Uncomplicating the Complicated: Fascia Finale

It’s finally here. The blog you’ve been anxiously laying awake at night to read. Okay maybe that’s not true, but this is the conclusion to diving deep into fascia, what it is, and trying to uncomplicate a complicated subject, fascia.

Let’s Get Started

Fascia as we’ve discussed is a complex network of connective tissue and it plays a significant role in the musculoskeletal system and overall body function. Its relationship with the nervous system, particularly the sympathetic nervous system (SNS), can have a profound impact on pain perception and the development of chronic pain conditions. In this section, we will explore the intricate relationship between fascia, the SNS, and pain, along with the concept of "fascial armoring" and its implications in chronic pain.

Relationship between fascia, the SNS, and pain

Fascia is richly innervated with sensory nerve fibers, which transmit information about tissue tension, pressure, movement, and stretch to the central nervous system (CNS). The SNS, a component of the autonomic nervous system, plays a crucial role in the body's response to stress, injury, or pain. When the SNS is activated, it can lead to increased muscle tension, creating a cycle of stress, pain, and further SNS activation. The interplay between fascia, the SNS, and pain is complex, as the fascial network can modulate SNS activity and influence pain perception.

Mechanical tension in fascia and its contribution to pain and SNS activation

Mechanical tension in fascia can result from injury, overuse, or chronic tension, causing restrictions and impairments in the fascial network. Think about leaning over a computer for hours on end, without taking any breaks to get up and walk around. This tension can lead to changes in tissue length, stiffness, and proprioception, ultimately affecting muscle function and joint mobility. Increased mechanical tension in fascia can trigger SNS activation, exacerbating pain and inflammation, and creating a feedback loop that may contribute to the development of chronic pain conditions.

Fascial armoring and its implications in chronic pain

Fascial armoring refers to the development of chronic tension and stiffness within the fascial network, often as a result of prolonged stress, injury, or repetitive strain. This armoring can lead to the formation of adhesions, restrictions, and fibrosis within the fascial tissue, impairing its ability to glide smoothly and maintain its elasticity. Fascial armoring can contribute to the development of chronic pain by altering muscle function, joint mobility, and force transmission, creating imbalances and compensation patterns throughout the body. Additionally, fascial armoring can perpetuate SNS activation, further exacerbating pain and dysfunction.

More on Fascial Armoring.

The concept of fascial armoring is a relatively recent development in the field of pain and musculoskeletal health. It's largely based on the understanding that the fascial network plays a significant role in sensory perception, mechanical force transmission, and movement coordination.

This concept involves a shift in perspective, from viewing the body as an assembly of individual parts to understanding it as a continuous, interconnected system.

Fascial armoring refers to a state of chronic tension and stiffness in the fascial network, often resulting from prolonged stress, trauma, or repetitive strain. This state leads to changes in the physical properties of the fascia, including increased density and decreased elasticity. These changes can restrict movement, alter force transmission, and cause pain, contributing to the development and persistence of chronic pain conditions.

Think about a knight wearing a full body of chain mail under their armor. The chain mail represents the fascia that connects our muscles and helps with the coordination of movement and force transmission. Now imagine that the chain mail protecting the lower back is welded together and unable to move like the rest of the chain mail. This piece of the chain mail being unable to move would alter the knights ability to walk normally, rotate their upper body, and alter nearly every movement. While this is obviously an exaggerated point and fascia doesn’t tighten down to the point of creating complete immobility I hope it starts to get some of the point across. Restrictions or loss motion in one part of the body can and will lead to loss of motions in other areas. Let’s now dive into how this happens.

When discussing fascial armoring the physiological properties of fascia has provides a foundation for this concept. Studies have shown that fascia is not just a passive structure but is dynamic and responsive to mechanical forces. For instance, research has found that fascia has contractile properties due to the presence of myofibroblasts, which can actively contract in response to stress or injury, leading to increased tension and stiffness in the fascia.

