Fascial Adhesions

7/24/2019 Fascial Adhesions

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FASCIAL ADHESIONS

Have you ever tried to watch a movie from the front row? Difficult

isnt it. Miserable as well. Todays Medical education, with its

huge emphasis onTECHNOLOGYandDIAGNOSTICS,can be a

lot like watching a movie from the front row.
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Because the practice of medicine is predicated on taking the body

and dividing it, subdividing it, and dividing it some more, it tends to

give student doctors a front row perspective of anatomy and

physiology. Think about it; we have kidney specialists

(nephrologists), heart specialists (cardiologists), nerve specialists(neurologists), butt specialists (proctologists), muscle and joint

specialists (orthopedists), stomach specialists (gastroenterologists),

arthritis specialists (rheumatologists), etc, etc, etc, etc, etc.

Unfortunately, this model is out of date. It fails miserably as far as

reallyadvancing our understanding of the human body because you

never really get to see theBIG PICTURE. For one, it cannot

explain how the whole organism is greater than the sum of its

individual parts. What do I mean by this? For instance,Hydrogen

(an explosive gas) + Oxygen(a flammable gas) = Water(H2O), a

liquidthe foundation of all lifethat is used to quenchfire.

The problem with using outdated models that reduce and

subdivide the human body into increasingly smaller parts is that the

big picture is frequently missedspend some time on our Blog

Roll (right margin) and youll quickly understand what I

mean. The movie ends without the student doctor ever moving fromthe front row. And unless doctors are willing to step outside of the

box of their formal educational model (something they are

encouraged notto do byTHE POWERS THAT BE), the BigPicture is rarely grasped.

Doctors use this same philosophy and thought process when trying

to explain the musculoskeletal system. Fascia is one of the best

examples that I can think of concerning this phenomenon. Doctors

frequently miss the forest for the trees because the books they

learned from doctors (that were taught by other doctors) trained in

the same reductionist philosophy. Furthermore, they use books that

show hundreds of pictures of individual muscles- without everreally showing or explaining the fascia.
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Go to virtually any anatomy text book and take a look. The fascia is

almost always removed so that we can see the really important

tissues underneath. But never forget that removed= ignored. And

after all; if the medical text books are not talking about fascia,

showing us lots of pictures of fascia, or explaining how fasciaworks; exactly how important can it really be?

Because the illustrator for the famous anatomy textbook of all time

(Henry VanDyke Carter) left the fascia intact in a large number of

his drawings; most of the anatomical drawings on my site come

from Grays Anatomy. Even though the first edition of his

renowned textbook was written over 155 years ago, Henry Gray is

still considered one of the greatest anatomists the world has ever

seen.

WHAT IS FASCIA?

Fasciae (plural) are the tough layers of fibrous, collagen-based

connective tissues that permeate the human body. If you are a

DEER HUNTER,you have seen fascia and know what it is. It isthe thin, white, cellophane-like, membrane that wraps itself tightly

around the muscles. Around here folks call it Striffin or Silver

Skin. But there is far more to fascia than what is readily observedwhile butchering.

Fascia surrounds individual muscles, muscle bundles within

individual muscles, groups of muscles, blood vessels, and nerves. It

binds these structures together in much the same manner that plastic

wrap is used to hold the contents of your Hoagie together. Fasciaconsists of several extremely thin layers, and is the tissue where the

musculoskeletal system, circulatory system, and nervous system all

converge. It extends from the top of the head to the tip of the toes,

and like ligaments and tendons, contains closely packed bundles of

wavy collagen fibers that line up in an organized and parallel
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fashion (PICTURES HERE). Subsequently, healthy fasciae are

flexible tissues that are able to resist great tensile forces. Unhealthyfascia? Well get to that shortly.

Fascia forms a whole-body, continuous, 3-D matrix of structuralsupport. Its connections extend to allfibrous (elastic) connective

tissues, includingAPONEUROSIS,LIGAMENTS,TENDONS,

RETINACULUM,joint capsules, organ and blood vessel sheaths,

the epineurium (nerve sheaths), the meninges (spinal cord sheaths),

the periosteum (sheath that surrounds bones), as well as the

membranes that surroundMUSCLES.

