Musicians' Health Collective

Musicians' Health Collective: Supporting the health of musicians (and normal people)

Fascianating! What's the big deal with fascia, and should you blast it?

    I sometimes neglect a key part of understanding our body's soft tissues in an attempts to focus on muscle and function.  Which tissue am I referring to?  Fascia.  While you may not be familiar with the complex and interesting properties of fascia, you have certainly heard of it in terms of feet: plantar fascia, or the fascia of the thigh: tensor fascia latae.  Fascia is controversial, or as controversial as a soft bodily tissue can be.  Some scientists and researchers completely discredit its ability to affect mobility and muscle movement, whereas others are deeply entrenched in research on how it affects body motion and how it creates structure and form in the body.  I happen to be pro-fascia, if that's possible, and I do believe that certain philosophical tenets of fascia research are incredibly valuable to looking at the whole person in regards to tissue injuries and pain.  (As a reminder, I am neither a doctor nor a scientist, many of whom can more thoroughly explain these concepts.  This is merely my understanding as a musician and movement instructor.) Let's backtrack, though.

 If we imagine that the peel is our most outer casing, we can see all of this white fibrous material which gives structure and organization to the fluid within.

If we imagine that the peel is our most outer casing, we can see all of this white fibrous material which gives structure and organization to the fluid within.

What is fascia?  Fascia is the soft tissue component of connective tissue (as opposed to nervous, muscular, and epithelial tissue)- there are many different types and textures of fasciae, from superficial to filmy to deep, interwoven around muscle and encasing organs.  Superficial fasciae surrounds all of our body much like a silk stocking, but tendons, ligaments, and even vertebral discs are considered part of the fascial system.  A great way of understanding this is looking at a grapefruit or an orange (thank you Tom Myers for the image).  The peel is akin to our skin and adipose layer, and when you remove it, there is an abundance of white pith, structural fibers, and casing around pockets of juice, AKA. the fruit.  Without the pith, there would just be a mess of juice inside the peel but with the pith, there is individual encasing and structure for the whole fruit, giving it a fibrous and juicy texture.  Over time, as the fruit ages, the pith and skin become less supple, and one may need to roll the fruit on a surface to restore some fluidity to the juice.  Most types of manual bodywork attempt to restore some of more fluid capacities of our fascial system, as we too are a fluid system (not fluid meaning like a waterbed, but fluid like a hydrated sponge).

Fascia is our body’s aqueous soft tissue scaffolding; It provides the matrix that your muscle cells can grow upon and it also envelopes, penetrates and surrounds all of your joints.
— Jill Miller
 When you bisect the orange, you can see the geometric organization of the fibers, as well as the asymmetry and the random bulge in the right.  While we are not divide into segments like this, the structural binding is very similar.

When you bisect the orange, you can see the geometric organization of the fibers, as well as the asymmetry and the random bulge in the right.  While we are not divide into segments like this, the structural binding is very similar.

Why is this relevant?  Well, I have been absolutely guilty of exposing one or two muscles at a time, in conjunction with related bones as a way of demonstrating function and location, whether for blogs or for my yoga and pilates classes.  Yet, fascia underpins the entire structure of the body, meaning that no muscle, no movement, and no body part is an island.  While anatomy books may cut out everything but a deltoid to demonstrate certain aspects of its properties, the deltoid is truly part of a web of myofascial structures operating as a team, and in order to assess injury, limitation, and range of motion, one has to look at the whole body.  In addition, when your fascia is restrictive or your muscles are "tight" or perhaps lacking full range of motion (PS. "tightness" is an experience not a technical movement term), there can be an adhesion against the fibers, which can additionally cause discomfort and restriction in the area.

 This is an image from Dr Jean-Claude Guimberteau's  Strolling Under the Skin , which takes a look at living human fascia!

This is an image from Dr Jean-Claude Guimberteau's Strolling Under the Skin, which takes a look at living human fascia!

As musicians, most of us assume an asymmetrical position to play our instruments (or sing, or type on the computer or drive or write), and our myofascial system adapts in accordance; something called adaptation, and sometimes adaptive shortening.  For example, as a violist, I have less range of motion in one of my shoulders from 24+ years of asymmetrical music making, but is it exclusively muscular shortening?  Definitely a combination of many different connective tissues adapting to the input I gave it, through the process of mechanotransduction!  While that is perhaps scary to think of, it also means that the body and brain are plastic, and that change is absolutely possible, both fascially and neurologically.  It also means that addressing the fascial system is KEY to healing from an injury, or simply improving performance.  

 

 In Gil's talk, he discussed how fascia is stronger than we ever realized before, and that the health of the fascia profoundly affects the function of the structures it surrounds.  

