The Fascination with Fascia

Elevation Physiotherapy & Wellness :: The Fascination with Fascia

New research indicates that certain cells found in the fascia communicate directly with the nervous system, each other, and with every other organ in the body. If this is true, this thinking challenges what we thought we knew—the central nervous system may not be the one in control of all of the body systems.

It used to be thought that the fascia was just a wall of tissue that surrounds everything—lining the walls of the trunk and pelvis, wrapping around muscles and organs.  This new research is showing that the fascia is more like a highway where cells live and where nutrients and waste can travel to other cells or directly to the lymphatic system. If true, it makes sense that the fascia would play a significant role in our immune system and overall wellness.

There are different types of fascia—superficial or deep, dense or non-dense.  The fascia of the nervous system is called meninges, the fascia surrounding the lungs is plurae, and the pericardium surrounds the heart.  Are all of these different types of fascia connected and working together on some deeper level?  Do they communicate amongst each other, and to the body as a whole?  We don’t know that yet for sure.

Sue Hitzmann, creator of ‘The Melt Method’ to address fascia, feels that it is key to keep fascia hydrated, and not just by drinking a lot of water.  Injury to the fascia through trauma or injury can cause it to become stiff, and just drinking water would be like running a faucet over a dry sponge.  It would take gentle manipulation of the fascia to “loosen” or mobilize the tissue and increase the intracellular fluid.

The research shows that our fascia is filled with proprioceptors which tell us where our body is in space. When proprioception goes awry because of injury to the fascia from muscle overuse, improper movement, and/or posture, the fascial layers no longer glide smoothly or work properly. The central nervous system would then take over, and if this goes on for too long, it becomes overworked and can contribute to neurological disorders or autoimmune disease like lupus, rheumatoid arthritis and fibromyalgia.

Wouldn’t it be great to use non-pharmacological treatments that could tap into our bodies’ own natural defenses against degenerative diseases. We know that eating right and moving help keep us healthy into old age, but we must move well and keep our fascia pliable and nourished. 

Exercises for Lower Back Pain Are NOT Created Equal!

Elevation Physiotherapy & Wellness :: Exercises for Lower Back Pain Are NOT Created Equal!

Research has shown that people suffering from lower back pain should focus on just two things:  keep moving, and be careful with sitting posture and avoid slouching.  There has been more recent research studying if specific directional exercises are more valuable to get rid of pain, or if general stretching and strengthening around the spine is more effective.

A directional preference is described as when repeated lower back movements in one specific direction (eg. arching the back) demonstrates quick improvements in pain and range of motion that remain better as a result.  This phenomenon doesn’t always happen, but when people’s back pain responds so nicely to repeated movements into one direction, they often progress faster than those who do not demonstrate any directional preference. Long et al (2004) developed a brilliant study where they identified those people who showed a directional preference to a lower back movement, and asked would happen if the person did not continue with exercise in their direction of preference?

 Three hundred twelve people with lower back pain had an assessment to determine who demonstrated a directional preference with lower back movements.  Those who did (n=230) were placed into one of three directional subgroups:  flexion (rounding), extension (arching) or lateral (sideways) preference. Each subgroup was then randomized into a matched (n=80), opposite (n=70), or non-directional exercise program (n=80).   All 3 groups were given education on posture and keeping active as able. For example, if one person showed a directional preference for lumbar extension (arching back) during their assessment, they were then randomly allocated to continue with exercises into lumbar extension (matched preference), or lumbar flexion exercises (opposite), or a third control group of generalized strengthening and stretching exercises of the lower back, hips and thighs (commonly prescribed multi-directional mid-range exercises).

Elevation Physiotherapy & Wellness :: Lower Back Pain Testing

After two weeks, 95% of the people doing the exercises in their preferred matched direction were improved or completely better and no one was worse. Yes, you read that right—95%!!!

This was over four times better than the group performing the opposite movement to their direction of preference (23% better or resolved and 15% reported being worse). The control general exercise group had 45% report they were improved and  15% were worse, but interestingly, 55% of these control group did not feel they were improved despite performing commonly prescribed exercises and general movement.  This study strongly demonstrates how individualized directional exercises can be very powerful to improve or resolve back pain quickly.  One does not have to suffer for weeks or longer to help the source of the problem.  A proper mechanical assessment can determine the proper course of action to help get better, faster… and stay that way!

Reference:

Long, A. et al.. Does it matter which exercise? A randomized control trial of exercise for low back pain.2004, Spine 29(23): 2593-2602