, P.T., L.M.T., N.C.T.M.B.
I graduated as a physical therapist from the University of Pennsylvania in 1960, 50 years ago. It’s amazing how much new information has been discovered over the years.
Fascia was rarely mentioned then, and basically we were taught fascia was only “packing material” and the covering of muscle. In anatomy class, as we dissected cadavers, I clearly remember the anatomy professor saying to us, “Scrape all of that stuff (fascia) off of there!” That’s the way it was then—and in many places, that’s the way it is now.
Max Planck, the father of quantum physics, said science grows one death at a time. This glacially slow pace has been a detriment to our growth and that of health-care professions. The ultimate loser has been our clients. There is a voluminous amount of research available that turns everything we were taught about the fascial system upside down and inside out. The following are just a few examples of this important information.
The following quotes are from Carol Davis, D.P.T., Ed.D., M.S., F.A.P.T.A., editor of a book titled, Complementary Therapies in Rehabilitation: Evidence for Efficacy in Therapy, Prevention, and Wellness, (3rd Edition) 1 (www.slackbooks.com/ctr). Davis has been researching the latest articles about fascia, as well as some previously published information, for an update of her chapter on myofascial release for a well-known neurological textbook to which she has contributed.
- Fascia turns out to be far more complex and far more involved in the moment to moment function of all our cells, and is intricately involved with the central, peripheral and autonomic nervous system tissue. It is no longer useful to view the body or the fascial system as a mechanical system alone. Nonlinear system dynamics are at work as we now understand the involvement of fascia with the neuroendrocrine system, the brain and the neurological plexus in the lining of organs like the stomach and gut.
Fascia must be viewed by practitioners and patients not as a static, but as enervated, alive, functional, fluid and self-regulatory. Involving the patient or client in the process of manipulation of fascia and its embedded tissue enhances the response of the tissue and the patient. (Schleip R. Fascial plasticity–a new neurobiological explanation. J. Bodywork and Movement Therapies. 2003;7(2): 104-116.)
Central to the complete understanding of the effectiveness of energy-based myofascial release for the relief of pain and the facilitation of healing are the following points:
- Fascia is piezoelectric tissue. Myofascial release that emphasizes sustained pressure into fascial restrictions generates a flow of electrical activity, or information, throughout the fascial system. Electrical impulses are generated in the collagen by compressive and distraction forces within the musculoskeletal system. These impulses trigger a cascade of cellular, biomechanical, neural and extracellular events as the body adapts to external stress. In response to internal stress, components of the extracellular fluid change in polarity and charge affecting fascial motion. (O’Connell, Judith. Bioelectric responsiveness of fascia: A model for understanding the effects of manipulation. Techniques in Orthopedics 2003; 18: 67-73.)
- With myofascial release, the extracellular matrix softens from “gel” to “sol” allowing the fascial restriction to melt and release pressure on pain-sensitive tissue, and to rehydrate to allow for conduction of flow of photons and vibration. (Twomey L, Taylor J. Flexion, creep, dysfunction and hysteresis in the lumbar vertebral column. 1982. Spine 7(2):116-122). It is hypothesized that this action facilitates the cell to cell communication required in homeostasis and self regulation, and thus facilitates the body/mind’s ability to heal itself. (Pert C. Molecules of Emotion. 1997; NY. Simon and Schuster/Touchstone.)
- “Our richest and largest sensory organ is not the eyes, ears, skin or vestibular system, but is in fact our muscles with their related fascia. Our central nervous system receives its greatest amount of sensory nerves from our myofascial tissue.” (Schleip R. Fascial plasticity–a new neurobiological explanation. J. Bodywork and Movement Therapies. 2003;7(1):16.)
- The presence of smooth muscle cells within fascia along with widespread presence of myelinated and unmyelinated, sensory and motor nerve fibers and capillaries has led to an hypothesis that fascia is an actively adapting organ with functional importance, rather than a passive structural organ alone. This may be the root of myofascial pain syndromes. (Schleip R. Fascial plasticity–a new neurobiological explanation. J. Bodywork and Movement Therapies. 2003;7(2): 108.)
- There are nine or 10 times the sensory nerve endings in the fascia for every one sensory nerve ending in the muscle. The fascia plays a major role in helping us to sense where we are in space and sense our inner tissue in ways not fully appreciated previously. (Kandel E. Essentials of Neural Science and Behavior. 1995; New York: Appleton and Lange.)
- Fascia contains myofibroblasts that can tense or release in fascial sheets. (Gabbiani G, et al. Granulation tissue as a contractile organ. J. Experimental Medicine 1972; 135:719-734.)
- Fascia has been hypothesized to play a role as the seat of consciousness in the body/mind system. (Oschman, J. Energy Medicine–The Scientific Basis. 200. Churchill-Livingstone.) As one example, there are 10 times as many connective tissue cells as nerve cells in the brain. Previously thought only to provide support and nutritional pathways to nerve, the latest brain scan research indicates glial cells “light up” during certain brain states, particularly emotional states. They have been shown also to play a role in regulating neuropeptides and neurotransmitters, thus thought to play a role in helping to regulate mood. (Koob A. The root of thought: What do glial cells do? Scientific American, Oct. 2009.)
- Fascia plays a role in the maturation of stem cells. The fascia that surrounds all cells as the cell wall, and the fascia of the extracellular matrix which is the environment of all cells in the body determine the pressure sustained on developing stem cells into their mature cells. (Kelly DJ, Jacobs CR. The role of mechanical signals in regulating chondrogenesis and osteogenesis of mesenchymal stem cells. (Birth Defects Research Part C: Embryo Today: Reviews March 2010; 90(1): 75-85.)
- Three specialized stretch receptor nerve endings in fascial structures play a role in helping us to be able to sense what is happening in our tissue moment to moment and when receiving manual therapy. Golgi tendon organs in both tendons and in aponeuroses give feedback about the straightening of the fibers in the tendon, paciniform ending in the myotendenous junction, joint capsules and ligaments report vibration and rapidly changing pressures in the fascial net, Ruffini endings respond to deep and sustained pressure (Schleip R. Fascial plasticity–a new neurobiological explanation. J Bodywork and Movement Therapies. 2003; 7(2): 104-116.)
Davis continues to study and write about fascia, and has written an important book that features up-to-date research on myofascial release and many different therapeutic approaches. She can be contacted at firstname.lastname@example.org.
1. Davis, C. Complementary Therapies in Rehabilitation: Evidence and Efficacy in Therapy, Prevention, and Wellness, 3rd Edition. Slack Inc: Thorofare, NJ. 2009.
John F. Barnes, P.T., L.M.T., N.C.T.M.B., is an international lecturer, author and acknowledged expert in the area of myofascial release. He has instructed more than 50,000 therapists worldwide in his Myofascial Release Approach, and he is the author of Myofascial Release: the Search for Excellence (Rehabilitation Services, Inc., 1990) and Healing Ancient Wounds: the Renegade’s Wisdom (Myofascial Release Treatment Centers & Seminars, 2000). He is on the counsel of advisors of the American Back Society, as well as on MASSAGE Magazine’s Editorial Advisory Board and is a member of the American Physical Therapy Association. For more information, visit www.myofascialrelease.com.
For more information about myofascial release, view two separate excerpts from the Fireside Chat with John F. Barnes, P.T. DVD on YouTube:
View Part 1
View Part 2
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