What is the fascia? Experts on the silver skin that could be behind your pain, and how to keep

The word fascia is derived from the Latin for “band”, and Dr David Cosman of the Cosman Health Group in Hong Kong describes it as a “silver skin”.

Experts, both scientists and therapists, have been gathering regularly to discuss fascia’s potential. The Sixth International Fascia Congress will meet in September in Montreal, Canada.

What does it do?

Cosman likens it to a highway system that enables signalling between different parts of the body. “It contains nerves and blood vessels; it’s an active communicating force.”

Healthy fascia, says Cosman, “glides” over the tissue it surrounds and “this enables the nerve endings to experience a change; the sensations are sent to the brain for processing and reflexive activity”.

In its healthy state, fascia is slippery and supple. Unhealthy fascia, says Cosman, has a “sticky relationship” with its adjacent muscle tissue, so is unable to glide and the nerve endings can’t sense any changes, except for pain nerve endings which feel the impingement of adhered or sticky tissue.

This is “densified” fascia, and can account for different cases of referred or shooting pain, which is often diagnosed as a “pinched nerve”. Nerves can be pinched by many means, but densified fascia as a cause is often overlooked.

What can go wrong?

If the fascia is inhibited in its “gliding” because it’s sticky, it adheres to muscle – this might be the result of injury, but could be due to poor posture. In time, if not dealt with effectively or quickly, these “adhesions” worsen, which make the fascia tighten and contort muscles that it surrounds, which can result in tender spots.

How can I keep it healthy?

That’s why staying active and hydrated are crucial, says Cosman. Keeping your fascia in top condition requires physical activity, good posture, a healthy weight and diet, sufficient restorative sleep and low stress.

We are largely made up of water – in muscle and fascia, it makes up as much as 75 per cent. If we don’t drink enough, those necessary fluid ratios are compromised. Water flushes waste out, and another factor that affects the smooth workings of fascia is cellular waste.

“When it is working normally, fascia is full of water and moves freely as we move,” says Amanda Oswald at the UK’s Pain Care Clinic.

“Youthfulness is the ability to move freely without pain,” Cosman says. Joints and muscles that are either compensating or overstressed because of adhesions in the fascia can cause painful, uneven torque or tugging on joints. This might be diagnosed as arthritis, but reducing the adhesions – known as myofascial release – can help reduce pain, sometimes immediately.

Oswald agrees and says that often this type of pain is overlooked in conventional medicine. For example, the symptoms of repetitive strain injury are mostly felt in the hands and wrists, but the restrictions causing them are in the neck and shoulders.

Focusing treatment only where symptoms are felt misses the cause. And identifying causes in turn balances behaviours that may contribute to pain – the way we sit to work, for example.

How can we fix the fascia?

Cosman uses a system called the Stecco Method Fascial Manipulation, developed by Italian physiotherapist Luigi Stecco. It uses a patient’s history to help trace the causes and connections of pain, then works on manipulating adhesions and those “densifications” to rebalance soft tissues.

Like every organ in our body, the fascia is supported by good diet. Lauren Roxburgh, a wellness educator based in California, says that foods that contribute to collagen production (especially those rich in vitamin C and zinc) are important as fascia is made up of collagen and, as we age, our body is less able to produce enough.

Collagen is also good for our complexions, so we’re supporting skin on the outside as well as this skin on the inside. She advocates bone broth, which is full of amino acids and collagen, and citrus and colourful peppers, which are high in vitamin C. Other “fascia foods” that support collagen’s production include berries, avocados and, happily, chocolate and red wine.

Keeping our fascia in good condition won’t just mean pain-free movement – it makes for good body alignment, increased blood flow to muscles, reduced appearance of stretch marks and cellulite, scar tissue healing, and improved sports performance.

Now get up and stretch your silver skin out.

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Six tips to keep your fascia fit

1. Stretch for 10 minutes a day, especially if your job is a sedentary one. Stretching elongates muscles, which helps to release tension.

2. Visit the sauna. Both traditional steam saunas and newer infrared saunas help improve exercise recovery.

3. Apply a little cold therapy to sore spots. An ice pack or a bag of frozen peas wrapped in a towel applied to an area of soreness for a short time helps reduce inflammation, which means less swelling and pain.

4. Use a foam roller, which can get into the fascia in much the same way that a deep-tissue massage does. Rolling regularly helps to “lubricate” your joints and reduce inflammation and can break up thickness and adhesion.

5. Get your heart pumping – and your blood flowing. Every organ in your body, including the fascia, needs a good supply of freshly oxygenated blood.

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