A question that gets tossed up time and time again in the clinic is what exactly is fascia. The reason this gets asked so frequently is because it's not what's taught in schools. If you take a look at any anatomy book or drawing you will more than likely see a well defined cartoon drawing of a body in anatomical position with muscles and tendons highlighted in red and white with a key beside it to highlight which is which. Some other posters might include the skeleton and probably come with an explanation of what ligaments, tendons and muscles are. But therein lies the problem. Much of the anatomy we learn today is based on Victorian science where tissue that was deemed unimportant was cut away to reveal the important structures underneath. I'm sure people are familiar with the idea of the “Gold standard”. Something that everyone does because that's what everyone has always done like the rice method for an acute injury which anybody who's into sport should know by now is not the optimal way to treat it. In my eyes this is the exact same thing that's happened to modern understanding of the body. In recent years new discoveries in the world of manual therapy and sports science have brought light to one of the most important tissues in the body which is fascia.
The first thing to understand about fascia is that its everywhere. Your entire body is fascia! Skin , bones, muscles , tendons ligaments etc are fascia containing different concentrations of proteins and minerals. The same can be said for connective tissue, Membranes and everything else in between. The next thing to understand is that much of what we are taught about muscles blending into tendons and attaching onto bone is not wholly true. More so that one continuous line of tissue blends and becomes the bone. For ease we can call that site a tendon but in reality it can be hard to discern where the muscle ends and tendon begins. Connective tissue fascia is essentially made up of collagen and elastin fibres together with bound water. It covers every inch of our body, It wraps around muscles and runs through them at the same time. I always see muscles as the driver behind a movement and the Fascia as the tensional force that makes movement possible. Fascia gives us our form. It can thicken over time through lines of tension and can pull us into postures good and bad. Without going too much into detail and from an injury and posture point of view I will simplify it to this. When we are tight, think fascia. A muscle does not tighten unless provoked to do so. If you feel like your hamstrings are always tight its probably not coming from your tight hamstrings. We can have painful trigger points and adhesions. But if you are stiff and tight think fascia.
Above is a picture of connective tissue fascia which wraps around and through every muscle in the body. Now imagine that that fascia is being pulled like a wire from above. Imagine how the fascia in your leg would feel if it's being pulled tight like a drawstring. Now imagine it's being pulled the exact same way from below in your foot due to poor foot mechanics. Imagine the strain you would feel in the leg.
What's the relevance ?
When i treat injuries and tensional issues in the clinic generally we do look for Myofascial trigger points as a primary source of pain along with nerve inflammation and bone and tendinous issues. But To answer the why as in why did this happen , why did my hamstring tear, Why is my lower back so tight, why is my shoulder clicking , why do i have tendon issues we must look at the fascial system.
Fascial tension lines are widely talked about through neuromuscular therapy and a number of specific lines have been hypothesised. Some kinetic chains have been brought foreward such as of the posterior, oblique and anterior chains just to name a few. Thomas myers has a widely documented course suggesting specific anatomy train lines that run through the body like train tracks, joanne avison suggests looking at fascia in a new way describing us as biomotional that fascia can ebb and flow with movement and that one restriction can affect the entire system. There is also work being done in relation to superficial scars in which it can have huge implications into fascial structure. Ultimately all roads lead to the model of Biotensegrity which is the theory of body wide tensional and compressive unification.
Some examples of Fascial tension lines below
We are only beginning to understand the world of fascia and the true nature of its full body communication and signalling systems. How specific fascial interventions can free movement , aid healing and help improve posture. Ultimately we are beings of our nature. If we are sedentary humans our fascia will adapt. If we move it will adapt. If we are in pain it will adapt. We adapt to the world around us. So we should put ourselves and our bodies first in a world that doesn't take that into account .Move.