Bones, muscles, tendons, ligaments… These tissues are synonymous with the structure of the body. However, there is a binding tissue that holds them in place, providing not only definition and robustness, but also facilitating flexibility and movement. Fascia is the dense connective tissue made up of closely packed collagen fibres which penetrates and surrounds muscles, ligaments, bones, nerves and other structures. It extends from head to toe in an uninterrupted, three-dimensional web. Just as one trains various parts (tissues) of the body, fascia training should also be included in strength and endurance programmes, warm-up and even warm-down routines.
Fascia binds the structures together while allowing them to smoothly glide over each other in order to facilitate movement. The tissues are highly tensile and can resist a great amount of load. However, they are also prone to injuries.
“As a natural consequence of trauma, inflammation or immobility, the fascia loses flexibility and becomes restricted,” says sports physiotherapist Tushar Saikat Paul, who is registered with Indian Association of Physiotherapists (IAP) and works at Sports Authority of India in Bengaluru. “This in turn leads to localised as well as larger problems in the body, with acute and chronic imbalances such as joint dysfunction, pain as well as dysfunctional venous and lymphatic systems.”
Role of fascia in balance
According to research, the fascia has 10 times more proprioceptors than muscles, says Paul. So, when the fascia gets injured, it becomes thick and fibrotic, forming adhesions. This could lead to disruption of balance and proprioception.
Recent studies suggest that the fascia has a large supply of nerves. The thoracolumbar fascia (membrane covering the back of the chest and abdomen) has a high density of mechanoreceptors. They are responsible for carrying implicit information about joint position and movement from the skin and sensory receptors to the brain and spinal cord.
What is fascia training?
“When you say fascia training, it mostly means training the myofascia – fascia surrounding joint capsules, tendons, ligaments, etc. In sports, it mostly means stretching to achieve a good range of motion for maximum functional activities,” says B. Maithili Dutta Pradhan, who works at the Sports Authority of India in Bhubaneshwar.
“Let’s say you are more of a sedentary person. As you are not moving around [much], your body starts to adapt to that posture,” explains Pradhan. “As a result, your muscles and fascia adapt to that shortened position. Then, when you start to move or do an activity, it will restrict your action. So, to execute that action, you will have to stretch the fascia/muscles properly and gain that lost range of motion to avoid any injury.”
The relationships among fascia mobility, proprioception (sense of movement), and myofascial pain are largely unstudied. A review article published in 2021 suggests that a better understanding of these areas could result in improved care for many patients with musculoskeletal pain.
Staying fit and pain-free with fascia training
“The purpose of fascia training is to facilitate soft tissue extensibility (by mobilising scar tissues, adhesions, etc.) and reduce pain,” says Paul.
“Also, fascia training can be incorporated in an athlete’s routine to achieve a greater amount of flexibility, which in turn can improve performance and reduce the chances of injuries,” he adds. “In addition, training the fascia can reduce your chances of getting DOMS (Delayed onset muscle soreness). Training prevents the tissues from becoming fibrotic and can help to stimulate the formation of new collagen fibres.”
Fascia training also promotes blood flow, which in turn speeds up the healing process.
“In addition, training the fascia can further help in removing adhesions so that the joint and muscles can work more efficiently,” says Paul.
Myofascial release therapy
Myofascial tissue is the fascia that surrounds and supports the muscles.
“Myofascial release is a manual therapy technique often used in massage and physiotherapy,” explains Paul. “Myofascial release therapy focuses on relieving myofascial pain, which differs from other types of pain as it characteristically originates from myofascial trigger points – stiff, anchored areas within the myofascial tissue itself.” In this technique, manual pressure is applied to locate myofascial areas that feel tight and static, instead of pliable and flexible. The focused manual pressure and stretching loosen up the restricted movement, reducing pain.
Apart from manual massage, foam rollers are used for releasing the fascia.
“Shock wave therapy (SWT) can also be used to release these trigger points,” adds Paul.
“In SWT, the physiotherapist puts ultrasound gel over the affected area and a shock wave gun is used to mechanically release pulses which are believed to release those trigger points.”
Takeaways
- Fascia is the dense connective tissue which extends from head to toe and holds the bones, muscles, tendons and ligaments in place, ensuring flexibility of movement.
- Excess inactivity or improper workouts may lead to fascial injuries, affecting vital mechanoreceptors involved in balance and proprioception.
- Fascia training must be a part of one’s regular workout. Apart from improving sport performance, it is also essential for avoiding and treating sport-related pain as well as injuries.
- Myofascial release therapy is a massage-based technique which focuses on releasing fascial stiffness and associated pain.
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