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What are fascia?

This is an excerpt from Myofascial Training by Ester Albini.

Defining Fascia

Fascia is what makes us who we are. Connective tissue is simply everything that binds and connects.

However, experts cannot agree upon a single definition. There are two key reasons for this lack of consensus on the fascia:

  1. Its thickness, function, depth, consistency, and position are extremely variable.
  2. It is a concept that has only been broadly accepted relatively recently, so its definition is still a work in progress.

The simplest definition that I have found is this: “Fascia is a bandage”, a concept that already existed in documents from the 18th century [15].

The fascial tissue is a four-dimensional network that wraps around and separates every part of the body, creating a structural continuity that gives shape and function to all tissue and organs. The human body is a functional unit in which every region is in communication with another through the fascial network.

Fascia can be defined as a four-dimensional structure because it extends beyond the three physical dimensions (width, height, and depth) to include a neural or sensory dimension, which represents its close connection with the central nervous system.

Think of the fascia as a close-fitting and semitransparent web that wraps us and connects us from head to toe and acts as an external nervous system that processes and responds to sensory and mechanical stimuli.

The fascial tissue, which can be found throughout the body, surrounds and permeates blood vessels, nerves, organs, the meninges, bone, and muscles; interacts with them; creates various layers at different depths; and forms a four-dimensional matrix of mechanical, metabolic, elastic, and neurovegetative characteristics. lt is four-dimensional because it operates beyond the three physical dimensions to connect and interact with the central nervous system: it's a genuine fourth dimension. In this light, the fascia becomes an organ that affects a person's health. From a more general standpoint, knowledge of its functions and of the areas it controls becomes important for a person's health and well-being.

If we could observe the fascial structure separately from the rest of the body, we would see an extremely dense four-dimensional web, with no beginning or end, that separates, connects, and gives shape to everything. It is a semitransparent network that starts from the skin and thickens in the fibrous tissue that surrounds muscles, bones, and the internal organs. It is a continuous system that covers and crosses our body and accounts for 20 percent of our body weight.

To simplify the concept, I would like you to consider an orange. I use this as a visual aid in my training courses, comparing it to our fascial system. Take an orange and cut it in half. If you look at the cross section, you will see the individual segments separated by white skin.

Just as the orange is surrounded by a white skin of cellular tissue, which simultaneously maintains the consistency and gives shape to the pulp, our body (under the layer of skin) is surrounded and covered by connective tissue called superficial fascia. In addition, the orange is divided into segments that contain small sacks full of juice. The human body is very similar, since every structure of the body, every muscle, and every organ is surrounded by a sheath of connective tissue. Even the juice of the orange can be compared to the ground substance (aqueous gel) found in the body (see section 1.3.1).

Let's take a journey into our body, from the surface (skin) to deep within (bones), passing through the different layers. The first superficial layer of subcutaneous fat, intertwined with the first layer of connective tissue, the so-called superficial fascia, can be found under the skin (dermis). The deep fascia is located after the deep layer of fat. Continuing our journey, we reach the epimysium, a layer that wraps around the whole muscle; the perimysium, which covers the muscle bundles; and the endomysium, which covers every fiber and muscle cell. Finally, we come to the periosteum, the layer that covers the bone.

The image below shows the different fascial layers.

Fascial layers

Returning to the analogy of the orange, the white skin represents the fascial components. Removing the white skin would just leave the juice of the orange. In the human body, the principle is the same: If the fascial layers (epimysium, perimysium, and endomysium) were removed, the muscle would lose its shape and consistency.

Visual Comparison of an Orange and a Muscle

Visual comparison of an orange and a muscle

The epimysium, perimysium, and endomysium can be clearly distinguished in the figure on the left.

  • Epimysium: Wraps around the whole muscle.
  • Perimysium: Covers the bundles of muscle fibers and connects them to form the most abundant fascial tissue of the body. Conducts blood vessels and nerves to muscle bundles (control of the perimysium's nutritional function). It is a mobile layer that, during contraction, allows the muscle to slip inside its casing.
  • Endomysium: Surrounds every muscle cell, creating an individual unit. It is arranged in tubes that wrap around every muscle fiber.

