‘Fascia’ has become a buzz word over the last few years, not only in healthcare fields but also with much of the general public. And it’s about time! Fascia is the reason that the neck bone really is connected to the foot bone. Some use the term ‘myofascia’ to mean the same thing, though technically this includes the muscle fibers along with the fascia itself. So what is ‘Fascia?’

Fascia is “the soft tissue component of the connective tissue system that permeates the human body. It interpenetrates and surrounds muscles, bones, organs, nerves, blood vessels and other structures. Fascia is an uninterrupted, three-dimensional web of tissue that extends from head to toe, from front to back, from interior to exterior… After injury, it is the fascia that creates an environment for tissue repair.”

- Paoletti, Serge (2006). The Fasciae: Anatomy, Dysfunction & Treatment. Seattle, WA: Eastland Press. pp. 151–161.

It is theorized that when fascia is distorted from its normal arrangement, it can restrict or change the movements of the above-mentioned structures, potentially causing pain and/or predisposing you to injury. These changes in fascia can have a wide variety of causes … everything from a one-time trauma, to repetitive overuse, and poor posture.  Luckily, in most cases, fascia can be manipulated back to a normal or at least more normal arrangement very quickly.

Let’s explore an example of how abnormal fascial changes can lead not only to pain in the areas they exist, but elsewhere in the body as well. One year prior to meeting ‘Mr Smith,’ an avid runner, he had strained his right lower back lifting a heavy box. The discomfort from that injury faded over the next couple months, and since the symptoms were getting progressively better he decided he would not get checked out by a healthcare practitioner.

Once his pain was gone, he resumed his daily run and progressed back to five miles per day. Within 2-3 months, he began to notice a mild pain in his right knee after his morning jogs. It wasn’t long before this pain was present during his runs as well, and within a few weeks he could no longer run. His Orthopedic specialist referred him to Physical Therapy with a diagnosis of Patellar Tendonitis. After a few treatments, Mr. Smith’s symptoms began to improve, and he started some light jogging. Two months, many Physical Therapy treatments, and a cortisone injection later, Mr. Smith was still not able to progress beyond a two-mile jog without pain. The ultrasound, leg/hip stretching and strengthening, and massage of the painful area had all helped but had not solved the problem.

When I saw Mr. Smith the first time, and watched the way he stood, walked, and ran, I noticed a very slight lean/shift of his trunk to the right. This prompted me to ask about his back, and any injuries/pain he may have had in the past. By the end of the evaluation, and after ruling out a few other factors such as leg-length differences, it was clear that his tendon irritation was due to repeatedly overloading his right leg. This overload was due to the fact that the injured myofascia in the low back had remained tight even though the pain faded over time, and it caused him to shift his weight slightly to the right. The overuse injury was an irritation of a tendon in his knee, though it actually could have manifested as a problem in a variety of other areas. The Orthopedist was correct. Mr. Smith did have inflammation and irritation of his patellar tendon. Treatment of this area was effective to a point, but was not addressing the underlying cause of the problem. A few treatments to release and lengthen the fascia and muscles in his right lower back, and Mr. Smith was back to running 5 miles pain-free.

The moral of the story is that even if the pain of an injury ‘fades’ quickly, it does not mean that it didn’t leave behind a problematic change in the Fascia. Though the source of pain/injury may be in the same place that symptoms are experienced, it is also quite common for it to exist in a different part of the body.

www.CarterPT.com