“… A loose chaotic network operating separately but with a global, unified goal” said Robert Schleip. He was actually talking about the research community when he made the statement, but the metaphor to the fascial system itself was lost on no one. In an era of medicine producing sicker and sicker people being treated conventionally in more and more specialized clinical silos, the fascial system coming to center stage is a hopeful metaphor for more unified, collaborative, integrous, interdependent times ahead. Fascia is the system of resiliency, integrity and exchange. It is a timely time for us to be discovering the importance of fascia.
FASCIA AND CONNECTIVE TISSUES
The terms are not synonymous. ‘Connective tissues’ and ‘fascia’ are not one-in-the-same. The body is formed from just four primary tissues types. Connective tissues are 1 of the 4 tissue types that form the body. Fascia is one of the 9 organ systems. It isn’t just semantics.
To be categorized as a connective tissue, three conditions must be met.
· First, there must be cells present.
· Second, there must be a fibrous component.
· Third, there must be ground substance, or a matrix.
A good visual analogy can be found when thinking of reinforced concrete. Rocks go in; we can think of these rocks as the cells which in reality are actually secreting the ground substance and forming the fibers. Metal support rods are inserted; we can think of these as the collagen, elastin or reticular fibers representing the fibrous component. And finally the cement, or the ground substance. When the ground substance is still fluid while kept in motion, we have a tissue something more like blood. As the ground substance becomes increasingly firm the analogy progresses to one of proper connective tissues, cartilage and finally bone.
Notice, none of the structures listed in the table are ‘fascia.’ Fascia is NOT a connective tissue. Fascia is a system of the body formed, in large part, from fibrous connective tissues. It can be separated from, and in some cases categorically include, other specifically organized structures. Fascia varies in thickness, density, and the amount of fat, collagen fibers, elastic fibers and tissue fluid it contains. It could be thought of as a three-dimensional, web-like structure that contains, organizes and supports all of the parts of the human body. A ‘snag’ in one part of the web necessarily impacts the entire structure. It has amazing properties. Fascia surrounds every structure in the body allowing for the perfect adaptive balance of tensile strength, connective integrity with gentle suspensory support and ample movement for optimal functioning. It is a full-body system.
In the introduction to the book that accompanied the 2007 First International Fascia Research Congress in Boston, T. Findley and R. Schleip offer this definition: “Fascia is the soft tissue component of the connective tissue system that permeates the human body forming a whole-body, continuous, three-dimensional matrix of structural support. It interpenetrates and surrounds all organs, muscles, bones and nerve fibers, creating a unique environment for body systems functioning.” Findley and Schleip extended this to include all fibrous connective tissues, such as ligaments, tendons, retinacula, joint capsules, aponeuroses, organ and vessel sheaths, the meninges of the central nervous system, the periostea and all the endomysial and intermuscular fibers of the myofasciae. And so, quite appropriately, from the first International Congress on Fascia a first formal definition for fascia was born.
It was only in 2015 that the American Association of Clinical Anatomists declared fascia an official system of the body. This came only after the elegant Delphi study conducted by Dr. Carla Stecco. While her work turned to ‘weekend workshop,’ ‘modality certification’ holistic healthcare apparatus upside down, it made perfect sense in the grounding of the field of gross anatomy. Textbooks are being rewritten.
CELLULAR MECHANICS OF FASCIA
Cellular biologists were among the first international researchers in the fascia research community. There are many cellular mechanism that will surely prove interesting in the decades of inquiry ahead. Collagen fibers are the primary fiber type found in fascia. Collagen is formed by the intermingling of three hollow tubes which together form a triple helix. Each tube is filled with an ultrafiltrate fluid which is very high in photons or light particles. Cerebrospinal fluid shares this similar quality. Collagen molecules are hydrophillic and attracting water molecules to them with tensional precision. These qualities allow fascia to act with great fluidity. Fluidity is fundamental to fascial function. It allows for ease of movement as well as provides a medium for effective paracrine intercellular communication. Fascia has the special electrical properties of being both piezoelectric and a semiconductor.
While this is a lot for the research community to take in, it is clear that exciting new knowledge is ahead. The fascial system is going to be a teacher further bridging the divide between native healing traditions, energy medicine and the unseen elements that connect and spark the human body.
THE FIVE PRINCIPLES OF FASCIA
Fascia needs to be dealt with within the parameters of its natural laws / response characteristics. One cannot treat fascia like muscles or bones and expect to get a lasting change in the fascial system. You wouldn’t think you could treat your respiratory system like your digestive system. The dynamics of fascia and the fascial system are unique unto itself and are now starting to be recognized as such.
Fascia isn’t a technique you might think about trying. It is a system of your body every bit as important as any of the others and as crucial to the whole. Providers from any background and people for their own self-care benefit, can and should work to engage incorporate fascia in many diverse ways.
These unifying principles were the outcome of a content analysis ending in 2009 and presented at the International Research Congress in Amsterdam that year.
