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Short answer
According to the modern definition, the fascial system is a continuous, three-dimensional network of collagen-containing connective tissue that extends throughout the body. Fascia is rich in nerve endings. However, mechanically altering dense fascia would require a force many times greater than can be applied by hand, and the evidence for the effectiveness of myofascial techniques is insufficient to recommend this treatment.
In classical anatomy, fascia was long regarded as passive “packaging material” covering the muscles. Over the last two decades, fascia research has developed rapidly.
The modern definition
According to the definition of the nomenclature committee of the Fascia Research Society and the international consensus in sports medicine, the fascial system is a continuous, three-dimensional network of collagen-containing connective tissue that extends throughout the body. This network envelops the muscles, organs, vessels and nerves and connects them with one another.
Fascia as a sensory organ
Fascia contains numerous free nerve endings and mechanoreceptors. Fascia may therefore be involved in the generation of pain and in the perception of the body’s position.
Can fascia contract?
Fascia contains myofibroblasts that are capable of contraction. However, the forces measured are very small and are not at a level that would affect the stability of the spine.
Is it possible to “change” fascia by hand?
Calculations show that mechanically deforming dense fascia, for example the fascia lata of the thigh or the plantar fascia, would require a force many times greater than can be applied by hand. The “release” that the therapist feels during manual treatment therefore cannot be explained by a mechanical change in the tissue and is associated with other mechanisms, probably a response of the nervous system. The idea of hyaluronic acid “densification” in fascia, for its part, remains a hypothesis for now.
Clinical evidence
A systematic review of the effectiveness of myofascial techniques in chronic musculoskeletal pain does not consider the available evidence sufficient to recommend this treatment.
Conclusion for the student
Knowing the anatomy of fascia is important for palpation and clinical reasoning. However, expressions such as “breaking up adhesions”, “removing toxins” or “releasing emotions stored in the tissue” have no scientific basis and should not be used in professional communication.
The lesson recordings of the “Fascia 1” module can be found on the video lessons page.
Sources
- Adstrum S. et al. (2017). Defining fascia: nomenclature. J Bodyw Mov Ther. DOI: 10.1016/j.jbmt.2016.11.003 (opens in a new window)
- Zügel M. et al. (2018). Fascia and sports medicine: an international consensus. Br J Sports Med. DOI: 10.1136/bjsports-2018-099308 (opens in a new window)
- Schleip R. et al. (2019). The contractile capacity of fascia. Front Physiol. DOI: 10.3389/fphys.2019.00336 (opens in a new window)
- Chaudhry H. et al. (2008). The forces required to deform fascia in manual therapy. J Am Osteopath Assoc. DOI: 10.7556/jaoa.2008.108.8.379 (opens in a new window)
- Fede C., Stecco C. et al. (2018). Hyaluronic acid in fascia. J Anat. DOI: 10.1111/joa.12866 (opens in a new window)
- Laimi K. et al. (2018). Effectiveness of myofascial techniques for chronic musculoskeletal pain: a systematic review. Clin Rehabil, 32(4):440–450. DOI: 10.1177/0269215517732820 (opens in a new window)
This article is for educational purposes and does not replace a physician's advice.