Fascia
By Brianna Delaney
The word fascia might be one you’ve heard before as either the source of your pain or contributing to it. Fascia are dense bands of connective tissue that cover and separate different tissues throughout the body. Wrapping around everything from muscles to bones to organs it is sometimes likened to glad wrap within the body, however it is quite different.
Fascia can be categorised into two main categories;
Superficial fascia is found just deep to the skin surrounding the whole body and containing fat, nerves, blood vessels and other connective tissues.
Deep fascia is a dense fibrous connective tissue that surrounds muscles, bones, nerves and blood vessels. Some muscles will even originate or attach directly onto fascia. There are also areas of sheet-like membranes called Aponeurosis that connect muscles to each other, to bones or other fascia. For example the abdominal aponeurosis.
The role of this connective tissue is to contain soft tissue structures and transmit mechanical tension throughout the body, providing support for tissues and helping to reduce friction as we move. When healthy, fascia is relaxed and malleable but can quickly become tight and painful when trauma or inflammation occurs. This can restrict movement of the underlying tissues and cause pain.
Injury or inflammation of the fascia causes conditions such as fascitis or compartment syndromes. Plantar fasciitis is one of the most common and is the result of repetitive strain typically at the plantar fascias attachment to the heel (calcaneous). It results in pain and inflammation at the sight making simple activities like walking and standing for long periods quite difficult.
However, fascia can play a contributing role in other musculoskeletal presentations. Due to fascia playing a large role in connecting muscles together, a network of connective tissue is created. There are some common patterns that are starting to emerge from this network that are being referred to as myofascial chains or meridians. When injury or pain occurs in one area of the body, tightness or lack of flexibility along other parts of a chain may contribute to the onset or experience of pain. For example, the superficial back line fascial chain connects from the plantar fascia to the gastrocnemius muscle, hamstrings, sacrotuberous ligament to the paraspinal muscles right up to the skull. Tight hamstrings and decreased flexibility has been shown to contribute both to lower back pain as well as plantar fasciitis (Ajimsha, Shenoy & Gampawar, 2020).
Stretching, hydration and staying active can help you to look after your body as a whole and keep your fascia malleable and working to help rather than hinder your daily life.