does fascia matter

7/30/2019 Does Fascia Matter

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Does Fascia Matter?

A detailed critical analysis of the clinical relevance offascia science and fascia properties

11,000 words, updated Feb 20th, 2013 Whats new?byPaul Ingraham, Vancouver, Canada

SHOW SUMMARY

ZOOM

Sheets of fascia can contract a bit like muscle but how strongly? Enough to make a difference?

Does fascia sheets and webs of connective

tissue have any properties that are relevant

to healing and therapy? Are there good
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reasons to do manual therapy (massage

particularly) that is aimed at fascia? Fascia

gets discussed in therapy offices a lot thesedays. It is supposedly the key to many a

therapeutic puzzle, and is now routinely

targeted by therapists of all kinds. But is fascia

actually important in therapy? More than any

other soft tissue?

This article questions fascia excitement from a

scientific perspective.1 Fascia enthusiasts are

rarely specific aboutwhyfascia matters, or how

exactly fascial work can help people with

common pain problems. They speak mainly

about the complexity and ubiquity of fascia, as

if those alone are good enough reasons to

focus on fascia. Attempts to get more specific

are usually sloppy. Poor clinical reasoning

about fascia seems to be common.

This problem was captured perfectly for me by

something a massage therapist said to me on

my 40th birthday in 2011. I was getting a
http://togglefootnote%281%29/http://togglefootnote%281%29/


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massage (because I really do love massage).

The therapist was doing fascial work, of course

you cant get a massage in Vancouver thesedays without getting some. She was using

some mildly uncomfortable pulling and twisting

techniques, trying to manipulate my fascia,

instead of using the more satisfying Swedish

styles I was craving. She launched into an

awkward explanation of her technique, but

words failed her:

Well, your problem2 is fascia. The fascia is thething you have to do something with. If you fixthe fascia, everything gets more well, thefascia will make everything better.

Somehow.

Deja vu? Feel like youve seen this here

before? You probably have. This is a like newcompilation of most of the fascia writing Ivedone over the last year about four oldarticles merged into one, with some re-writing


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and new information. You can now buy a $5lecture version from Movement Lectures.

TABLE OF CONTENTS

1. Introduction

2. 1.1Barely known to science!3. 1.2En garde!The fascia science challenge

4. Sloppy fascia reasoning

5. Rewritten Feb 20 '13

2.1Electrified by piezoelectricity6. 2.2Fuzzy logic: Gil Hedleys fuzz speech

7. NEW Feb 19 '132.3Idas idea about thixotropy

8. NEW Jul 31 '12

2.4The acupuncture connection: is fascia actuallymagic?

9. 2.5Not so exotic after all

10. Real fascia science that supposedlymatters

11. 3.1Fascia is much too tough to release12. NEW Feb 15 '13

3.2Release may not even be real13. 3.3Does stimulating fascia reduce post-exercise

