!

Close-up photo of living fascia - cross-linking strands containing droplets of water

Living fascia in the body, magnified many times

Fascia (pronounced fash-ya) is the connective tissue that holds and connects all the structures in our body.  Fine, strong and flexible strands constantly divide and re-join in a watery world to form an immense, fluid network that is vital in allowing us to move and to protect ourselves.

Specialised fascia forms tendons and ligaments, like the tough, fibrous sheets you find in meat, as well as the ‘bags’ that hold our organs together.  Other fascia is so fine it’s only visible under an electron-microscope; from 2 minutes in, this video  shows ‘myo’ or muscle fascia moving in the living body.

Fascia gives us bounce and protection

Fascia acts as a sort of elastic cushion to spread the effect of movement, non-movement, illness and injury around the body, like the ripples when you throw a stone into a pond.  But this also means it holds a ‘memory’ of everything we do, somewhere in its structure, in the form of restrictions.  These are literally areas (microscopic in most cases) where strands of fascia have got stuck together.

A small tent in a field, squashed on one side with bulges and pulls on the other

A collapsed tent illustrates the effect of injury on fascia

Then, because this is just one, continuous structure through the body, it changes the tension of the rest of the fascia, causing pulls and snags in other places.  Rather like a tent sagging when one pole breaks in a high wind.

And the reason fascia has such a lot to do with pain?  The simple explanation is that fascia has a strength of up to 2,000lbs per square inch.  Tight, stuck fascia puts an incredible pressure on crucial structures such as blood vessels and nerves and unless released (wild animals do this by shaking themselves after a shock or trauma) it triggers changes that tighten things up even more.

Fascia ‘remembers’ everything that happens to us

Fascia is particularly sensitive to chemical changes caused by the balance of our stress and de-stress hormones. An un-relenting build-up of chronic stress from poor posture, a stressful job, too much or not enough exercise, inflammatory foods, or constant arguments with a partner, will de-hydrate the fascia and make it stickier and tighter, making it in turn more susceptible to injury.

A man in a suit tries to stagger forward but a net of fibres holds him back

Is stuck fascia holding you back?

Most people with chronic pain will have suffered a major trauma of some kind, maybe a car accident, a close bereavement, or ill-treatment in childhood.  Whether the chronic, smaller restrictions have built up before or after this trauma, together they have such an effect on the fascia that it simply can’t unstick any more.  A cycle develops with more chemical changes, causing sluggish digestion, shallow breathing, brain fog, tiredness and (of course! –  there are lots of tight spots!) pain. The structure is gluey and sluggish and communication gets confused, often meaning that pain is constant and appears in places that seem to have no connection with each other.  Natural lines of fascial tension mean that a twisted ankle can be the final straw that triggers a frozen shoulder or nagging headaches!  There’s also a whole thing about how the brain perceives pain and many other factors that I won’t go into here.

Fascia’s role, evidence-based

We know this about fascia because some very clever and sensible anatomists have studied, in depth, a structure that has been known for many decades to touch and affect the whole body and are constantly making new discoveries about how it works.  Unfortunately, the modern medical profession tends to break the body down into ‘systems’ – circulatory, musculo-skeletal etc, ‘parts’ – heart, hand, hip etc, and into symptoms, because they are easier to understand and ‘treat’.  Fantastic if your appendix bursts, you develop angina, or you need a cancerous lump removing and, of course, modern medicine has saved countless lives.  But then how does the body cope with the resultant scarring, and the side effects of the drugs?  And what, in the ‘whole body’, triggered these things in the first place?

When fascia is healthy it helps to protect us from many types of trauma and stress, both physical and emotional.  A whole combination of factors help it stay healthy, including hands-on myofascial release treatment.  I think we’ll be hearing a lot more about fascia in the coming decades, particularly in relation to treating chronic illness or pain that seems to have no known cause.

Catherine Franks, Integrated myofascial and remedial massage therapist


July 2018