Say the word "fascia" a few years ago and many people would have given you a blank stare, as apt to think you were referring to a houseplant as to your body’s critical connective tissue.Fascia refers to the extensive web of connective tissue underneath the skin. Historically ignored and assumed to play a passive role in daily movement and functioning, it’s now having a renaissance.
Some researchers, progressive physical therapists and fitness professionals are beginning to think of fascia as a bigger player in the human movement system — and in overall health and well-being.
Clinical studies are racing to catch up with what these progressive thinkers have learned. Meanwhile, anecdotal evidence supports the idea that knowing more about your fascia and how to take care of it — especially in middle age when it begins to lose elasticity — may help alleviate chronic pain, prevent injury and “keep the body young by keeping elasticity in your tissue,” says Thomas Myers, an anatomy expert and author of Anatomy Trains: Myofascial Meridians for Manual and Movement Therapists.
Says Myers: “We can train ourselves to be younger.”
Here’s what you need to know about your fascia and how to care for it:
What is fascia?
Myers refers to fascia as “biological fabric.” If you cut away the top layer of skin, you would see fascia as a white sheath encasing your muscles. It looks a lot like the thin layer of tissue you find on chicken breasts in the supermarket.
Fascia is comprised of collagen fibers and other proteins, says Dr. Partap Khalsa, deputy director of the Division of Extramural Research at NCCAM. “It’s composed of roughly the same fibers as ligaments and tendons,” says Khalsa, “just not as dense.” It is also comprised of water — in fact, it is one of the biggest storers of water in the body.
There are three layers of fascia: one that lies closer to the skin, one deeper within the body and one that wraps around the internal organs. “Every visceral organ, every muscle in the body, every nerve has a covering of fascia that literally wraps around it,” says Khalsa. “In addition, the fascia layers within muscle, and each of the compartments within muscle are separated by fascia.”
Why is interest in fascia surging right now?
Scientists recently discovered that fascia is full of nerve endings, which suggests it may play a role in chronic pain and other musculoskeletal problems.
Anecdotally, many people report relief from musculoskeletal pain when they proactively take care of their fascia, both through manual treatments (such as massage or structural integration work) or various types of movement and exercise.
This new knowledge, coupled with anecdotal reports on the effectiveness of conventional and alternative therapies that target the fascia, has sparked “a resurgence of interest in the biomechanics of fascia,” notes Dr. Helene Langevin, a professor of neurological science at the University of Vermont, in a paper she co-authored called Communicating About Fascia: History, Pitfalls, and Recommendations.
Those whose interest has been sparked believe that fascia’s role in the body, and in particular in chronic pain, may be more significant than once thought. They’ve begun to argue for an evolution in the science of understanding fascia, and they’re advocating for more research.
“Clinical studies are ongoing,” says Khalsa. “It is not a static field.”
How is fascia injured?
Fascia comprises so much water that it is susceptible to drying out. And dehydrated fascia can lead to trouble.
“In your movement body, getting older is a process of drying out,” says Myers. “When fascia gets dehydrated, it starts sticking to itself. In fact, it’s very much like glue if you imagine that you took some of the water out of glue and the glue dries.”
Keeping fascia hydrated is key because fascia allows the body’s muscles, organs and other tissues (all of which are encased by fascia) to glide by each other. When this tissue dries out, organs and tissues can’t move past each other with ease.
“Every time you move a body part, your skin must slide related to muscle, and muscle must move relative to muscle,” says Khalsa. When this isn’t happening, you’re more susceptible to injury.
“When [tissues] don’t move past each other for a long time, they get stuck to each other,” says Myers. Then, when you reach for that Frisbee or do that big stretch in yoga class, all of a sudden something tears instead of glides.”
What’s important to know about fascia in midlife?
Fascia is very elastic, notes Myers, and the hormonal changes that happen in midlife, such as andropause and menopause, reduce the amount of elasticity in your tissues.
“If you think of children, they bounce. If you think of grandma, she doesn’t bounce,” says Myers. “That is a difference not in muscle tone as much as it is a difference in fascia, which has an intense, lovely, childlike springiness to it in your younger years.”
The good news, he continues, is that you can train more elastic back into your fascia.
Great! What’s the best way to do that?
The best thing for fascia is variability of training, says Myers.
“I run four miles a day,” he says. “It’s great for my heart, I like it, all of that, but I’m not doing much for my fascia. When I want to train my fascia, I go to yoga or I stretch in unusual ways.”When you move in atypical-for-you ways, “it’s like you’re squeezing water out of a sponge and the water that comes rushing back in the sponge is cleaner, or has more proteins, or has more of what your body needs to renew itself,” says Myers. “Whereas, if you don’t squeeze the sponge it will stink after a few days.”
Bouncing-type movements also help fascia. Think: jumping on mini-trampolines (though be careful of fragile ankles), jumping rope, skipping and barefoot running.
Drinking lots of water is important, too, but can’t solely fix the problem. There’s no direct way for the water you gulp down to get to the sticky fascia in, say, your elbow.
Some practitioners, including Myers, also advocate for ballistic stretch — an exercise style made popular by Jane Fonda.
After Fonda had her heyday in the early '80s, there was a backlash against ballistic stretch. People advised against doing these workouts — and some still do advise against it — because they say it tightens your muscles and makes you less mobile.
Myers counters that, yes, they do make you tight, but it’s a “bouncy tight, an elastic tight.” In other words, it’s the kind of tightness that helps bring a youthful elasticity back to your body.“Go to someone who has been in the business for 30 years and they will say ‘don’t do that,’” says Myers. “But the newer research is saying that you can train elasticity into your body — and keep it young by — doing ballistic stretch.”
Regular manual treatments, like massage or other bodywork, are also key, says Myers.Adds Khalsa: “There is evidence that many of these manual treatments have some clinical benefit.”
Khalsa also notes that activities that promote general wellness — eating well, drinking plenty of water and exercising regularly — support healthy fascia.
What doesn't help fascia?
Sitting on a bouncy ball, says Myers. “That will not do the trick because the bounce is all in the ball.”
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