muscle soreness?
http://www.movementlectures.com/MEG0312-20.htmlhttp://www.movementlectures.com/MEG0312-20.htmlhttp://saveyourself.ca/articles/does-fascia-matter.php#sec_welcomehttp://saveyourself.ca/articles/does-fascia-matter.php#sec_barelyhttp://saveyourself.ca/articles/does-fascia-matter.php#sec_challengehttp://saveyourself.ca/articles/does-fascia-matter.php#sec_challengehttp://saveyourself.ca/articles/does-fascia-matter.php#sec_reasoninghttp://saveyourself.ca/articles/popuphttp://saveyourself.ca/articles/does-fascia-matter.php#sec_piezohttp://saveyourself.ca/articles/does-fascia-matter.php#sec_fuzzhttp://saveyourself.ca/articles/popuphttp://saveyourself.ca/articles/does-fascia-matter.php#sec_thixotropyhttp://saveyourself.ca/articles/popuphttp://saveyourself.ca/articles/does-fascia-matter.php#sec_acupuncturehttp://saveyourself.ca/articles/does-fascia-matter.php#sec_acupuncturehttp://saveyourself.ca/articles/does-fascia-matter.php#sec_exotichttp://saveyourself.ca/articles/does-fascia-matter.php#sec_sciencehttp://saveyourself.ca/articles/does-fascia-matter.php#sec_sciencehttp://saveyourself.ca/articles/does-fascia-matter.php#sec_toughhttp://saveyourself.ca/articles/popuphttp://saveyourself.ca/articles/does-fascia-matter.php#sec_releasehttp://saveyourself.ca/articles/does-fascia-matter.php#sec_DOMShttp://saveyourself.ca/articles/does-fascia-matter.php#sec_DOMShttp://www.movementlectures.com/MEG0312-20.htmlhttp://www.movementlectures.com/MEG0312-20.htmlhttp://saveyourself.ca/articles/does-fascia-matter.php#sec_welcomehttp://saveyourself.ca/articles/does-fascia-matter.php#sec_barelyhttp://saveyourself.ca/articles/does-fascia-matter.php#sec_challengehttp://saveyourself.ca/articles/does-fascia-matter.php#sec_reasoninghttp://saveyourself.ca/articles/popuphttp://saveyourself.ca/articles/does-fascia-matter.php#sec_piezohttp://saveyourself.ca/articles/does-fascia-matter.php#sec_fuzzhttp://saveyourself.ca/articles/popuphttp://saveyourself.ca/articles/does-fascia-matter.php#sec_thixotropyhttp://saveyourself.ca/articles/popuphttp://saveyourself.ca/articles/does-fascia-matter.php#sec_acupuncturehttp://saveyourself.ca/articles/does-fascia-matter.php#sec_acupuncturehttp://saveyourself.ca/articles/does-fascia-matter.php#sec_exotichttp://saveyourself.ca/articles/does-fascia-matter.php#sec_sciencehttp://saveyourself.ca/articles/does-fascia-matter.php#sec_sciencehttp://saveyourself.ca/articles/does-fascia-matter.php#sec_toughhttp://saveyourself.ca/articles/popuphttp://saveyourself.ca/articles/does-fascia-matter.php#sec_releasehttp://saveyourself.ca/articles/does-fascia-matter.php#sec_DOMShttp://saveyourself.ca/articles/does-fascia-matter.php#sec_DOMS


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14. Minor update Aug 30 '12

3.4Does it matter that fascia contains muscle cells?15. Minor update Aug 30 '12

3.5Fascia strong like bull! Or mouse?

16. 3.6Do weak fascial contractions matter?17. 3.7No clinical relevance at all? Not even a teensy

bit?18. 3.8Is fascial contraction even interesting?19. 3.9What does Dr. Schleip think?

20. ConclusionsResults of the Fascia Science Challenge so far

21. 4.1To be continued

22. Appendices

23. 5.1Further Reading24. 5.2Whats new in this article?25. 5.3Notes

Barely known to science!

There is a lot of fascia research going on these

days. However, because none of that research

is clearlyclinically relevant some of it mightbe, but its all quite debatable theres also a

lot of speculating about whyfascia is

important, which leads to some claims that it
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has clinically relevant properties and functions

that are still barely known to science. For

instance, perhaps fascia can actively sinch uplike a corset around muscles, or maybe it is the

medium of a liquid crystal communication

system, or even maybe it melts like butter

when you move. Who knows!

In the history of science and medicine, guessestend to fill knowledge gaps and the guesses

usually turn out to be wrong. Exotic and new

biology is also not very usefulbiology. No one

can get safe, effective, reliable treatment

protocols out of poorly understood biology. If

you could, the biology wouldnt be poorly

understood anymore, and youd probably be

famous for pushing back the frontiers of human

knowledge.Exotic and newbiology is not also not veryuseful biology.

Some fascia research is truly intriguing, and

what many researchers are saying about fascia


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is reasonable and not an awkward reach

beyond where the data can take us.

Unfortunately, far too many therapistsfascinated by fascia are reaching beyond what

the science can actually support today way

beyond and it is doubtful that it ever will. In

some cases, in fact, we already know enough

to know that a property, even if it is confirmed,

is not really all that useful.

Please beware the implication of therapeutic

significance from scraps of basic biology. It is

easy to sound cool talking about new biology

because biology is cool. It is quite hard to make

biology useful. Few basic biology facts ever

become the basis for any kind of treatment.

Certainly a lot of fascia science is right, but I

question whether or not itmatters that it is

right.

