by Cora Nieuwenhuis, RMT
For years the human body has been portrayed in a very simplistic form. Bones, muscles, nerves and organs have been the main focus of science. It hasn’t been until recently that scientists, doctors and manual therapists from around the world have begun to re-evaluate the importance of a largely neglected and overlooked type of connective tissue called Fascia. We have since begun to evolve our perspective about this very important organ in the human body.
What is Fascia?
Fascia (plural-fasciae), the soft tissue component of the connective tissue system, is found throughout the entire body. It interpenetrates and surrounds all organs, muscles, bones, nerve fibers and skin, forming a continuous three-dimensional web-like support system. If we were to take away all other structures within our body and only leave the fascia, we would still have a very well defined human form. Fascia encompasses all forms of fibrous connective tissues, including but not limited to ligaments, tendons, joint capsules, the meninges, the framework of organs (viscera), intermuscular and endomysial fibers of the myofasciae (within, surrounding and throughout the muscle fibers) and the skin. Like ligaments and tendons, fasciae are generally composed of dense regular connective tissues, containing closely packed bundles of collagen fibers oriented in a wavy pattern parallel to the direction of force or pull. Fasciae are normally thought of as passive structures that transmit mechanical tension generated by muscular activities or external influences throughout the body. Often trauma, which all of us experience throughout our lives, can be held in the Connective tissue/Fascia due to the increased production of collagen fibers during the healing process
Since fascia is so diverse within our body, it plays part in a multitude of bodily processes and thereby crosses several disciplines across the medical, scientific and therapeutic fields. We have only begun to scratch the surface on how important fascia actually is. Due to the pervasive and interconnected quality of this tissue, it has been difficult to adequately divide and classify the number of forms and roles this organ takes part in. Some roles fascia is thought to take part in has been that of active joint stability, structural support of organs, blood vessels and nerves, providing a medium of transport for various cellular process within our bodies and allowing muscles and tendons to slide and glide over and alongside each other. There have also been studies into the role fascia plays in chronic pain syndromes, lower back pain and neurological conditions.
How does Myofascial Therapy relate to Massage Therapy?
Massage therapy has been shown to help the healing process when treating common dysfunction within our bodies. In combination with therapeutic massage, I tend to combine Facial or Myofascial Release Therapy in my treatments as I see greater results in injury prevention and recovery, as well as the ability to compliment and improve the outcome for clients that are partaking in regular massage therapy. Whether it be at a superficial or deep level, Myofascial Release Therapy approaches the tissues in a manner that uses its mechanical and sensory properties to stimulate a release of holding patterns & restrictions in the body, thereby allowing greater ease of movement in the body, a decrease in discomfort or pain as well as a greater sense of well-being. Since fascia acts as a medium for transport of cellular process, hydration and even some sensory functions, it is my belief that we can indirectly affect the nervous system though sensory receptors located in this structure and all those it connects. By perhaps releasing the tensions held in the body through various structures, we then allow the body to regain its natural desire to maintain balance within itself and the healing process can continue with ease. This form of therapy does not always use oils or lotions and often has the client take an active part in the treatment process as they may be required to move through various positions to increase the effectiveness of certain techniques. Please also note that this form of therapy including pressure, active participation and techniques will be modified depending on your individual body’s requirements.
In combination with Myofascial therapy, I also perform a type of therapy called Visceral Manipulation. Similar to Myofascial Release, Visceral Manipulation is a form of treatment that deals with the mobility of the internal organs (viscera). Connective tissue not only surrounds the various organs but also creates the framework (stroma) of each. Applying the knowledge of mechanical properties of connective tissue/fascia to the visceral is virtually the same as within the musculoskeletal system. The principles of the techniques remain the same. When treating restrictions of the viscera it is important for the therapist to recognize its tissue sensitivity, physiology, shape and relationship to other structures. It is not uncommon to find restrictions of the organs presenting as musculoskeletal dysfunction, especially after trauma, chronic stress or even indigestion. Often our symptoms of pain and decreased range of motion are attributed to an isolated area, however, the fascia or connective tissue knows no boundary within the body, therefore, restriction can spread throughout tissue layers and into “seemingly” distant areas. Very subtle techniques as well as patient positioning and breathing are used to engage and encourage the organs to release holding patterns. If restrictions are present within or around the viscera and are a part of a musculoskeletal dysfunction, the body will never fully heal until the visceral restriction has also been addressed. Some common restrictions that I treat are restrictions in the diaphragm from altered breathing patterns (this restriction will usually include restrictions in rib mobility and imbalances in respiratory musculature) and intestinal restrictions (digestive disorders, constipation and stress can all impact our intestines).
*Please note that if you wish to take advantage of these forms of therapy, I usually suggest to clients to bring a sports bra/loose shirt and shorts to their appointment. This way, we can gain access to various restrictions while making sure you are comfortable and secure at all times.
Bednar DA, Orr FW, Simon GT. Observations on the pathomorphology of the thoracolumbar fascia in chronic mechanical back pain. A microscopic study. Spine 20(10):1161-4, 1995
Stilwell DL Jr. Regional variations in the innervation of deep fasciae and aponeuroses. Anat. Record 127(4): 635-53, 1957
Stecco C. et al. Anatomy of the deep fascia of the upper limb. Second part: study of innervation. Morphologie 91(292):38-43, 2007
Threlkeld AJ. The effects of manual therapy on connective tissue. Physical Therapy. 72(12): 893-902, 1992
Minasy B. Understanding the process of fascial unwinding Intern J Ther Massage Bodywork; 2(3):15-22, 2009
To arrange your appointment for a therapeutic session of Integrative Myofascial Release Therapy and visceral manipulation with Cora, please call Pacific Wellness at 416-929-6958 or submit your online appointment request form from our website.