Issue link: https://www.massageandbodyworkdigital.com/i/296580
114 m a s s a g e & b o d y w o r k m a y / j u n e 2 0 1 4 Understanding Fascial Change Continuity, Plasticity, and Sensitivity By Til Luchau What is the most abundant tissue in the body? Did you say bone? Good guess—after all, we have around 206 bones. Muscle? It's true that we have somewhere between 600 and 800 named muscles, depending on who is counting. But even more profuse than those are the fasciae—the membranous connective tissues that surround and connect every part of our internal structure (Image 1). And yet, instead of having hundreds or thousands of fasciae, some say we have just one. WHAT IS FASCIA? The term fascia (from Latin, meaning "band") generally applies to the fibrous connective tissues covering, connecting, and investing muscles, tendons, bones, vessels, organs, and nerves. It has many subtypes, which can vary from dense to loose, and from highly regular to very irregular. Academics still debate precisely which tissues can justifiably be considered fascia. 1 But researchers generally agree that all the tissues under discussion are composed of the same basic elements (cells, fibers, and a matrix or ground substance) in varying proportions and arrangements, and that all these tissues interconnect. Fascial researcher Robert Schleip and his collaborators offer a commonly accepted definition of fascia: "Soft tissue components of the connective tissue system that permeates the human technique MYOFASCIAL TECHNIQUES Artist Lisa Nilsson reinterprets anatomical cross-sections using rolled paper, simulating the interconnected fascial wrappings around and within muscles, bones, nerves, etc. Photographer: John Polak. www.lisanilssonart.com, used by permission. body." 2 This definition includes not just the enveloping membranes, but also aponeuroses, joint capsules, ligaments, and tendons. We'll use this broader interpretation in our discussion here. WHAT IS MYOFASCIA? What, then, is "myofascia"? Strictly speaking, myofascia refers to the fascial connective tissues related to the skeletal muscles (myo meaning "muscle")— their internal fascial structures and external connections, coverings, and septa. Informally, myofascia is often used interchangeably with fascia, though there are many kinds of fascia not directly related to the muscles. THE UPS AND DOWNS OF FASCIA Fascia has several qualities that are particularly relevant to hands-on work. Three of these are continuity, plasticity, and sensitivity. Each has both beneficial and detrimental aspects when it comes to the body's functionality (Image 2). We'll discuss each of these qualities in turn, and list techniques that utilize them. In the next column, we'll describe additional fascial techniques in greater detail. 1. Continuity Fascia is good at connecting things. Anatomy students are taught that fascia connects individual muscle cells to bones in an uninterrupted chain that includes the endomysium, perimysium, epimysium, tendon, and periosteum. This is true, but not quite the entire story: less well known is that about 30 percent of a muscle's fascial attachments connect to neighboring fascial structures, rather than directly to a bone. 3 This fascia connects in turn to other fasciae, and so on, forming a complex three-dimensional network of interconnections (Images 3 and 4, page 116), not a one-to-one linear chain. This nonlinear, multidimensional interconnectedness has advantages such as more even load distribution, tensional responsiveness, and increased overall sensitivity—much as a fly wriggling in a spider's web can be sensed throughout the whole web's network. 1