In fact, on one occasion, a rather pedanticexperimental psychologist was telling himabout a long, complicated experiment he haddone, incorporating all the proper controls andusing considerable technical virtuosity. When


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he saw Cricks exasperated expression he said,but Dr. Crick, we have got it right we knowits right, Cricks response was, The point is

not whether its right. The point is: doesit even matterwhether its right orwrong?

V.S. Ramachandran,telling a story aboutFrancis Crick

En garde! The fascia sciencechallenge

Fascia is biologically interesting! All biology is.

But clinical relevance is the central question of

this article: if fascia science cannot

actually inform treatmentin some practical

ways, then it makes no sense to be fascinated

by it in a therapeutic context. You might as

well get excited about the biology of the

immune system, or olfaction, or epigenetics,

for all they have to do with hands-on healing.

Reader suggestions and feedback are welcome, bothcritical and supportive. However, hate mail will be
http://cbc.ucsd.edu/blog/archives/cat_scientificmethod.phphttp://cbc.ucsd.edu/blog/archives/cat_scientificmethod.phphttp://cbc.ucsd.edu/blog/archives/cat_scientificmethod.phphttp://cbc.ucsd.edu/blog/archives/cat_scientificmethod.phphttp://cbc.ucsd.edu/blog/archives/cat_scientificmethod.phphttp://cbc.ucsd.edu/blog/archives/cat_scientificmethod.php


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ignored. I receive a quite a bit of hate mail on thistopic.Please think twice before you hit send.

Fascia enthusiasts routinely denounce this

article, accusing me of ignorance of the current

Science of Fascia. Thats understandable.

However, I am pretty up on massage-related

research its my full-time job so I feel

confident challenging critics to cite

even one example of fascia researchwith clear,

direct relevance to what happens in treatment.

If such a thing exists, I will be happy to publicly

discuss it, and acknowledge my oversight. I

could be wrong about fascia. I even hope that I

am. Maybe it is important to manipulate fasciaspecifically.

This article covers three main examples of

allegedly clinically relevant fascia research

below. (That may not sound like much, but the

article is already several thousand words long,so be careful what you wish for.) I will add

more in time. All three are actually good


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examples of fascia science withpoorclinical

relevance. We do not have a winner yet.

Before we get to that, though, Id like to start

with a couple stranger examples of sloppy

fascia science piezoelectricity and fuzz!

and some of the general issues with fascial

therapy.

There is a crack in everythingThats how the light gets in.

Leonard Cohen, Anthem

PART 2

SLOPPY FASCIAREASONING

Electrified by piezoelectricity

A popular notion is that piezoelectric effect

an electric charge generated by flexing crystals

is at work in fascia, and an extrapolation
http://en.wikipedia.org/wiki/Piezoelectricityhttp://en.wikipedia.org/wiki/Piezoelectricity


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that it is also the mechanism for fascial

release. It is hardly clear that this is actually

the case. It has never been more thanspeculation. The first part is possible but

unproven. The second part goes much too far

and is demonstrably false and clearly

contradicted by modern researchers.

Crystalline properties are a pre-requisite forpeizoelectricity. To get a piezoelectric spark,

you have to have crystals. In the famous 1987

bookJobs Body which I read three times,

back in the day Juhan proposes that

connective tissue may behave like a liquid

crystal.3 A strong emphasis on may: this has

never actually been shown to be the case.

Juhan was speculating. This doesnt mean that

there is no piezoelectric effect in fascia, and

there are plenty of problems with the idea, but

its not totally out to lunch. Wedo know that

piezoelectricity sparks fly when bone is

flexed and stressed, and this guides the slow


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remodelling of bone,4 which is super cool. Its a

terribly clever system!

Its also a great example of a

clinically irrelevantbiological property. It has

nothing to do with anything a manual therapist

could ever do to a bone. It is beautifully

evolved to change bone extremely slowly in

response to extremely specific stimuli which,presumably, cannot remotely be simulated by

manual therapy. Trying to affect that system

with your hands is quite futile. Thats going to

be the case for the great majority of

physiological systems, known and unknown

even if you understand them, it doesnt mean

you can use them, or affect them with your

hands.