1. The Exchange Principle:
The fascial matrix gives home to the cells of our immune system. It is the medium through which waste and nutrients are exchanged between cells and their blood supply. It is where tension is handed off and redirected. The ‘tangibles’ of this principle include fascial propertyies of: mechanotransduction, semiconduction, piezoelectricity, crystallinity, hydration, continuity and coherence.
2. The Scaffolding Principle (aka Tensegrity):
Our bodies are geometrically efficient. They have tensional integrity. Fascia acts as the ‘guide wires’ that the rest of our structures organize around. Throughout the body 45- and 90- angles are visible in the meshwork of fascial sheaths. Diagonal relationships abound. A fascinatingly, not-yet-understood, pattern of 78-degree angles is also found at fiber cross-striations. Structural integrity in the fascia makes it possible for other systems to function properly and most efficiently.
3 The Container Principle:
Fascia organizes our muscles and organs into separated, but interwoven, compartments and cavities. Just beneath the skin and the fatty layer is a fascial ‘wetsuit’ that forms the outermost container of the entire body. Deep to this there are fascial sheaths that identify individual muscle compartments (i.e., anterior thigh) or separate out large structures (i.e., carotid sheath). Within each of these compartments each individual structure (muscle, vessel, etc.) has its own fascial sheath. Within each individually sheathed muscle every 100 or so muscle fibers are contained in their own fascial sheath called a fascicle. At the cellular level, each muscle fiber has its own fascial sheath. Each of these containers within a container are interwoven by the fibers of the fascial matrix. A ‘snag’ anywhere in the matrix impacts the entire ‘container’ (your body).
4. The Hugging Principle (aka Creep):
The fascial matrix ‘hugs’ its areas of weakness, injury, pain or misuse. Think of the posture of a person following open heart surgery. Picture what your skin does as a wound is healing. Think of how a person holds their arm when it is broken. What do we do when we have abdominal pain? The fascial matrix will try to lend support to areas that are perceived as in danger by our nervous system or immune system. Studies have shown that mechanical stress will cause fibroblasts (cells that make collagen) into myofibroblasts (cells that make smooth muscle). Unfortunately, this ‘hugging’ can yield layering of compensatory patterns which will eventually become too difficult for our musculoskeletal system to efficiently support.
5. The Unwinding Principle:
The collagen fibers that predominate throughout the matrix, at a molecular level, are a triple helix filled with fluid. At its core it is nonlinear. Fascia will not respond to linear stretching. Instead it has a very unique, slow, sustained, meandering quality to the release characteristics observed clinically. Some of this may be explained by the sol-to-gel transformational ability of the collagen molecule.
TAKE-AWAYS FASCIAL FACTS …
Fascia, together with our muscular and skeletal systems, gives us our posture, defines the quality of our movement, holds our tension patterns and provides a structural casing for nerves, arteries and veins, all skeletal muscles and nearly all organs of the body.
Other than the muscles that act on the vertebral column, few muscles cross more than one joint. When we feel a sensation that does cross multiple joints, there is a good likelihood that that sensation is fascial or nervous.
In the embryo, fascia develops before muscle. Future muscle cells migrate into the fascial sheaths and then develop into the muscles that we can identify by name. This means that the muscles are to a great extent at the whim of the fascial casing that encloses them. Releasing the muscle will have little long-term benefit if the fascia is not coaxed into better functioning as well.
Fascia has a strictly afferent (sensory) relationship with the nervous system. We cannot tell our fascia what to do. It is not under efferent (motor) control of the nervous system like muscles. Instead, our fascia is constantly telling our nervous system what is going on in the fascial environment.
Fascia has natural response characteristics to activities such as rocking/shaking/bouncing, traction/compression, floating, direction-of-ease unwinding and diagonal reinforcement. Holistic therapies such as Rolfing, Trager, myofascial massage, Yin Yoga, Body Rolling and in general many physiotherapies make use of some or all of these fascial response characteristics in their therapeutic approaches.
When people have thoughtful practitioners attempting to increase strength and/or flexibility and they cannot make gains. If the fascial ‘container’ is malpatterned, then the muscle does not have the functional ‘room’ to hypertrophy or lengthen.
In another generation or two, this won’t be confusing. It will likely seem silly that it ever was. Kids will learn in health class that they have a fascial system. Branches of physical medicine like physical therapy and osteopathy will likely be the training grounds for skilled fascial therapists. Just as we have pulmonologists and yoga teachers both talking about breathing, we will have a spectrum of providers working with fascia.
It is in large part on the shoulders of an industrial age that western medical education grew. We weren’t in a paradigm looking to celebrate the connectedness and interdependence of it all. We wanted to name and understand pieces and parts to make it easier to live in these machines called bodies. Many false truths have been handed down. We are ready for a new era.
Fix-the-machine medicine is literally the lifesaver in crisis and trauma. But it doesn’t serve us as well in the decades between. As we live longer, we need to do more to help our bodies adapt to the wear and tear of the lives we’ve lived. Fascia holds the patterns, stories and acquired inefficiencies to a fault.
Reestablishment of relationship. Bringing parts back into the whole. Connection. I’d like to think that’s the metaphor this ‘newest’ system of the body brings.
Dr. Melinda Cooksey Bekos