Fascia, Trigger Points, and How To Deal With It
Fascia
Imagine you have Saran Wrap covering your whole body. That’s what fascia is like. Fascia also surrounds every single muscle, organ, and joint in our body. There are many layers of fascia throughout our body. At its basic function, it is considered connective tissue, which might make you think of ligaments and tendons. These are essentially the same as fascia, just more dense. However, fascia is a little bit more complex.
Fascia is responsible for a lot of the sensation throughout our body. There are cells that tell our brain how much tension or pressure is on a spot.
It’s also very elastic. When you jump, you are putting tension on the fascia of the back of your legs before you use that tension to explode and jump upward. Most explosive movements we see professional athletes do on TV involve stretching/loading their fascia, then contracting their muscles to throw a ball, jump, or swing a bat.
Something that is not widely known, is that fascia can actually contract. Like muscles, fascia can shorten. The elements that contract are essentially like a tow strap that you can ratchet to pull two ends of a rope together. This is good and bad when it comes to fascia. Good when you want to swing a golf club faster or throw a ball harder. Bad when you have a big knot in your back that you can’t seem to get rid of.
We mentioned the many layers of fascia. Often, the layers will stick together, leading to what feels like tight muscles. Imagine you have two pieces of paper stacked on top of each other - when you slide them across each other they glide easily, but if there was wet glue between them it would be much harder. Fascia will actually connect each layer together as a web. If there are more web connections between the layers, there is less movement between the layers of muscles. I often see people with upper back stiffness, this is a great example of when the big layers of muscles do not glide well across each other and cause stiffness, because the web of layers has more connections.
What causes fascia to contract and stiffen?
Inflammation
Getting hit, poor diet, lack of movement, and several other things can cause inflammation. Inflammation leads to cells rushing to the area in a healing response to an injury or threat to the body. This cascade of events is not great for our fascia and can lead to the layers of fascia ‘sticking’ together, as the web of layers becomes more intertwined, the connections become stronger. Inflammation is also sometimes accompanied by a lack of blood flow, and the combination of fascia stiffness can compress the smallest vessels which supply blood to our skin and most superficial tissues.
Stress
We mentioned that fascia has the ability to ‘sense’ things. There are special nerves in the fascia that are connected to part of our nervous system that is related to stress or ‘fight or flight’. When we are stressed, our brains can send a signal to the fascia that tells it to contract through these nerve endings (sympathetic nerve endings). You may have experienced upper back tightness when dealing with something stressful, and you blame it on your body holding the stress in your upper back and neck. This is why that happens. And FYI, the upper back is a highly susceptible area for this stress-induced stiffness.
Bad Posture
Posture is another term for ‘Position’. We commonly sit in a position with our hips and knees flexed and after a while, our shoulders will roll forward. Certain muscles will be shortened, such as the hips flexors, chest muscles, and the back of our neck. As an example, with our hip flexors being in a shortened position for so long, it will eventually want to stay that way. The connective tissue that surrounds it (fascia) will remodel itself to support the activities or POSITIONS that we typically are in day-to-day. The fascia is constantly laying down more fibers in areas where we need it more than others. Moreover, if they are shortened and no tension is on the fascia the fibers will be distributed in an un-orderly fashion, not straight.
Pain
When our body is in pain, the fascia around the painful area goes on ‘high alert’ to protect the body from more injury and will tighten up as a result. Similar to how fascia will contract from stress, it does the same with pain. The brain perceives a threat and does its best to prevent further injury. This typically works against us. Our muscles weaken, we are more sensitive to pressure, and it hurts to move our joints. Of course, the longer the injury has been present the more pain there is.
So what do I do about it?
It’s helpful to understand why pain and discomfort can come from our fascia, but it’s even better to know what to do about it. There are four main ways to help fascia relax and to help the layers of fascia loosen up:
Blood Flow
Pressure
Tension
Breathing
Blood Flow
When those layers of fascia are ‘stuck’ together, it causes less blood to come to the area. Bringing more blood means more oxygen and can begin to decrease inflammation where there is stiffness or an injury is present. Several things can improve the blood flow to an area:
Cupping - using cups that create a vacuum with less pressure than the air, so the skin and layers underneath the skin are pulled to the surface. It will also pull blood flow to the area and can decrease the inflammation in an area, especially if it is within the fascia layers. If there is not much blood flow when the cups are on, it can mean someone’s tissue is very tight, restricting blood flow. If there is a lot of bruising, it indicates stagnant blood. If the cups cause dark circles at the time, but they go away quickly, this is healthy and normal.
Heat - Hot tub, hot bath, heat pack, or a sauna provide heat to our body and can bring more blood flow to an area. Heat will help flush out bad cells leading to our fascia layers sticking together.
Pressure
We can get tight tissues to loosen up with mechanical work. These include:
Myofascial release techniques - widely known as massage, but includes an extensive list of different hands-on techniques to improve mobility.
Massage gun - similar to the previous example, but it is technically different as it utilizes vibration. Vibration has a calming effect on our fascia and can allow it to loosen and allow more movement.
Body Scraping - also known as Graston or IASTM. This is the use of tools to manually loosen up tissue. It can be somewhat uncomfortable, but effective. Also another form of a myofascial release technique.
Tension
When our bodies are tight, they resist the ability to stretch and extend. Tension across our fascia can prevent and help get it more elastic and extensible. Including:
Stretching - There are many ways to stretch and different types of stretching. Static, dynamic, etc. Stretching our fascia is an effective way to make it more loose and prevent stiffness.
Proprioceptive Neuromuscular Facilitation (PNF) - This is a technique I use a lot as a PT. It involves taking a muscle or joint to end-range, contracting the muscle that is being stretched, then relaxing and allowing a deeper stretch. I mentioned that fascia has cells that sense tension - this technique communicates with those cells to tell them to relax and basically tell the body it is okay in that position.
Breathing
This may be the most important aspect to helping our fascia release. Deep breathing stimulates our parasympathetic nervous system, our “rest and digest” nervous system, which allows our body to relax and prevents the fascia from stiffening. Most of us do shallow breathing throughout the day and are in more of a “fight or flight” state. Deep breathing promotes lower blood pressure, improved lymphatic circulation, and prevents the release of cortisol in our body.
Prolonged Exhale - Breathing out longer than breathing in. Ex., Inhale 7 seconds, Exhale 12 seconds
Box Breathing - Breathe in 4 seconds, Hold 4s, Exhale 4s, Hold 4s, Repeat
What I’ve found to be most beneficial is to combine multiple of these techniques. Stretching with deep breathing is the easiest way to combine these. Using some of the myofascial release techniques and deep breathing is also very effective and easy to do.
All of these are ‘tools’ and help us to maintain mobility and prevent injury. They can be done as maintenance, which is helpful to maintain healthy muscle and joint function, but they can also be time consuming. It is best to learn how to monitor our bodies well enough to know when these ‘tools’ are needed. Experimenting with all of these techniques helps to figure out what they are all like and when they might be most useful.
If you have any questions, please reach out or fill out our contact page. Whether you want to try them or if you want more information. If you do, send us an email at byltpt@gmail.com, through our website www.byltpt.com, or by phone.