Maybe fascia does something similar to bone

with piezeoelectric effect. It wouldnt shockme. But no one has ever demonstrated that it

actually does. Indeed, no one has even tried to

find that property of fascia, as far as I can tell.


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Some people have run with the idea like its a

proven fact, though. For instance, James

Oschman states unequivocally andoverconfidently that connective tissue is

piezoelectric, a fact that can be used as a firm

foundation for the furtherspeculation that it

accounts for the fascial releases.5

Is this a straw man? Nope. A straw man would be

an idea that no one actually believes or takes seriously and therefore meaningless to criticize. Certainly noteveryone interested in fascia thinks that fascialpiezeoelectricity is real or important. However, enough dothat its no straw man! It may not represent the bestthinking in the field, but it is certainly out there.

And its simply inconsistent with the reality of

fascial plasticity, which we do know quite a lot

about. Theres no point in speculating

abouthow fascia responds quickly to

manipulation, because it cantand doesnt: its

too tough and slow-changing.6 In contrast to

the total absence of research into fascial

piezeoelectricity, the properties of fascial

plasticity are well studied, and there simply is

no short term change in fascia to explain! It

cant respond to the pressures of massage
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therapy any more than bone can. In addition to

the footnote, this will be substantiated in

various ways throughout the rest of the article.

Could piezoelectricity be at work in some other

way in fascia?Anythings possible. But now

were cruising into pure guess work. Do we

know anything at all about it, let alone the

physiological intricacies of such aphenomenon? Do we know why it evolved?

What it does, how it does it? Can we affect it?

And, if we dont know these things, how can we

possibly use it to devise a reliable therapy?

Obviously we cannot.

Fuzzy logic: Gil Hedleys fuzzspeech


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Another fine example of imprecise scientific

enthusiasm is Gil Hedleys extremely popular

fuzz speech. In this video with a bazillon

views, Hedley plays fast and loose with a

dissection observation: there are cobwebby

layers of fine, loose connective tissue between

thicker sheets of fascia. The anatomy is

interesting anatomy is always interesting

but Gil Hedleys interpretations are dubious.

His leaps of logic are charismatic, but also

large and precarious.

That stiff feeling you have is the solidifying of

the fuzz, Hedley confidently explains. He

thoroughly makes the case that fuzz explains

the sensation of stiffness.
http://www.youtube.com/watch?v=_FtSP-tkSughttp://www.youtube.com/watch?v=_FtSP-tkSughttp://www.youtube.com/watch?v=_FtSP-tkSughttp://www.youtube.com/watch?v=_FtSP-tkSug


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At best, that is an unsafe assumption, and one

that ignores many other highly relevant factors

like neurology, say, or the fact that heslooking at a dead person. He does not know

what happens to that tissue in a living body. In

fact, that fuzzy texture only manifestspost

mortem according to biotensegrity expert,

Dr. Steven Levin.7 This is a very interesting

passage, worth reading carefully, but note the

emphasized phrase particularly:

In Guimberteaus video, Strolling Under TheSkin, what you see there is that the fuzzystuff is really dynamic tissue that is underconstant change. Tissues dont slide, there isno shear, they reconfigure with eachmovement. The dynamics of a cell ceases withdeath. Ca++ [calcium ions] flood into the celland it stiffens thats rigor mortis. It startswithin minutes of death, as soon as thecirculating ATP [energy molecule] runs out. Thefuzz is connective tissue that is stiffened

during rigor mortis, and it doesnt happenunless you die. It occurs within minutes ofdeath, and you can almost watch it happen. Itis like snot hardening. The mucus booger thatcomes out of your nose quickly hardens and
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becomes quite stiff; at death, the mucus thatconnects all our tissues, does the same.

All that melting the fuzz is conjecture based

on misinterpreted observations on dead tissue.Even so called fresh cadavers are but poorplayers in the game of life.

Almost any amount of normal movement is

sufficient to sustain a normal range of motion.

Fuzz solidification either isnt happening ordoesnt matter, because its effortless to move

through. Also, there are other explanations for

the sensation of stiffness: better, evidence-

based, and un-fuzzy explanations. I discuss

them in some detail in Quite a Stretch.

