You have hundreds of muscles in your body. Ever wonder how they all keep their specific shape? Why don’t muscles constantly knot up and get twisted around? How do skeletal muscles stay secured to bones without fraying at the ends?
Fascia is how.
Fascia is a thin, clear collagen matrix much like shrink wrap that envelopes every organ, muscle, tissue, and structure in your body. It provides support for muscle fibers and maintains continuity between adjacent muscles so your every movement is smooth and seamless. This much we know for certain. Believe it or not, the scientific community is split on how exactly to classify fascia anatomically. Since it exists in all of our body structures, it’s like an internal skin without a boundary or clear function of its own. It’s not technically considered an organ, and it doesn’t produce cells or secrete compounds or plug any evolutionary holes (that we know of).
So we have shrink wrap on our organs. What else does it do?
Despite the ubiquity of fascia in our bodies, our understanding of its purpose is still not comprehensive compared to internal organs and tissues. Scientists don’t even agree on whether fascia is only a passive structure that merely aids movement - or something more.
Here’s an example of just how unresolved our understanding of fascia is. A group of researchers from the Neurosurgical Clinic Günzburg of Ulm University in Germany have recently decided to challenge the notion that fascia is a passive structure that is simply there; they posit that the fascia could serve a more active role in movement by providing an extra contraction force to muscles. However, they found that the fascia alone could not contract enough to actually flex a joint, but it could contract enough to provide mechanosensory stimulation to the muscles.
The overarching point here is that fascia is a slightly mysterious film made of primarily of collagen that exists within our bodies and covers all our internal structures to help maintain continuity, provide form and boundary to those structures, and potentially even aid in the efficiency of movement. Furthermore, we can only perceive its existence when we feel pain - and injuries to our fascia can cause significant amounts of pain.
Even though fascia is a beneficial and necessary structure, it can be the cause of significant medical issues. While it’s not a body part that you can sprain or strain or break or bruise, it is prone to inflammation and microscopic tears, which can lead to two life-altering conditions.
This common injury is caused by inflammation in the tissue that wraps under your heel, runs along the bottom of your foot, and connects to your toes. You probably don’t realize how crucial this part of your body is until the pain is so bad you can barely walk.
Myofascial Pain Syndrome
Characterized by pain in the muscles that becomes apparent when pressure is applied, this condition is a bit more elusive. (‘Myo’ is the prefix for ‘muscle,’ which means that ‘myofascial’ refers to the fascia of the muscles.) From the Cleveland Clinic: “In some cases, the area where a person experiences the pain might not be where the myofascial pain generator is located. Experts believe that the actual site of the injury or the strain prompts the development of a trigger point that, in turn, causes pain in other areas. This situation is known as referred pain.”
Myofascial pain is commonly felt in the lower back, neck, and shoulders, which may explain why people who experience injuries in those areas usually have long recovery times. Perhaps we’re failing to fix the real problem by ignoring the fascia and treating the muscles just because they are better understood.
In both plantar fasciitis and myofascial pain syndrome, the primary treatment option is physical therapy. Still, there are some preventative strategies you can use to ward off myofascial injuries before they force you to seek medical treatment.
Chances are if you’re into yoga, if you go to the gym frequently, or if you regularly see your physical therapist, you’ve rolled around on the floor with a dense foam cylinder at least a couple times. Self myofascial release - also known as foam rolling - is a fast, effective, and inexpensive way to keep your muscles and their accompanying fascia loose, stretched, and happy.
Simply put the foam roller on the ground, then put your calf, your hamstring, your quad, your back, your butt or any other body part you want on top of the roller and begin to slowly rock back and forth. By putting this intentional, diffuse pressure on your muscles, your muscle fibers and fascia will stretch and smooth out, preventing those nasty trigger points from knotting up.
Conceptually, the traditional massage you can get from a spa isn’t wildly different from that self-myofascial release you get from foam rolling. Both methods stretch and smooth-out the fibers of your muscles, but here’s the thing: even the best foam roller will never get as deep or as intense as a quality masseuse.
Trigger Point Injections
Trigger points are the hallmark of myofascial pain syndrome. In layman’s terms, a trigger point is like a pinched or tangled muscle fiber (and fascia, of course) that causes pain when pressure is applied. When massages or foam rolling doesn’t smooth out the fibers and fascia, your physical therapist may opt for alternative trigger point therapies such as an injectable combination of steroids and anesthesia. This will relax your muscles and give your fascia a chance to reset and for inflammation to recede.
Receiving an injection shouldn’t be the first remedy you try. Experts widely agree that myofascial injuries can be improved with physical therapy and massage before resorting to invasive procedures. Your doctor might also have some remedies to help you navigate your way through a myofascial injury - since swelling is often the root cause for myofascial pain, there may be certain medicines you can use to reduce swelling and give your body a chance to recover.
Any way you look at it, fascia is a crucial - if misunderstood - structure in our bodies. Now that’s fascia-nating.
Relevant Sources for Fascia Explained