Muscles and joints get blamed for a lot of things. Sharp pain, aching pain, burning pain, stiffness, cracking, and creaking generally get chalked up to “tight muscles” or “damaged joints.” In a musculoskeletal sense, not every ache or pain can be traced back to a specific injury or damaged structure. Often, pain can come on gradually and without much incident or change in behavior. When this happens, a culprit to question is a type of body tissue, called fascia.
Fascia is a thick, dense, fibrous connective tissue that covers the entire human body. Literally, from our scalp to the soles of our feet, fascia surrounds joints, muscles, groups of muscle, individual fibers within muscles, organs, nerves, and even blood vessels. Think of an orange. When you remove the peel, the white pith covering the fruit is a lot like how fascia covers the muscles and bones of our body (if you were to look beneath the skin). Even the webbing within the orange, in between the slices of fruit is equivalent to fascia inside of our muscles. The role of fascia is to be a link between other body structures, and when injured or overused, fascia can pipe up with its own set of symptoms.
When fascia is healthy, it is a smooth sheath of tissue wrapping firmly around the structure it surrounds. When fascia is unhealthy, it bunches and becomes rigid, losing its fluid, gliding-type movement. In this state, when the fascia is asked to move or contract, it hurts, often giving a burning sensation. A good example of how fascia contributes to pain is in relation to low back pain. Picture this scenario: An office worker sits the greater part of eight hours per day. His chair is not very supportive, and his low back slumps and rounds, as well as his shoulders and neck. After sitting for an hour, he feels stiffness in his low back and hips, and has pain in his low back once he stands up. Once he has walked around for a few minutes, the pain starts to ease. Depending on the location and type of pain he experiences, a few structures could be directly responsible for the pain.
However, either directly or indirectly, fascia is a culprit, too. When a person sits for long hours during the day, the fascia that covers the gluteus muscles (glutes) in the buttock get overstretched and weakened. As the spine rounds from slumping, the fascia “tugs” at the spine, as it is tethered in the other direction at the glutes. Standing up and moving helps to lubricate the fascia, in addition to unloading the joints and muscles of the spine. If this scenario occurs long-term, the fascia gets more and more taut and unhealthy, and it becomes harder for the person to move his spine into a position that relieves the pain, even after getting up out of their chair. The loading of the fascia in this way can contribute to joint pain and disc problems in the spine in the future.
Debate exists as to whether fascia actually stretches like a muscle, or if doing stretches just helps to quiet the pain receptors in fascia that get turned on when fascia is inflamed. Either way, a couple of ways to keep fascia healthy and happy is:
1) Massage the major bands of fascia in the body regularly. This can be done with self-massage, using a foam roller to the ITBs, glutes, and muscles at the base of the skull called the suboccipitals.
2) Hydrate! Fascia is comprised mostly of water. Staying hydrated helps to keep fascia lubricated and flexible.
Physical therapists can help identify whether fascia is contributing to your pain. Please feel free to contact me with questions at: Beth@JointVenturesPT.com