Fascia is a thin layer of connective tissue found between the skin and the muscle. It is similar in thickness and color to Saran-Wrap; for years, researchers and anatomists working on aged cadavers thought that was all it
was: an extra structure to help hold us together.

However, more research is quickly be amassed that is changing the minds of researchers and clinicians alike. It appears that fascia helps coordinate our movements. The debate is now starting as far as how fascia works. One study proposes the fascia is an extension of the central nervous system.

Through injury and overuse, we develop adhesions (small knots) in the fascia. If we take the Saran-Wrap from earlier and wad it up, it doesn’t open back up very easily. This is similar to how fascia responds to injury: it becomes “sticky” through the release of various chemicals from the cells. The fascia sticks to itself as well as the skin superficially and the muscle deep. This limits movement and causes pain as the fascia pulls on the surrounding tissues. The fascia also attaches to the bone and can pull bones and joints out of alignment, further contributing to pain and dysfunction in even distal regions of the body. This is because fascia is one continuous sheet so tension or adhesions in one area will tension the entire tissue towards that area of pull.

An injury in one area affects the entire fascial system.

Most clinics take a “traditional” approach to rehabilitation by focusing on muscle weaknesses. However, appropriate treatment of fascial adhesions requires a high level of skill in both manual evaluation and manual therapy techniques. Tissue must be lengthened to return to its normal length and to return joint to their proper postural position. Only then is it appropriate to begin a therapeutic exercise program.