Idas idea about thixotropy

A shabby, decades-old idea is still often

seriously cited as the explanation for howfascial therapy works: because it softens fascia

with thixotropic effect. The idea came from
http://saveyourself.ca/articles/stretching.phphttp://en.wikipedia.org/wiki/Thixotropyhttp://saveyourself.ca/articles/stretching.phphttp://en.wikipedia.org/wiki/Thixotropy


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Ida Rolf (founder of Rolfing). Fascia

researcher Robert Schleip:8

Many of the current training schools whichfocus on myofascial treatment have beenprofoundly influenced by Rolf (1977). In herown work Rolf applied considerable manual orelbow pressure to fascial sheets in order tochange their density and arrangement. Rolfsown explanation was that connective tissue is

a colloidal substance in which the groundsubstance can be influenced by the applicationof energy (heat or mechanical pressure) tochange its aggregate form from a more densegel state to a more fluid sol state.

A quick look at how thixotropy works in human

physiology shows that this just doesnt add up.The thixotropic effect is nifty physiology, but

its not a therapeutic effect in itself, nor is it

the mechanism of one. Idas idea was wrong.

Thixotropy is an obscure physical property of

certain slimy body fluids that get thinner whenagitated or stressed. You can easily observe

thixotropic effect in beach sand, near the


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waters edge: stamp your feet in the sand, and

it starts to liquify.

What makes these substances gooey andslimy? Why, a family of carbohydrate molecules, ofcourse: the glycosaminoglycans. Also known as the snotmolecule. Think of any movie monster with tons of ropysaliva thats glycosaminoglycans!

Thixotropic fluids in the human body include

synovial fluid in joints, mucus, semen, and the

gelatinous and poorly-named goo called

ground substance the stuff that gristly

connective tissue fibres are embedded in like

bits of coconut in Jello. Ground substance is the

most plentiful thixotropic substance in the

body.

But thixotropy is minor, slow, and temporary,

and fascia is too tough to change.

Fascial sheets are incredibly tough, and

you cantchange their density and

arrangement quickly or easily. And thixotropy

just isnt fastenough to explain the relatively

speedy, dramatic effects on tissues that
http://en.wikipedia.org/wiki/Glycosaminoglycanhttp://en.wikipedia.org/wiki/Glycosaminoglycan


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therapists claim to achieve. Dr. Schleip: either

much longer amounts of time or significantly

more force are required for permanentdeformation of dense connective

tissues.9 Thixotropy might slowly make fascia

morepliable, but not stretchier. If thixotropy

had the power to increase the extensibility of

connective tissue, then we would become

obviously more flexible just from sitting in a

sauna Ive tested this repeatedly and never

observed any increase in flexibility just from

being hot.10

Even if it works in some small way, thixotropic

effect is going to be temporary, fading within

seconds or minutes after hands are

removed. When the stimulationstops, so does thethixotropy, and a therapy

cant work if the affectedtissue immediately revertsto its previous state.Thixotropy
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will stop when the stimulation stops but a

therapy cant work if the affected tissue

immediately reverts to its previous state. Dr.Schleip calls this the reversibility problem

and definitely not an attractive implication of

this model for the practitioner.

Last but not least, thixotropic effect is simply

aminoreffect. Its occurring a little bit all thetime, with or without massage. Massage surely

does induce it a little, but just as surely

much less than ordinary physical activity like

with circulation. Massage therapists are very

fond of claiming that massage increases

circulation, but if it does so at all, the effect is

much smaller than what exercise does!

Perspective matters. Another similar thought

experiment: if sustained pressures or sheering

could significantly change connective tissue,

then working a chair all day long or any

long-duration posture would also deform

your fascia.


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The idea of thixotropy is hardly state-of-the-art

thinking about fascia, but it is certainly still

prevalent among therapists practicing fascially-focussed therapy, and trying to explain what

they do. Unfortunately, it was never even a

good idea in the first place, even decades ago.

The acupuncture connection: isfascia actually magic?

Another disconcertingly popular notion about

why fascia matters is that the meridians of

Chinese medicine correspond directly to fascialanatomy and function. If you polled therapists

doing fascial manipulation, I think you would

find that a great many believe that they are

doing the same thing that an acupuncturist is

doing just in a different way. They believe

that fascial therapy works for the same reasons

acupuncture works.