In Gil's talk, he discussed how fascia is stronger than we ever realized before, and that the health of the fascia profoundly affects the function of the structures it surrounds.  

How is this different than other approaches?  Nowadays, Western medicine is focused on specialists-we have nerve specialists, hand specialists, orthopedic specialists, etc.  The catch, is that if you have nerve entrapment in the elbow, which affects your motion in your hand, you will be sent to all of these different specialists, without taking an integrated viewpoint of the big picture.  (i.e. you have may have nerve entrapment due to your motion patterns, as a result of injury to one shoulder, or to a poor setup in sitting with your instrument, or a compensation pattern, etc. etc.)  It can be incredibly frustrating to be in this situation, especially when no one can diagnose your ailment effectively, or when no one can treat your condition completely.  Many types of holistic practitioners, be they osteopaths, acupuncturists, physical therapists, chiropractors  etc, look at the whole picture of the body's wellness as a reflection of one area of sensation.  (Side note, holism is looking at integrated health, reductionism is the traditional western medical approach.  Both have their place, but many medical professionals are now looking beyond reductive means to find solutions).   This is in line with the idea that the whole body is fascially continuous, which means that an issue in the foot or ankle can affect the hip, knee, or spine, but not just on a muscular or neurological level.

 Image courtesy of AnatomyTrains.com.  The first image questions the dissect and separate logic of traditional study, and the second explores the more integrated idea of fascial webbing.

Image courtesy of AnatomyTrains.com.  The first image questions the dissect and separate logic of traditional study, and the second explores the more integrated idea of fascial webbing.

I'm still confused.  How does this affect me again?  Many injuries start with the health of our fascia, the hydration level of the tissue, and the ability of the layers of myofascia to slide and glide against each other.  When our fascia is dried out or brittle, we are at higher risk for injury, and our capacity for proprioception, or bodily awareness is diminished. *An article by Tom Myers of Anatomy Trains proposed that there are 10 TIMES more proprioceptors in fascia than in muscles!  As musicians and movers, proprioception is our portal to movement quality, movement efficiency, and increased performance, whether in daily activities, musical activities, or athletic performance.  Your movement choices, or lack thereof affect your fascia profoundly!  Also, scientists are discovering that fascia is significantly stronger, more malleable, and impactful than ever thought before- it used to be something discarded in dissections, and it's way more than that.  It affects the muscle system more than we realize!

 The Fascia-Blaster.

The Fascia-Blaster.

Healthy fascia benefits from diverse, varied, and frequent movement, as well as manual therapy (or tool assisted therapy).    A bodyworker can also help to expose issues in your myofascial web (myofascial meaning muscle+fascia), whether that be through myofascial release, rolfing, etc. 

Should I be blasting my fascia? Ugh...well, I'm glad that the fascia- blaster made the word fascia mainstream, but I'm pretty against the fascia blaster.  In case you don't know, the fascia-blaster is a "tool" that attempts to rid the body of cellulite via a hard plastic self inflicted torture device.  The first part I dislike about the fascia blaster is that it demonizes fat and cellulite, which isn't helpful.  It makes money by shaming people (often female identifying) about their bodies.  Your fat layer is your superficial fascial layer, and yes you can change it based on diet, exercise, etc., but there's nothing wrong with having one to begin with, and the goal is not to get rid of all your fascia or superficial fat.  I always bristle at schemes intended to have dramatic before and after images, and to say "thin is better than whatever you are now."  Oh, and don't forget that the product can cause bruising and other severe reactions- yes, your cellulite will be gone if you bruise it up, but it will probably return once those bruises heal.  Don't worry, I had a thigh master in the 90's and an ab roller as a teenager, so I've tried that seen on TV $#*%.  The founder of the implement doesn't have any professional training as a medical professional, bodyworker, or movement trainer (or at least none of her credentials are listed...anywhere).  At the end of the day, I'm just sad that people are beating themselves up with a hard plastic implement that causes bruising because of cosmetic reasons.  (Softer stress transfer mediums are great- not lacrosse balls or blasters, but softer balls, squishy balls, rubber balls, etc.)  Love your fascia, treat it kindly, and it will move you well.

 I had the opportunity to hear Gil Hedley in Austin, and he dropped some excellent truth bombs about fascia.

I had the opportunity to hear Gil Hedley in Austin, and he dropped some excellent truth bombs about fascia.

Want to know more?  I'll definitely post more on fascia in the future, but some of the leading scholars in fascia are Robert SchleipTom Myers of Anatomy Trains and Gil Hedley of Somanauts.  I also really like Brooke Thomas' blog, The Liberated Body, and her respective Ebook.

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