I recently attended some continuing education courses for my professional standing. Generally my continuing education is very hands-on, but this one was different. I sat for two day watching the replay of a fascia congress that occurred earlier in the fall in Boston. The replay allowed about one hundred and thirty massage therapists in BC to see where the cutting edge research of fascia is taking place and I was delighted to see how intrinsic fascia is coming to be considered to healthy function of the body. This article will not be a recap of the recap, as, even I must admit, the replay was not endlessly riveting, nor am I going to tell you the most technically detailed data or the specific clinical information I managed to extract, instead I am going to talk about the basics of fascia.

I may have lost a few of you back the first time I mentioned “fascia”. It is a term that did come up in some of my previous articles and which is dear to my heart and my practice, but, you ask, what is it? Fascia is a connective tissue in the body and it comes in a variety of forms that provide several functions within the body and it is one of the most common tissues found in your body. Made up of collagen and elastin arranged in a honeycomb like matrix fascia acts to separate, to contain and to protect your body and its various parts. The two basic categories of fascia are superficial and deep (or investing).

The largest single piece of fascia in the body is the superficial fascia. This layer runs under your skin from the top of your head to the bottom of your feet. The thickness and toughness varies with its location and from person to person. Deep or investing fascia surrounds our individual muscles, bones, and nerves. This encapsulation also occurs within muscles and nerves with each muscle and nerve fiber having its own fascial sheath. There are also several sheets of thick fascia in various parts of the body. These types of fascia act differently from each other and in this article I am going to focus on the superficial fascia.

Generally speaking superficial fascia is not terrible tough or thick, though as our subcutaneous fat stores are contained within this layer some of us have thicker superficial fascia than others, and that thickness can vary for an individual over time. This layer of fascia is designed to keep out skin separated from the muscle and bone underneath, to allow our skin to slide over these deeper tissues when we move. This type of fascia is actually quite delicate. You can easily tear it by pushing with your fingertip, but it is also very powerful. If you have ever grabbed a hold of a cat’s skin, or a Char-pei’s you know that their skin moves on their underlying tissue – and so does yours. Another place you may have seen fascia is the last time you pulled the skin off a raw chicken breast (apologies to the vegetarians). As you pull back the skin of the chicken you have likely seen the shiny clear material that lifts up with it, that is the superficial fascia.

Most people can pick up their skin in several places on the body; try it on your forearm. How much or how little can you pick up? The quantity is partially reflective of your heredity. Everyone has unique levels of collagen vs. elastin in their connective tissue, and this affects how pliable your skin, ligaments, tendons, and fascia are. More elastin means stretchier tissues. The other factor that could be impacting your ability to lift the skin up is whether or not your fascia has extended little collagen bonds into your tissue. Why would it do that? Immobility and any inflammation encourage the fascia to send little fibrous strands into the surrounding tissue. So if you have injured you arm or tend to overuse your arms (i.e. spend a lot of time typing or mousing on the computer, massaging people or playing racquet sports) you are more prone to the development of adhesions. These adhesions may be limiting, completely or partially, your ability to lift your fascia or they may be making it uncomfortable (a stretching or burning is the common description for the sensations that occur with picking up shortened fascia).

Other than an interesting party trick or a way for a mother cat to pick up her kittens without injuring them what does this superficial fascia do? Well, as I said it keeps the skin separate from the underlying tissue. This is important in allowing the body to move freely and with ease. In everyday movement your various muscles contract and relax in a myriad of directions and when the skin becomes stuck to that underlying tissue it creates lines of stress in the skin and can lead to discomfort with movement as the skin is stretched, or overstretched in too many directions at once. Once it becomes stuck the fascia tends to constrict at the point of restriction and that can limit movement and exacerbate the discomfort with movement that I already mentioned. The other problem that can develop is that there are many blood vessels and nerves that travel just under the skin and when the superficial fascia becomes restricted these structures are compressed and their function can consequently be impaired.

Over long periods fascial restriction can become distortion and the pull on the fascia can lead to postural distortions. Conversely, postural distortion can be a causal factor in creating fascial restriction. Fascia provides a certain amount of stabilization within the body and by constricting or allowing stretching of itself superficial fascia is often called into action to stabilize the inherent instability we create within our bodies with postural distortion.

There are the basics of the superficial fascia. In my next article I will look at the investing, or deep, fascia. In that article we will look at the importance of fascia in allowing our muscles to work efficiently and freely.