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Indeed, most fascial therapists probably

believe that acupuncture works. And therein

lies the problem. Unfortunately for fascialrelease therapy, acupuncture is not a good

ally: it has been failing many fair, good quality

scientific tests for years now, and is simply not

what it seems to be.

Acupuncture as we know it today is not soancient after all: its current form is a modern

invention of the pediatrician Cheng Danan (

, 1899-1957) in the early 1930s1112Formost of history, acupuncture

existed primarily as amethod of bloodletting exactly like the prescientificmedieval Europeanpractice.Before that, for most of history, itexisted primarily as a method ofbloodletting

exactly like the prescientific medieval

European practice. And then theres the myth


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of acupunctures popularity.13 Even its alleged

popularity and widespread use in China is quite

trumped up it is, for instance, not actuallyused for anaesthesia.14These are rather

embarrassing facts for acupuncture.

Acupuncture is obsolete Eastern folk medicine

propped up by Western hype and wishful

thinking. The proposed association betweenfascial meridians and the chi meridians of

traditional Chinese medicine is meaningless.

Even if meridians and all the other rubric of

acupuncture were real, though, acupuncturists

are unable to demonstrate their power clearly:

their needles are consistently no more helpful

than placebos. Even pro-acupuncture

researchers have repeatedly admitted that the

effect of the needles is small at best. And if the

acupuncturists cant manipulate these

meridians effectively enough to achieve clearly

measurable effects, why would pulling on

fascia be able to do it?


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Acupuncture lore has no business in a serious

discussion about fascia and its possible

importance in therapy.SYDoes Acupuncture Work for Pain? Areview of modern acupuncture evidence andmyths, particularly with regards to treating lowback pain and other common pain problems

Not so exotic after all

Piezoelectricity, fuzz, and fascial meridians are

three good examples of popular but poor

reasons why fascia supposedly matters. There

are other reasons, both better and worse, and

discussion of genuine fascia science is still

coming. But first I want to make it clear that

common fascia talk often fails to even reach

the level of being science-y. Despite all the

talk of exotic properties of fascia, fasciasclinical importance is usually expressed only in

terms of a couple extremely simplistic

rationales, which dont seem exotic at all:
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1. its everywhere and connects everything(well, yeah),

2. and it gets tight (not clear, see below).

A strong theme in fascial therapy is the

emphasis on the interconnectedness of

anatomy via fascia, always making the point

that pulling on any one part of fascia affects

the whole body, like pulling on the corner of asweater affects all the threads. (That sweater

analogy appears virtually everywhere online

that fascia is mentioned. It gets really

tiresome, actually. Didnt think it mattered

much ten years ago. Still dont.)

The main idea of fascial therapy is that the

stuff can get tight and restrictive, like clothing

a size too small, and needs to be released,

and that therapists can achieve this by various

methods of yanking on it. The yanking may be

extremely intense, too some flavours of

fascial therapy are among the most painful of

all hands-on techniques.15


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And thats what fascial therapy boils down to

most of the time, in the wild. I have personally

encountered lots of talking about fascia that isexactly this rudimentary and even worse,

like the example I quoted in the introduction

The fascia will make everything better! Many

therapists are perfectly capable of discussing

the topic more intelligently, of course, but low

quality reasoning and communication about

fascia is distressingly common (and my

exposure is quite extensive, due to the large

volume of email I receive).

Consider this gem of simplistic rationalization,

reported by Barrett Dorko, PT:

Restricted fascia is full of pockets. When thetissue starts to release, these pockets areopened up. When these pockets open, thesensations that were trapped in them arereleased.

Such overconfident, poor quality clinical

reasoning isnt universal just excessively
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common within the culture of fascia

enthusiasts.

Now, lets get to some real fascia science.

The greatest enemy ofknowledge is not ignorance, itis the illusion of knowledge.

Stephen Hawking

PART 3

REAL FASCIASCIENCE THATSUPPOSEDLY

MATTERS

Fascia is much too tough torelease

Manual therapists need notfeel threatened by the newsthat we cannot stretch fascia.


