As an osteopath I find fascia fascinating by understanding its roles within the body. This helps me to look at the body with holistic glasses, allowing me to connect and join the dots of not only where the problem is but giving me a better understanding of how it could be going wrong and which areas are causing the problem.

I’ve heard so many times through friends and patients who have seen Southampton osteopaths, chiropractors and sports massage therapists, how they have presented said therapist with shoulder or neck pain and had their pelvis treated as well as the areas concerned.

After explaining what they have had done they usually say to me “it’s all connected, right?” not really having any idea how. This is probably due to the fact that us therapists like to waffle on forgetting you haven’t spent five years reading anatomy.  Of course it’s correct, through connective tissue (which is fascia, bone, ligaments, tendons and muscle; bodily tissues that connect with each other – the clue is in the name), previous injuries and longstanding postures can present with pain in other areas of the body.

I hope by explaining what fascia is and their adhesions I might give you an understanding of how holistic therapists such as myself can look at the body and treat accordingly.  Fascial adhesions is a term which is becoming more common now, especially with those in the holistic community, either therapists or clientele. That is ok if you are in the know but if not, what are they?

Firstly you need to have some understanding of what fascia is and what it does.

Fascia, what is it?

Fascia like all connective tissue runs throughout the whole body but it has many different roles and takes on several different forms. The different forms of fascia are open to debate but in Osteopathy we define them into four different types;

Superficial Fascia:

This particular fascia lies underneath the skin, it is a very thin and pliable form of fascia allowing the skin to move over the muscles, bones and joints.

Deep Fascia:

Is probably the best known type of fascia, it envelops all muscles keeping them separate, this allows the muscles to slide against each other. It also bands muscle groups together, sheaths tendons, and acts as an anchor point for when multiple amounts of muscles attach to one area. This type of fascia is a lot tougher than superficial fascia because it is made of multiple layers of fascia, each layer has a higher density of collagen fibres running through it. Collagen is a tough elastic proteinase substance made by the body. The layers are formed in a way similar to ply-wood, each layer having the collagen fibres running in different ways. This makes it a very durable tough material allowing it to absorb stresses in multiple directions. The role of the deep fascia dictates how many layers it requires. For example there are fewer layers in the deep fascia that envelops muscles but there are many layers found in the fascia underneath the foot (planta fascia) which whilst walking or running absorbs all bodyweight repeatedly.

Internal Fascia:

This is similar to the superficial layer but it lies deeper inside the body. Its role is to separate the deep fascia from the delicate lining (serous membrane) and it attaches it to the walls of the body cavities that house our organs as well, protecting the delicate lining from muscle movement.

Subserous Fascia:

This is a very fine layer of fascia that covers all the organs, this allows the organs to move against each other.

The Adhesion:

Whatever the fascia type, they all rely on one thing that allows them to move freely and that is the fluid which surrounds them. This lubrication allows the muscles, skin and organs to move and slide freely against each other. Like most fluid in our bodies this has a high protein content which makes it viscous and this means that when it is kept still for a while, the fluid thickens and becomes sticky which can produce adhesions causing friction between the fascias. As the fascia pull against each other and as fascia, like a lot connective tissue have a high amount of sensory nerve endings within them, this is why adhesion can cause pain.

What causes the Fascia adhesions?

There are multiple causes; scar tissue from old muscle strains or increased muscle tension from being held in a posture for a long time can cause the fluid to become restricted making it unable to move and thickening the fluid. Inflammation either through injury or infection increases the protein content, thickening the fluid. Dehydration through lack of water in the fluid again increases the protein content. These are just a few examples of how the fascial adhesions can occur.

So how can they be treated?

We naturally breakdown our own fascial adhesions every day when we get up each morning by stretching. This is one of the ways we as practitioners try to affect these adhesions that you can’t release, by using techniques that stretch fascia. Either by stretching the muscle directly with our hands or by moving limbs to stretch muscle and fascia.

So hopefully you can now see how extensively fascia runs through our bodies having many different roles superficially under the skin, inter woven into muscles, tendons and ligaments and lying deep within our bodies lining our organs; And this is what allows me as an osteopath to look at the body holistically. The way fascia connects our muscle, bones and organs together and the way the fascia and other soft connective tissues connect our bodies together is thought to give our bodies a tensegrity structure. This means that by having an increased pressure or weakness in one area of the structure the whole structure is affected. This brings me back to how adjusting or balancing the pelvis can help with treating a shoulder. So yes, it is all connected you’re right! I hope this has helped you to understand how.