Among the different kinds of tissues that are involved in the bodys

elastic framework (chiefly ligaments, tendons, muscles, etc);fascia has received the least scientific attentionprobably because

in most regions of the body it cannot be imaged with even the most

technologically advanced imaging techniques such as MRI (hey, out

of sight, out of mind). Nevertheless, fascia plays a major (albeit

poorly understood) role in joint stability / instability,

PROPRIOCEPTION,coordination, strength, joint motion, as well

asPAIN SYNDROMESof all kinds. It can even be involved in

DISEASE PROCESSES.

Critical Functions of Healthy Fascia:

It binds and holds muscles together compactly.

It ensures proper alignment of the muscle fibers, blood vessels,

nerves, and other tissues within the muscle itself.

It transmits forces and loads evenly throughout the entiremuscle.
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It creates a uniformly smooth surface that essentially

lubricates the various surfaces that come in contact witheach other during movement.

It allows the muscle to change shape as they lengthen or

shorten.

I included this picture of the Groin Region from Grays Anatomy to show you just

how much fascia there is in the groin.
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Collagen

Collagen is the building block of all connective tissues. Some

collagen-based connective tissues like bone and most cartilages, are

part of your bodys load-bearing framework. Their purpose is towithstand compressiveforces, while grossly maintaining the bodysshape.

Collagens Triple Helix Structure by User Vossman

On the other hand, you have the Elastic, Collagen-Based,

Connective Tissues, whose chief job is to resist the tensile forces

that are constantly trying to pulljoints apart whenever movement or

muscle contraction takes place. These tissues dont need to be able

to bear heavy loads, but instead, must be able to stretch and elast (at

least to a slight degree) while resisting tearing. Of these elastic

collagen-based connective tissues, fascia is the most elastic.

As long as the individual collagen fibers that make up the fascia, are

aligned in parallel fashion to each other, the tissue is stretchy and

elastic (think about long hair that has been combed out. If you run a

comb or brush through it, it glidessmoothly and unrestricted.)

But what happens when fascia is injured?
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When fascia is stretched beyond its normal load-bearing capacity, it

begins to tear. Bear in mind that these tears are so microscopic that

they nevershow up on an x-ray, and only on rare occasions will they

show up on an MRI (possibly in the Plantar Fascia on the bottom of

the footsee above). Fascial tears can be caused by sports injuries,

repetitive trauma, car wrecks, postural distortions, falls, child

bearing, abuse, etc, etc, etc. Oftentimes people have no idea how

they ended up with Fascial Injuries, which often result inFASCIAL

ADHESIONS(sometimes known as FASCIAL

DENSIFICATIONSsee below).

Fascial adhesions
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Whenever a muscle is impacted (contact sports, falls, abuse, etc) or

overused / injured (lifting weights, running, over-training, heavy or

repetitive jobs, etc), collagen microfibers form in between adjacent

layers of fascia to bind them together so that the muscles can

heal. These microfibers are sort of like natures internal cast.

Unfortunately, these casts do not automatically go away after the

area has healed, andthey tend to accumulate over time. This means

that over time, the elastic, collagen-based tissues (particularly

muscles and fascia) get increasingly stiffer and less stretchy. If you

are over the age of 35 or 40, you have likely figured this out the hardway!

Think of the collagen found in fascia in terms of a Slinky. In normalcollagen, there are waves. A slinky is no different. The coils of a

slinky act like waves and give it the ability to elast and stretch in

response to tensile forces. As long as the load is not too great to

overcome the tissues tensile strength, it can spring back - andthings are peachy.

However, if the most elastic of the collagen-based tissue (fascia) is

forced to resist more tension than it can handle, tissue failure begins

to occur. The tissue increasingly loses its ability to stretch and

elast. Think of this as a slinky that has been stretched out to the

point of failure. The material has not necessarily broken, but it has

been stretched far enough that it is not going to spring back like it

should. This leads to tangles, which is a whole other problem unto

itself. We have all experienced a mangled Slinky before. This issimilar to a Fascial Adhesion!


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FASCIAL ADHESIONS

UP CLOSE & PERSONALBottom Line: If something causes fascia to exceed its normal tensile

capacity, there will be a disruption or micro-tearing of individual

collagen fibers. This in turn leads to fascial scarring and adhesion

/ restriction.

