Fascia: Anatomy, Function, and Dysfunction

Massage therapist performs pain relief technique targeting fascia on mature female patient's foot

This article is based on the 4-hour on-demand video course, NeuroFascial Patterning: Assessing Movement, presented by Steve Middleton, DPT, MS, ATC, CSCS, CES, CKTP, FMT, in partnership with HomeCEU.

Early anatomists tossed it aside. Later researchers debated its function, whether it was connective tissue, part of the muscular system, or something else entirely. We now know that fascia plays a vital role in supporting tissues, organs, and even neurological processes.

Layers on layers on layers

Fascia is a type of connective tissue found throughout the body in sheets or bands. It has unique properties depending on where it is located.

Pannicular fascia is found in the superficial tissue layers, where it provides protection for the layers below. Axial fascia, or deep fascia, surrounds muscles and groups of muscles and assists with movement. Meningeal fascia encloses tissues of the brain, spinal cord, and nerve roots, while visceral fascia supports the internal organs.

More than support

The properties of fascial tissues go beyond mere structural support. Recent research has shown that fascia houses more neuroreceptors than other tissues, including nociceptors, which sense pressure; mechanoreceptors, which sense movement; and proprioceptors, which sense position.

Fascia also carries a small piezoelectric current, which helps coordinate movement and stimulates fibroblasts to remodel tissues when injured.

On-Demand course: NeuroFascial Patterning: Assessing Movement

Folded plastic wrap

While collagen and elastin proteins give fascial tissues elasticity and adaptability, they do not have infinite stretch.

Fascia found in high friction areas like the hands and feet can thicken in response to trauma or repetitive forces, causing adhesions. Like a roll of plastic wrap stuck to itself, fascial adhesions reduce the glide between the layers and can cause pain, lymph accumulation, and reduced range of motion.

As well as thickening, injured connective tissues may shorten as the body adjusts and compensates, causing widespread reflexogenic pain or chronic conditions.

Possible solutions

As anyone who has tried to unpeel stuck plastic wrap from itself can imagine, restoring smooth movement between fascial tissues with adhesions is no easy task. In cases where adhesions are caused by repetitive or habitual motions, a lifestyle adjustment may be required in addition to manual interventions.

If you’d like to learn more about specific therapy techniques targeting fascial tissues, check out the full 4-hour on-demand video course, NeuroFascial Patterning: Assessing Movement, presented by Steve Middleton, DPT, MS, ATC, CSCS, CES, CKTP, FMT.

Here is a brief clip of the course:

View the full course.

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