Everything I learned during completion of the Fascial Dissection certification with Thomas Myers completely changed my perspective of human anatomy, given that until then I had only studied it in traditional anatomy textbooks. These entail nothing more than colored illustrations of muscles in which the fascia is not even visible and is therefore not given the importance it deserves. The individual muscles are depicted with an insertion and an origin and are represented as separate from one another, but this does not reflect reality. In fact, every muscle is connected to its adjacent muscles and communicates with them through the fascia.

Try this with the orange: If you want to separate the segments from each other; you will have to peel off the white skin. The segments are not just tightly packed against each other; they are attached and connected to each other. The same is true of our muscles. This therefore represented a hugely significant discovery, since it affects how I now see the body as well as my approach to training. Remember: The fascia separates, gives shape, and communicates.

It should also not be forgotten that the white skin of the orange is made of fluids and fibers. Taken as a whole, this structural model ensures high tolerance to deformation compared to an apple, for example. Pressing an apple with your finger creates a permanent pressure point. However, if you exert light pressure on an orange, it deforms but will return to its original shape over time.

The fascial tissue performs the following functions.

Connecting Function

The fascia acts as a “placeholder” for the muscles and organs and therefore stabilizes the body.

The entire bone system is in contact with connective tissue, joint capsules, and ligaments. The muscles are connected to bones (periosteum) by their tendons. The muscles, organs, and skin are connected to the surrounding tissue by fascial structures. It is a four-dimensional network that encloses the whole body and has no beginning or end.

Perception of the Body

The body is able to perceive thanks to sensory communication, which relies more on the fascial structures than on the joint and muscle structures. The receptors responsible for our perception of the body are up to six times more abundant in the fascia than in the muscles. This is extremely important for accelerating the healing process, increasing well-being, and enhancing performance.

Impact on Flexibility

The fascial tissue network connects everything with everything else. If the fascia is well-hydrated and elastic, its adjacent structures can slide freely over each other. Dehydrated fascial tissue, on the other hand, has a negative impact on flexibility, thereby reducing well-being and sporting performance and increasing the risk of injury.

Quality of Movement

The fascia is involved in every movement we make. The quality of a movement depends on the structure of the muscles and of the fascia, as well as their coordination.

Transmission of Kinetic Muscle Energy

It has been discovered that the energy generated by the muscles is transferred to other parts of the body during a movement, not only by the ligaments, tendons, and joint capsules but also and predominantly thanks to the fascial structures that surround the muscles. If the transmission properties of the fascia are good, an athlete can achieve his or her maximum performance. However, if the fascia is not trained, these properties may be altered and inhibited, with an increased risk of diminished performance and injury.

Defense

Fascia plays a defensive role from an immunological perspective. In fact, our body's immune system relies on the quality of the fascia.

In a well-balanced and healthy fascial structure, waste is transported away. Many phagocytes can be found in the ground substance, which is similar to a transparent gel and surrounds all the cells in the body. These phagocytes act as garbage collectors that ingest and destroy cellular debris and bacteria. In dehydrated fascia, a lack of fluid due to a lack of movement or unilateral move­-
ment inhibits the function of many of these cells that have specific functions, which literally remain dry.

Transport and Nutritional Function

Nutrients are transported from the arterial system via the connective tissue to where they are needed; in the other direction, waste is carried via the connective tissue to the venous vascular system or the lymphatic system.

Cause of Many Types of Pain

The fascial structures contain many pain receptors. Many scientists now subscribe to the theory that about two-thirds of all pain is associated with the fascia. Numerous studies have shown a direct link between myofascial pain and the body's perception. For persistent myofascial pain, the body's perception in the painful region is significantly reduced. However, if the body's perception in this region is improved, the myofascial pain diminishes or completely disappears. These studies found that many people reported reduced pain after a training session with a foam roller, balls, sticks, and other similar equipment.