Further, studies have shown that fascia is richly innervated and plays a significant role in proprioception and nociception(painful sesnations). When fascia becomes restricted or armored, it can interfere with these sensory functions, potentially leading to altered movement patterns, impaired proprioception, and increased pain perception.

Fascia and Myofascial Pain Syndrome (MPS)

Myofascial Pain Syndrome (MPS) is a common musculoskeletal disorder characterized by chronic pain arising from trigger points (TrPs) within the muscular fascia. These trigger points are hypersensitive spots within the fascia that cause pain and discomfort when compressed. The pain is often referred to other areas of the body, a phenomenon known as referred pain. MPS is estimated to affect approximately 30% to 85% of the general population, with a higher prevalence in females and middle-aged individuals.

Tensegrity, TrPs, and Myofibroblast Contraction in MPS

The concept of tensegrity, or tensional integrity, plays a crucial role in understanding MPS. This principle describes how the fascial network, a tension-based structure, maintains the balance of forces within the body. Disruptions in this balance, such as those caused by stress, injury, or poor posture, can result in increased tension and stiffness in the fascia, leading to the formation of TrPs.

Trigger points are believed to result from the sustained contraction of myofibroblasts, specialized cells within the fascia capable of contraction. These myofibroblasts become active in response to mechanical stress or injury and can create areas of increased tension and stiffness in the fascia, contributing to the development of TrPs and, subsequently, MPS.

Sedentary Behavior, Mechanical Tension, and MPS Development

Sedentary behavior has been linked to the development of MPS. Prolonged periods of sitting or inactivity can lead to increased mechanical tension in the fascia, particularly in areas like the lower back, neck, and shoulders. This constant tension can lead to fascial restrictions and changes in posture and movement patterns, all of which can contribute to the formation of TrPs and the development of MPS. Studies suggest that by interrupting sedentary behavior and promoting regular movement, the incidence of MPS can be reduced.

The interconnectedness of fascia throughout the body, and its ability to transmit force and communicate changes in tension, play a key role in the development of MPS. Understanding the relationship between fascia, the nervous system, and patterns of movement and tension can provide valuable insights for the prevention and treatment of this common and often debilitating condition.

Fascia and Body Alignment

Fascia's Role in Maintaining Symmetrical Alignment

One of the things that we measure and work to improve is the alignment of the body. Our body's symmetry and alignment are deeply intertwined with the fascial system. As we’ve discussed fascia forms a continuous web that envelops and connects every structure within the body, providing a framework that maintains the position and alignment of muscles, bones, and organs.

Importance of Proper Alignment

A body that is more symmetrical can help when it comes to overall health and reducing pain. When the body is aligned, forces can be distributed evenly across the musculoskeletal system, reducing undue stress on any single structure. This balanced distribution of force promotes efficient movement, lessens wear and tear on joints and tissues, and can help to reduce the risk of injury and chronic pain. Furthermore, proper alignment can enhance circulation, improve respiratory function, and support the optimal function of various physiological systems.

Nuances of Alignment

However, it's important to understand the nuances of body alignment. Not everyone who has asymmetrical alignment will experience pain, and not everyone with asymmetrical alignment will develop pain over time. Many factors can influence whether or not asymmetry leads to pain or dysfunction, including individual anatomy, lifestyle, activity level, and overall health.

Furthermore, the body is a dynamic system and can adapt to a certain degree of asymmetry without issue. However, when asymmetry results in an imbalance of forces and strain within the fascial network, it can lead to issues such as chronic pain, reduced mobility, and increased risk of injury. In such cases, identifying and addressing the root causes of the asymmetry can play a crucial role in treatment and prevention.

Assessing alignment provides an important perspective on understanding how the body is functioning. It is one piece of the puzzle in a holistic approach to health that includes elements like physical activity, nutrition, stress management, and more. By maintaining a balanced fascial system, we can support proper alignment and promote overall health and wellbeing.

As always I hope you enjoyed this blog and if you have any questions feel free to reach out to me at drcoffman@optimizecolumbus.com and remember if you or someone you know suffers from pain of dysfunction we always offer complimentary consultation to see if we are a fit when it comes to helping you move and feel better.