Exploration of Fascia
by Ashleigh Howland, LMT
When we were taught about the fascial system in massage school, our instructors enthusiastically explained that fascia was a connected web throughout the whole body, a substance the consistency of egg-whites that has a tendency of getting stuck in places. Causes of it sticking were immobility, guarding from injury, chronic overuse, dehydration, cold, and so forth. By releasing these stuck areas, we could create miracles! You could relieve a headache by working on the feet! We could release elbow tension by working the opposite shoulder! We could help the plantar fasciitis in the left foot by working up the left leg, crossing to the right glutes, and up into the right shoulder. We were taught that fascia was sort of a new discovery, something that was originally cut away and discarded as useless in the early days of body exploration, when entrepreneurial anatomists dug up bodies in their quest for knowledge. Fascia, it seemed, was the part of the body to understand the most clearly, as it was the key to better helping our clients.
I tried to get excited about fascia.I let my hand sit on my practice partner’s back for what seemed like eons, visualizing my healing power sinking down into the layers of dermis, fascia, muscle, and impacting the fascia that wove into the very bones. I tried to get the right level of “stickiness” where I could lift my hand, my partner’s skin would have warmed up to the point where it came with me, and then I could glide, without emollient, down the fascial line, releasing trigger points and adhesion as I went. I tried to note the changes in breathing as I worked the fascial restrictions through the ribs. Once, when I was having my own hamstrings worked on, I felt this incredible fluttering in my muscles as the tissue resisted release and then let go. I felt the woozy, almost intoxicated effect of the post-fascial session, when the body tries to acclimate to the new freedom you’ve created. But overall, I was underwhelmed. I just didn’t get it.
I happily continued massaging, forgetting about the glory of fascial work. I used Swedish strokes, long and slow, to increase circulation and relax muscles. I employed deep tissue tools, an elbow in the glutes, a forearm up the ITband, heel of the hand kneading the gastroc. I gave great massages, and I gave decent massages. My clients were happy, relaxed, and loose of muscle. All was well.
Then, in June of this year, I had a couple of different massages with colleagues who focused very much on fascial release. I sort of huffed to myself, convinced this would be a waste of my time when I could have been getting a good elbow through the shoulder.
The first massage was excruciating: I breathed deeply; I asked for less pressure, slower work; I wiggled and giggled and tried not to kick my therapist. I got off the table completely disoriented, and the next day, every bump I drove over sent shocks of pain into my paraspinal muscles. I felt like my nerves were raw and exposed. It was terrible, and my main issue, a sticky right hip, was no better.
The second massage was just 30 minutes between clients with a Well Within colleague (Mary!!). Her approach was slow. steady, and patient. She began with gentle palpation of the area to determine where the fascia was most restricted, and when she found an area with adhesion, she waited. And waited. And then began to move, ever so slowly. I felt little at first, and then warmth, like blood flow was returning to a parched area. There was some intensity, bordering on the edge of my comfort zone, as she worked closer to my sacroiliac joint and greater trochanter in the right hip, but when those moments passed, I felt looser. When I stood up, I felt freer than I had in months. It lasted a day or two, until I drove to the Cape and back, and then the tissue got stuck again. But over the next few weeks and months, as I continued to foam roll, receive both fascial and muscular work, stretch, and hydrate, the sticky hip resolved.
With myself as a test body, I began to explore this fascial situation once again, and then with clients. This time around, for an unbeknownst reason, I got it. I could feel the softening of tissue under my hands. I could feel and see the twitch of skin as the fascia below reacted to stretching. When my hands pass over the posterior ribs, I feel the rib cage expanding, feel the muscles working, and to me, it’s truly freedom blossoming beneath my hands. I have grown to understand that rock solid hamstrings will bend if I pin the fascia in the glutes with one hand, and hold and rotate the lower leg with the other, working my way down until I’m pinning just behind the knee. I’ve felt the quadricep attachments at the knee expand as I sink into the tissue and then begin to stretch. Sometimes it’s a long movement, such as down the erectors on either side of the spine; it can take anywhere from 3-5 minutes for one stroke, depending on how stuck the tissue is. Or I can use shorter, quicker friction to break up restrictions, such as the plantar fascia on the bottom of the feet.
It’s rare now that I don’t use fascial work in my treatments, at least as a palpation tool to indicate where the body is holding restrictions and stuck points. If a client truly wants to just unwind, I will not include fascial release; it’s absolutely effective, but not always relaxing. Feedbacks from clients is of the utmost importance, as is my listening to verbal and silent cues. I need to know, and to intuit, when enough is enough; fascial work can be very intense, and since I immensely enjoy using it as a technique and seeing its results, I have to be careful not to overwhelm my client. This is what happened to me in that first massage. Initially, the work was interesting; then it got uncomfortable; then my body began to activate its fight or flight response. As soon as that triggered, I was tensing and guarding while my therapist continued to push, quickly, through unwilling tissue. Yikes!
What I perhaps love the most about fascial work is that, for my die-hard deep tissue clients, it not only qualifies as “deepest tissue” since fascia blends into the bone; but it allows me to warm up the muscles and sink through even more layers of tissue. Once the fascial restrictions in and around a muscle have broken up, even a little, the muscle itself also begins to let go, which means I can manipulate it just that little bit extra. It’s easier on me than just digging in with my elbow and body weight; and much more effective for the client. For this reason, myofascial release works wonderfully with pregnant women, runners, desk jockeys, weekend warriors, cyclists, yogis, equestrians, teenagers, geriatrics, CrossFit fans, couch potatoes… Pretty much everyone!!
For an awesome and current article on fascia, check out this Runner’s World link: