All About Fascia
What does your massage therapist mean when they say, "Everything in the body is connected"? Is that really true? What exactly is Fascia?
Fascia is a fibrous connective tissue that is responsible for connecting skin to muscle. Fascia covers, supports, and separates muscles in the body. When your therapist vaguely suggests “everything is connected in the body” in a mysterious tone, fascia is the structure in the body that makes it true! Once thought to be directly related to muscles alone, we’ve since learned that Fascia also runs through nerves, bone, organs, and even blood vessels! The stereotypical (if not esoteric) image often associated with Fascia is a spider web of thin tissue that connects everything together.
There are many techniques and disciplines of massage and manual therapies developed with the goal of freeing restrictions in the fascia layers. These modalities commonly use the umbrella term, “Myofascial Release” or the abbreviation “MFR”. “Myo-” being the clinical prefix referring to muscles, “Myofascial” refers to the fascia that most directly relates to muscles- the structures in the body of most interest to massage therapists and other bodyworkers. In the most general sense (and to be the least confusing) any technique that is applied to free fascia restrictions is a form of Myofascial Release. When movement restrictions of the fascia and/or muscles occur, they can appear as Adhesions or Trigger Points.
A brief on Trigger Points
One of the most common ways fascial restrictions present is in the formation of Trigger Points. These “Trigger Points” or “T.P.”s are localized areas of hypersensitivity or hyperirritability that will refer pain elsewhere in the body when pressed upon. These are very specific regions in the body that cover a small surface area that cause much discomfort or pain. Trigger Points are not the same thing as your run-of-the-mill Adhesions (bound muscle fibers that are “stuck” together) because TPs have sensation referrals. There are many who devote their practices to learning paths of common Trigger Point referrals (Trigger Point Therapy). Active Trigger Points will present with pain at all times, even while the body is at rest. Symptoms of Trigger Points can include pain, tingling, prickling, itching, burning, pins-and-needles, or numbness. Latent Trigger Points on the other hand are the points that refer sensations when pressed upon, these are often the points that you notice during a massage when you lift your head up and say, “I didn’t even realize that hurt!” or “I can feel that all the way up to my ears!”. Trigger Points are always a Neurochemical event.
So what causes Trigger Points?
The most commonly sited causes of Trigger Points are localized ischemia (inadequate blood flow), abundant or overabundant calcium, and inadequate ATP (the molecule in the body that stores biochemical energy- necessary to release muscular contractions). That is the more physiological answer, but what sort of things in your day-to-day life can contribute to the formation of Trigger Points? Repetitive Activities (occupational or athletic practices), Trauma and Injuries, Disease and Disorders, Fatigue, Stress, Postural Habits, Surgeries, Inactivity or Inflexibility, Compensation Patterns, Structural Asymmetry, Insufficient Strength, Nutritional Deficiency, and even Emotional Traumas can all play a part in creating Trigger Points. In short, LIFE can cause Trigger Points! When asking your therapist “what causes that to hurt?” bear this in mind. Your therapist might not have enough information on your background to answer that question. And ultimately the best any healthcare professional could provide (even with the best and most complete information) is a best educated guess. Who’s to say really what’s causing any individual’s specific Trigger Point or Myofascial restriction?
This has been my overview of Fascia practices. There are many different approaches to working with fascia in the massage and bodywork profession and many therapists who devote their entire careers to this kind of work. I describe the majority of my massage practice to be “based” in Myofascial Release, but of course there are certain rules of MFR that frequently break- namely, the lack of lubricant and extended periods of “holds” on individual points or tissues.
Peace and Healing,
Kirby Clark Ellis, MMT, BCTMB