The fascial system is still a medical mystery. But that could soon change, thanks to an unlikely alliance between researchers and alternative therapists.
In October, 2007, more than 100 scientists from around the world convened in Boston, Massachusetts to discuss the latest research on fascia, an enigmatic, gauze-like matrix of connective tissue that envelopes the muscles, surrounds the nerves and swathes the organs in a body-wide-web of fibrous collagen
But the researchers had some unlikely company. Also in attendance, and outnumbering researchers 5:1, was a throng of complementary- and alternative-medicine practitioners with a mutual interest in fascia.
The scientists who did attend the meeting had been assembled through the efforts of conference-founder and Executive Director Thomas Findley. An MD with a PhD in physical medicine and rehabilitation, Findley has studied the science of rehabilitation for close to forty years
“The point of science is to ask a question in a way that can be answered either ‘yes’ or ‘no,'” he says, “and a lot of practitioners pose questions in ways that aren’t really answerable in a scientific context.”
Findley thinks the answers he’s looking for could be hiding in fascia. On the scientific side of things, the field of fascia research has grown considerably in recent years, though it lacks the coherence of other, more established areas of physiological investigation.
For decades, anatomical dissections and representations have presented the body as stripped of its fascial tissues, and the majority of physiology textbooks make little mention of it.
By uniting alternative therapists with researchers, Findley hopes to spur discovery.
“We strip it, do away with it, say it has no function at all,” he continues. “Well, I suspect we’re going to find major functions in fascia, just as we find major functions in glial cells.”
And yet, fascia’s “major functions” have yet to reveal themselves. To date, there have been no home runs establishing a clear, causal link between fascia’s molecular, cellular, or biomechanical properties and the effective treatment of pain, injury, or disease – at least to the satisfaction of the broader scientific community.
Does it not make intuitive sense that a tissue found throughout the body would harbor some form of medical or therapeutic significance?
What Does Medical Science Know About Fascia?
Scientific investigations of fascia have grown considerably in recent years, as evidenced by a continuous rise in its MEDLINE references since the 1960s.
Paul Ingraham sums up a great deal of this work in his article “Does Fascia Matter?“
Robert Schleip sent me six scientific articles that he regards as “home runs” for the field of clinical fascia research [see references below]
Scientists know, for example, that fascia surrounds, separates and connects muscles throughout the body. According to Blemker, Huijing and his colleagues have developed a long line of research demonstrating fascia’s ubiquity in the body enables it to transmit some degree of force within and between muscles, but “this line of thinking has yet to adopted by the mainstream biomechanics community because it does not yet fit within our conceptual model of musculoskeletal function.”
Ingraham, for his part, draws a similar conclusion:
Fascia is biologically interesting! All biology is. But clinical relevance is the central question of this article: if fascia science cannot actually improve treatment, then it makes no sense to be fascinated by it in a therapeutic context.
The New Age Tradition vs. Science
Where do new age ideas about fascia originate? To hear Findley tell it, therapies exist that have targeted fascia for thousands of years. But his personal views on fascia, and the ethos of the Fascia Research Congress as a whole, have been informed in large part by the writings of Andrew Taylor Still, the 19th Century founder of osteopathic medicine.
An essay titled “The Fascia Research Congress from the 100 year perspective of Andrew Taylor Still“: reveals how much Findley’s work is influenced by Still’s osteopathic philosophy, which he summarizes in four points:
- The human body functions as a total biologic unit
- The body possesses self-healing and self-regulatory mechanisms
- Structure and function are interrelated, and
- Abnormal pressure in one part of the body produces abnormal pressures and strains upon other parts of the body.
The Future of Fascia Research
The issue of nomenclature was first brought to the table in an editorial by University of Padova anatomist Carla Stecco. She summarizes the problem with fascia nomenclature as follows:
Fascia is often described as an ubiquitous tissue that permeates the human body, organized as a three-dimensional network that surrounds, supports, suspends, protects, connects and divides muscular, skeletal and visceral components of the body. If we agree with this wide definition, then fasciae could include every connective tissue, loose or dense, regular and irregular, with so many functions that would be impossible to study and understand from a scientific point of view.
Papers that Robert Schleip recommends on fascia:
- Huijing – “Epimuscular myofascial force transmission: a historical review and implications for new research”
- Tesarz et al. – “Sensory innervation of the thoracolumbar fascia in rats and humans. Neuroscience.”
- Langevin et al. – “Reduced thoracolumbar fascia shear strain in human chronic low back pain”
- Schilder et al. – “Sensory findings after stimulation of the thoracolumbar fascia with hypertnoic saline suggest its contribution to low back pain”
- Corey et al. – “Stretching of the back improves gait, mechanical sensitivity and connective tissue inflammation in a rodent model”
- Stecco et al. – “Ultrasonography in myofascial neck pain: randomized clinical trial for diagnosis and follow-up”