BY RUTH DUNCAN

INTRODUCTION “Fascia” seems to have become quite a buzz word. Fascia, connective tissue, soft tissue, elastin, collagen, myofascial dysfunction and myofascial pain syndrome... the list goes on. So what is this fascination with fascia, and why?

RESEARCH BASE Fascial work is far from new, but recent research into the soft tissue of the body has highlighted some amazing facts that are slowly changing the way traditional healthcare views the anatomical structure. This has liberated therapists from the confines of oil and fluffy towels into actually having scientific backup that soft tissue harbours injury, inflammation and dysfunction and, with the use of fascial techniques, is ‘mouldable’ back to health and balance. More importantly, this research proves that fascial dysfunction has a physical and emotional history. A patient’s presenting symptom can now be traced back to a seemingly unrelated trauma several years ago that has slowly affected the overall fascial tensegrity, posture and balance, creating the present symptom. Ervin Laszlo’s Science and the

Akashic Field, Lynne McTaggart’s The Field and James Oschman’s Energy Medicine in Therapeutics and Human Performance each discuss the nature of the human body, the body’s electromagnetic qualities, and the concept of the body acting as a whole rather than as separate parts (1–3). Laszlo states that the living organism is not a mere biochemical machine but a living organism, dynamic and fluid with all components in instant and continuous communication. Could he be describing the fascial network (boxes 1 and 2)? When we use the term “myofascial

pain”, we are not simply talking about trigger points, myofascial meridians or lines. We are describing a dysfunction that affects the entire tensile network. Fascial scarring from an old injury to the coccyx can create a twist and pull throughout the entire network right up into the jaw, creating a temporomandibular joint (TMJ) problem that a dentist may try to resolve with jaw splints – but this is treating the symptom, not the cause. The constant groin strain will not be resolved unless

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MODERN MYOFASCIAL RELEASE

Fascial work is not new, but current research changes the way we view the anatomical structure and stresses the importance of the fascial network in musculoskeletal dysfunction. In the modern form of myofascial release, less is more. The therapist treats in a three- dimensional manner, which allows the fascia to release naturally, breaking habitual holding and bracing patterns and permitting a reintegration of awareness with physical function.

BOX 1: FASCIAL FACTS

■ Fascia is a continuous three-dimension tensile web or network reaching from head to toe ■ Fascia is a microscopic tubular network made predominantly of collagen, elastin and a gel-like fluid called “ground substance” ■ Ground substance acts as a shock absorber ■ Fascia interweaves, supports and protects every other living cell of the body ■ Fascia is fluid in nature and provides cushioning and form to the body ■ Fascia supports the skeleton and visceral organs ■ The fascial network dissolves soon after death, leaving adhesions as the only visible sign of its existence ■ Fascia responds to pressure but is not compressible ■ Fascia resists force proportionally against the force of velocity applied to it ■ Fascia is affected by trauma, inflammation, overuse, underuse and poor posture.

BOX 2: DYSFUNCTIONAL FASCIA

■ Dysfunctional fascia does not show up on X-rays, magnetic resonance imaging (MRI), myelography, computed tomography (CT) or electromyography scans ■ Dysfunctional fascia sticks to its own fibres, creating a pull throughout its structure ■ Dysfunctional fascia pulls the skeleton out of balance and compresses organs, nerves, blood and lymph vessels ■ Dysfunctional fascia harbours toxins, and decreases cell elimination and water and nutrient exchange within the cells ■ Dysfunctional fascia can exert a pressure of up to 200lbs per square inch on to pain-sensitive structures, vital organs and cells ■ Dysfunctional fascia solidifies the ground substance, affecting body temperature, proprioception and movement ■ Dysfunctional fascia creates emotional and physical holding and bracing patterns.

we look at the symmetry, balance and function of the entire network. A unilateral rotated pelvis, a rotated thorax and an anteriorly rotated shoulder girdle create enough tension and fascial pull to harbour the pain felt in the groin. We must find the pain and look elsewhere for the cause. In fact, surgery can potentially create more fascial scarring and in turn cause more dysfunction.

USING MANUAL THERAPY TO RESOLVE INJURIES Manual therapy is not just about bones, nerves and muscles. It’s about the entire fascial network that supports and includes everything else. This is where myofascial release (MFR) has gained its reputation. There are two main approaches: the direct, or traditional, approach; and the non-direct, or modern, approach.

Direct approach Direct, or traditional, MFR is the approach that most therapists are aware of. There is limited or no use of lubricant. Moderate to firm pressure from the finger, thumb, hand or elbow is applied into the tissue, following the muscle length and meridian or fascial lines. The therapist moves or glides through the tissue in order to restore length and balance, sometimes using strumming, stripping and skin rolling. The direct approach can be protocol- and structure-oriented, and it can be part of a series of treatments.

Non-direct approach The non-direct, or modern, MFR approach uses no lubricant. The

sportEX dynamics 2008;18(Oct):14-16