Think of fascial scarring in another way. Put both of your hands flat

on a table in front of you, and slide the fingers of one hand back andforth between the fingers of the other. This is similar to the way

fascia works, and is what gives all of the elastic connective tissues

including fascia, ligaments, tendons, etc, an incredible amount of

stretchiness and flexibility. Normally functioning fascial

membranes are not only arranged in a very organized and parallel

manner, but if you were to look at them on edge, they are flat and

smooth- like a piece of paper.

Once fascia is injured (stretched, pulled, torn, etc.), the microscopicfibers become disrupted and deranged. Instead of fibers running

parallel to each other in an organized fashion with their normal

degree of elasticity / flexibility, the fibers now run every possible

direction in all three dimensions and have an extremely diminished

amount of organization and elasticity. Interlock the fingers from

one hand with the fingers from the other, only now do it with the

fingers pointed in all directions. Now try to slide the hands back and

forth. See the difference in flexibility?

Also notice that when the fingers are interlocked randomly, they will

no longer lay flat on the table. Facial Adhesions act in much the

same way. When fascia is injured, individual fibers run every which

direction, in all three dimensions. This means that the fascial

membranes no longer lay flat like a piece of paper. Instead, they are


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more like a wadded up or crumpled piece of paper. Unfortunately,

injured fascia frequently heals in this tangled, twisted, and wadded-up manner.

We can also think of this fascial scarring and adhesion in terms ofhair. Remember our example of well-manicured hair that a comb or

brush glides through easily? Now think of the exact opposite. Think

of aHAIR TANGLE.What happens to hair that is not well taken

care of, or was slept on wet? Instead of the individual hair follicles

lying parallel to each other in a neat and orderly fashion, they

become tangled with the individual hair fibers running in every

conceivable direction. The result is a tangled messa ball of

hair that takes forever just get a comb or brush through it. Hair

balls can be so restrictive that just tryingto get a comb through it,

pulls and causes great pain. This is even more true with

fascia. Most people are unaware that..

FASCIA I S THOUGHT TO BE THE SINGLE

MOST PAIN-SENSITIVE TISSUE IN THE ENTIRE

BODY

When the organization of the parallel collagen fibers of fascia aredisrupted by injury, a host of really bad things begin to happen. The

first thing that occurs is restriction of joint motion. Understand that

if you have tissue restriction, you will automaticallyhave some

degree of loss of normal joint motion in the corresponding area(s) of

the body. Also understand that loss of normal joint motion virtually

assures you that sooner or later there will be pain- even if you are

not yet experiencing pain. Unfortunately, pain is not the only thing

associated with loss of normal joint motion. One of the biggies isdegeneration.

Loss of, or abnormal joint motion, is the known causeof localized

joint degeneration. When I speak of localized joint degeneration, I

am talking about things like calcium deposits, bone spurring, and
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loss of articular cartilage or disc height. Degeneration is a great

example of a vicious cycle: Loss of joint motion causes joint

degenerationand joint degeneration causes loss of normal joint

motion. Repeat. As this cycle spins around and around, it causes

pain.

STOP!Think for just a moment. Pain is frequently nothing more

than a by-product of the vicious cycle. This is why pain pills and

other similar measures (drugs), mask symptoms of Chronic Pain

(ineffectively, I might add) without ever addressing its underlying

cause. And on top of this, some of the most popular musculo-

skeletal drugs (corticosteroids for instance) actually increase the

degenerative effect (HERE). In many cases of Chronic Pain, the

underlying cause is Subluxation, Fascial Restriction, and

microscopic Scar Tissue.

Think for a moment how problematic this whole scenario is. Fascia

is the single most pain-sensitive tissue in the bodyyet it does

not image well with even the most advanced imaging technologies

such as MRI! What does this mean? Those of you who have dealt

with Chronic Pain long enough, know exactly what it means!

It means that when you go visit various doctors (orthopedists, pain

specialists, neurologists, etc) they run all sorts of tests, and then look

at you as though you are crazy. Or maybe they look at you like

youre adrug seeker, or trying to get Social Security Disability. Or

maybe they just chalk it up to hard work and too many sports. Or

maybe they just tell you that you have arthritis or Fibromyalgia

just to get you out of their office. Or maybe they used that old and

trusted standby, After all Mrs. Smith, you just arent as young asyou used to be.

