24 Jan What is Fascia and How Can it Cause Pain?
Kath Welland and Laura Woods from Halo attended a Fascial Manipulation Course run by researcher and clinician Dr Antonio Stecco.
Dr Stecco performs dissections and histological studies in order to gain a detailed understanding into the anatomy and physiology of fascia and to develop treatments for Myofascial pain.
Historically, anatomy books have identified fascia as a ‘fibrous sheath’ that covers and keeps in place a group of muscles or serves as the insertion of broad muscles. Little was known about the role of fascia within our bodies. The last decade has seen significant developments in the understanding of the role of fascia. It is no longer considered ‘just’ a covering of tissue over a muscle.
Recent research has demonstrated that more than 30% of the force generated from a muscle is transmitted by the fascial tissue within a muscle. This is a new concept as we previously understood that tendons were responsible for force transmission.
In fact, it has now been established that a normal functioning fascial system is the basic requirement for joints, muscles, organs and tendons to work effectively.
Located within fascia are mechanoreceptors that respond to stretching of the fascia and proprioceptors which provide feedback on the position of the associated body part in relation to the central nervous system. This indicates that normal stretching of the fascia affects the force of muscle contraction, muscle tone, rate of change of muscle length as well as the relative position of the body part.
Stecco’s studies have shown that these receptors become inhibited and the feedback to the central nervous system is altered when the fascia becomes restricted or chronically overstretched. The main cause of fascial restriction is alteration in the viscosity of the tissue related to a substance called hyaluronic acid which provides lubrication and allows gliding between joints and connective tissue. Hyaluronic acid can alter in viscosity if exposed to injury or sustained stresses leading to myofascial pain.
Studies have shown that manual treatments including application of vertical pressure in a forward and back gliding motion can reduce the viscosity of hyaluronic acid and therefore improve the required lubrication to allow fascia to glide and restore function.
As physiotherapists, we can provide fascial manipulation techniques in order to restore function and relieve myofascial pain. A thorough case history that considers areas of previous trauma or surgeries is essential, together with functional testing and palpation of fascial planes in order to diagnose the location of the fascial restriction.
Blog compiled by Laura Woods, Senior Physiotherapist at Halo