This is the latest “organ” to be discovered my modern medical science. It weighs as much as 20 per cent your bodyweight, but it hadn’t been “discovered”.
Has a role in posture, strength, wound healing, interoception (look that up), aging- but, it hadn’t been discovered.
Usually discarded as inconsequential packaging material, during surgery. Regarded as an obstacle by surgeons. Pointless stuff that slows you down as you try and get to the good stuff, like muscle, bone or organs.
Here’s the thing though. Nothing, is useless in our body. There’s millions of years of evolution behind our structure. Before dismissing the products of that process as useless, we need to be extra certain.
Fascia isn’t just your body’s version of cling film/cardboard or polystyrene. It is attached to everything in your body. It’s what connects everything to everything else. It is, what physically unifies your body into a single unit.
That particular property, which is in its name- “connective tissue” also lets it influence parts of the body that are far away. It lets parts of your body communicate with each other.
Most of us are familiar with how the nervous system and the hormones let parts of the body talk to each other and influence function. And that is so most of us are aware of. Fascia is another way that the body does the same. Since we have remained blissfully unaware of the existence of this system and more importantly, this function, symptoms or effects caused by fascial communication gets attributed to nerves, hormones and “psychosomatic” processes.
A very large percentage of the symptoms that are treated in hospitals and clinics world wide probably have a significant contribution from fascial dysfunction.
Low backache is a great example.
Pretty much every case of low backache we see in clinics are from myofascial origin. They all have symptoms of pain and numbness running down a leg. Since the possibility of fascial origin of pain is not even mentioned in medical school, everything gets attributed to the discs, and nerve compression. Cue, MRI scan, which will obligingly show bulged/torn/degenerated discs in the lower lumbar region. And in most cases, also neural foramen compromise. Time for a discectomy. And if you’re really unlucky, a fusion with instrumentation. Pain goes away for a while. Then returns. You’re now labelled as a “failed back”. You feel like a failure, and so does your surgeon, because he’s done exactly what he’s been taught, with complete sincerity and all he could provide was temporary relief.
In a lucky few, symptoms go away for years or permanently.
There are 3 possible reasons for this.
1. There really was a nerve root compression
2. You got really lucky
3. The fascia which was cut during surgery healed up in a way that fixed your earlier problem.
My point is-
Surgery should be last resort for low back pain. Most surgeons hate operating for low back pain. Even if it is a minor procedure or a minimally invasive procedure, because the results are so inconsistent.
If there is no impending paralysis, there should be no reason to rush into surgery for low back pain.
Most cases of low back pain settle in 4 weeks.
Most cases will benefit from graded, progressive exercise.
Most cases will be worsened by bed rest
Most cases will not have a recurrence if treated with exercise and the regime is continued.
Most cases will benefit from manual therapy like massage
Most cases did not happen like a bolt from the blue, it was a result of years of sitting and poor posture that lead to a strain when challenged with a relatively trivial load.
In most cases, there is no correlation between symptom severity and extent of tissue damage
For example, the source of the low back pain can be from the ankles, knees, hips (usually) or from abuse of the neck (also very common). It can come from indigestion causing the anterior abdominal wall to tighten up. Or it can be caused by an excessively loose anterior abdominal wall caused by previous surgeries and scars (Caesareans, appendicectomies, gall bladder surgery, whatever) Even a minor scar can cause the body to maladapt it’s movement pattern and transfer movement and load to another part . This is why, chronic pain is so difficult to diagnose and solve.
The pain could be coming from anywhere. Not just where you’re feeling it. Which is why, everything has to be fixed. Everything.
It can be as complicated or as simple as you want it to be.
The simple method is what I keep talking about. Diet. Sleep. Exercise. Stress reduction.
You need the body suit that you’re wearing under your skin, the fascia to Gliiiiiiide.
It has to move smoothly. Without hitches. Without undue tension, but with enough of it, in the right places. That’s when you get full range of movement and that’s when you get pain free movement.
If you you want movement. You’ll have to move. Repeatedly, persistently, frequently.
You’ll have to move gradually, and push boundaries at each session. Strive for perfection in range and quality. It’ll be a slow process of you’ve got an injury, but like an avalanche, you’ll gather more and more momentum, the more you move.
There is direct microscopic evidence of fascia responding to movement.
Fascia, is formed of mainly water, collagen, proteoglycans like hyaluronic acid. This is what gives it, it’s lubricant property. The ability for it to let tissues glide past each other without hitches and pain.
The more water your fascia can hold, the more fluid it’s movement will be. Dehydration, is therefore, bad news for people with chronic pain.
Fascia that isn’t challenged daily, will remodel itself to become more tight. This is caused by cells called fibroblasts that secrete collagen fingers that interlink and thicken according to the movement patterns that body part is subjected to. The longer a body part stays immobile, the more the collagen accumulation and more they interlink.
Which is why yoga practice is most effective when done daily. Which is why limbs refuse to move without pain after 4 to 6 weeks in a cast. The bone would have healed, but the soft tissue would be Criss crossed by newly laid down collagen fibers that have used the period of immobility to become more solid and stronger.
Which is why most people coming out of surgery and immobilisation need physiotherapy.
Moving your head up and down can cause pain in your toes if your fascia is tight enough or dysfunctional enough. That symptom doesn’t automatically mean that nerves are affected.
So, what methods do you have, broadly speaking to recuperate from an injury. Whatever that injury might be. An accident, a fracture, a strain, a sprain, a surgery, an old scar?
Movement informs the fibroblasts about which pattern of fibers are needed, and which pattern isn’t. It’ll help you remodel your fascia and scars
Movement is what lets water and nutrients enter fascia, which usually has relatively poor blood supply. Movement helps wash away the chemical mediators of pain that have accumulated in parts of the fascia for weeks, months or years.
The more frequently you move through the full range of movement your skeleton is capable of, the healthier your fascia will be.