Whatever the case, the result is almost always the same. A blank

stare and the recommendation for more pills- or maybe even

Corticosteroid Injections. The latest trend for Chronic Pain patients

involves putting them on SSRIs (anti-depression drugs) while
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trying to convince them that their Chronic Pain is the result of

Clinical Depression; when just the opposite has been proven to be

closer to the truth. (Chronic Pain is far more likely to cause

Depression than the opposite).

Oh, and how about your doctor kick you a few more times while you

are down. Scientific studies have repeatedly shown that beyond the

wide array of side-effects to the kidney, liver, and heart; both

NSAIDS, and cortico-steroids actually deterioratecollagen-based

tissuesseverely and rapidly. This is why doctors will ration the

amount of cortisone you can have, even if it helps your pain.

The Journal of Bone and Joint Surgerypublished a study over a

decade ago that said if a person has more than one cortico-steroidinjection in the same joint, over the course of their lifetime, their

chance of developing premature deterioration of the affected joint is

(gulp) 100%.

EFFECTIVELY HANDLING

FASCIAL ADHESIONSThe question always comes up, If fascia cannot be imaged with

advanced techniques such as MRI, how in the world does a

chiropractor from the rural Ozark region of southern Missouri

image it? Plainly stated; I dont. I examine the areas that I believe

to be affected by Fascial Adhesions (15 years of experience hashelped me know what to look for), and I start treating. Every year I

get more proficient at knowing what to look for, finding it, and

fixing it. What am I using to fix it? Glad you asked. I simply call

TISSUE REMODELING.
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WARNING

BRUISING AHEAD

Because our Tissue Remodeling Treatment consists of actually

breakingthe Fascial Adhesions and subsequent tissue restrictions

that cause so many symptoms, there is often some bruising

associated with the technique. Microscopic scarring is dense,

inelastic, random, and unorganized tissuenot what anyone

really wants. If you have been paying attention, you are aware that

scar tissue is not exactly an optimum situation. Nonetheless, scars

(even the microscopic kind) are living tissue with a blood supply.

This means that when I break the adhesion, I also break the blood

supply. There will be some internal leaking of red blood cells from

the scars capillary bed into the surrounding tissue. Please dont

panic. In plain English, this means that you will have a bruise.

When I break Fascial Adhesions, it is not uncommon that this

bruising can be really really (really)ugly. Dont worry it really is

OK. See ourBRUISING & PICTURES PAGE.You can also visitourVIDEO TESTIMONIAL PAGEas well.

Although there are people out there doing similar things, I have yet

to find anyone doing things quite like I am doing. This is why our

results (click on the link above) are so radically different than those

that most others are getting.

CONCLUSION

Fascia is the fabric that it woven throughout every part of our body

to hold us together. Perpetually disregarded by the medical

community as unimportant (hey, after all it does not show up on

MRIs), fascia is beginning to take its rightful place at the forefront
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of both cutting-edge medical research andcutting-edge treatment

(particularly in the field of Sports Injuries and Chronic Pain

Syndromes). It should! Fascia is arguably the most prevalent

connective tissue in the body.

Other than the nerve system, is there another body system that

CONNECTS THE DISTANT PARTS OF THE BODY

TOGETHERin such an intimate manner? I say no! Fascia covers

the body from the top of the head (Epicranial Aponeurosis) to the

bottom of the feet (Plantar Fascia), and everything in between.

When there is a tightening or restriction of the fascia in one place, it

can cause pain and dysfunction in distant and seemingly unrelated

locations. And the kicker is that problems in the fasciae not onlycause pain, they cause the nerve system to misfire. As you can

imagine, the problems associated with a misfiring nerve system are

many and potentially severe.

also be aware that what is true about fascia is true about the other

Elastic, Collagen-Based Connective Tissues as well. Yes, ligaments

are injured andrespond to treatment in a similar manner to fascia.

We also know from medical research that an almost identical tissuemodel can be applied for the treatment and healing process of people

dealing with certain tendon issues as well. This is good news

because tendon problems are a leading reason for musculo-skeletal

doctor visits- and Chronic Pain. To better understand the Fascia,

HEREis a post that organizes dozens of articles on the topic.
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Fascial Adhesions