By Anna Skura, RMT

You may have heard of the term fascia or fascial work; it’s an area that has gained considerable attention in recent years. What does it mean and how does a treatment targeting fascia differ from a traditional swedish massage? As an Registered Massage Therapist, one of the most commonly held beliefs that I come across in my practice is the idea that the more painful a treatment the more effective it must be. While there are times during a treatment when uncomfortable sensations may arise and techniques that are used which may require more pressure, this is certainly not always the case.

For anyone that has suffered through a treatment silently waiting for it to be over, or questioned the benefits of “gentle” less invasive techniques, understanding fascia and its responsiveness to touch could offer insights into the treatment options available to you.

What is fascia?: This is an anatomical term to refer to tissue in the body that connects muscles and separates organs. Once thought of as an inert tissue it now has been demonstrated to be innervated and has the ability to contract. It is highly adaptive and over time will respond to things like poor posture.

Where is fascia?: It links and blends with all tissues of the body (organs, muscle, bone) on the surface of the body as well as deep within. For an organized and more in-depth look at how some fascia link and are mapped out, you can refer to Thomas Myers’ Anatomy Trains1 where fascia has been organized into specific groupings or “chains”.

How do you treat fascia?: Working with fascia is different than direct muscular work  and therefore requires different techniques. Fascia is supplied by what are called mechanoreceptors (wiki:https://en.wikipedia.org/wiki/Mechanoreceptor )  which have been found to respond to different types of stimuli such as long sustained pressure and vibration. What this means in practical terms is that in order to get stubborn tissue to respond a practitioner may hang out in one area for a longer period of time (sometimes 3-5 minutes) with what may be perceived as very little pressure. Especially to someone who may be used to “deep tissue” massage. In fact, I have found in my own practice when working with fascia that the greater depth I am working at, the less pressure I am using. This is not to say that there is no place for more aggressive, “deep pressure” techniques. The important thing to remember is that a balanced approach  to treatment is often required especially when treating persistent or chronic issues.

What kind of injuries involve fascia:  All chronic pain involves fascia as the body responds to prolonged periods of pain and stress. Chronic pelvic pain for example often involves the fascia in the front of the body, especially in the abdominal and pelvic cavities where the organs are held. Another important example of injury to fascia is scar tissue that occurs as a result of a perforation wound or surgery such as a C-section.

What to expect from a fascial treatment: While fascial techniques may vary depending on location and type of injury, in order to achieve release of this tissue pressure is often held for longer periods and progress from lighter to deeper pressure. Sometimes the practitioner may use little or no lotion and use a broad contact directly on the skin which can be experienced as a pulling sensation similar to that of a slow stretch. When stretching a fascial chain (a particular group of fascia in the body) it is important to hold the stretch for longer periods of up to 5 minutes, slowly progressing into the stretch. Some other techniques that may be used are vibration of the palm over the tissue, picking up the affected tissue or an oscillating pressure. Every body is different and therefore the techniques and pressure will vary person to person as will the sensations that these techniques illicit.

 This interesting tissue provides insight into injury and treatment approaches that are available. In my own practice, working with fascia has led me to listen to the body in a different way, encouraging me to slow down.

If you’d like to learn more check out the wiki link above in the article, that will send you to links for the 4 types of mechanoreceptors present in fascia.  You can also check below and review the reading list I’ve provided and link to the fascia research society.

1. Myers Thomas W. Anatomy Trains: Myofascial Meridians for Manual and Movement Therapists. 3rd edition. Elsevier Health Sciences 2013.

Schleip R 2003: Fascial plasticity – a new neurobiological explanation. Journal of Bodywork and Movement Therapies 7(1):11-19 and 7(2):104-116

https://fasciaresearchsociety.org/welcome-fascia-research-society