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If We Cannot Stretch Fascia,What Are We Doing? AliceSanvito, Massage Therapist

My original challenge to readers (in the fall of

2011) to suggest fascia science that supports

fascial therapy was kicked off with a fine

example: one that is just about the exact

opposite of what I asked for, underminding the

clinical relevance of fascia rather thansupporting it. Despite the extraordinary

number of comments I received on early

versions of this article, few readers answered

my challenge directly. Of the handful of

scientific papers that were suggested to me,

this was the most interesting:

Three-dimensional mathematical model fordeformation of human fasciae in manualtherapyChaudhry et al.Journal of the American Osteopathic

Association. Volume 108, Number 8, p379-90. Aug

2008.

The Chaudhry et al article is indeed clinically

relevant to fascial therapy but not in a
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supportive way. This fascia science actually

contradicts the big idea of fascial therapy.

The main pointof manipulating fascia16 is

tophysically change it in some way to

achieve what is usually described as a

release. Although the concept of release may

correspond to some other physiological

phenomenon another discussion itcertainly cannot be explained in general by

physically changing the fascia.

What Chaudhry and colleagues showed is that

fascia is much too tough to release"

(mechanical deformation17) by stretching it.

Although they oddly imply in their summary

that it might be possible to do so with the

superficial nasal fascia, the main textof the

paper makes it clear that even that thin tissue

is extremely tough, and would only

mechanically deform if subjected to

surprisingly intense forces. This is consistent

with well-established properties of fascia,


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namely that its extremelytough stuff.

Collagen is like that.

If I could write my own conclusion to this

paper, it would go more like this:

CONCLUSION: You cannot change thestructure of fascia, because it is tougher thanKevlar. If the stuff were thicker, people wouldbe bulletproof.18

CLINICAL IMPLICATIONS: If you want tophysically change someone's fascia by force,you're going to have to get medieval. Thisdirectly contradicts a major popular rationalefor fascial manipulation.

This paper is only clinically relevant to fascialtherapy insofar as it presents evidence that

discourages and undermines existing common

practices and beliefs. Therefore, perhaps it was

a poor choice to cite it in this context.

Its also just old news that fascia is too tough tochange. For instance, Dr. Robert Schleip

debunked the idea in his 2003 paper about

fascial plasticity, and if you dont take his word


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for it a well-respected fascia researcher

then whose opinion would be credible enough?

He dismisses the traditional explanations ofthixotropy and peizoelectric-effect-mediated

adaptation, and thoroughly describes fascial

toughness. He concludes that plastic fascial

change in response to moderate loading is

impossible to conceive.19

As strongly stated as that may be, Ill go even

further. Dr. Schleip (and virtually everyone

else) assumes that release is a real thing

that needs explaining. Im not so sure

Release may not even be real

In the context of fascial therapy, a release is:

a palpable, relatively quick change in

tissue texture

clinically meaningful (makes some kindof real difference to the patient)


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somewhat lasting (if it didnt last, whatwould be the point?)

somewhat predictable (that is, itshappening because of treatment)

And fascial therapists more or less

unanimously assume that its fascia,

specifically, that is doing the releasing.

No doubt the first thing a quick change intexture happens in the course of manual

therapy. It is notsafe to assume the rest,

though. And whats left of the concept of a

release if you take away the clinically

meaningful, lasting, and predictable parts?

What if itsjusta change in texture, a bit of

movement under the skin?

Yes, I do have experience. Many readers accuse me ofhaving no practical experience with patients, when inmany cases I clearly have more (and better) than they do.Not that its a contest, but its just so deeply ironic andamusing when people assume that the only possibleexplanation for my opinions is that I must not have anywork experience as a massage therapist. I have a decadeof it, and this fact is readibly available in my bio.

In my many years working as a massage

therapist, I felt various and sundry ripplings,
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twitchings, and shifts under the skin. But in

order to qualify as releases, those

movements should have correlated stronglywith my intentions and with the patients

experience. Sometimes they did, but often they

did not. So I always thought they were really

quite random, occurring with great variety

pretty much no matter what I did, or what

patients reported.20 So while I certainly felt

something change, I rarely thought of those

changes as a meaningful release.

Dr. Schleips 2003 paper about fascial plasticity

basically just said that fascia is too tough to

change, but muscle may react to touch and

pressures, and that this is probably mediated

by sensory nerve endings in all soft tissues.

This is hardly surprising it basically just

means that people react when poked and

prodded and it doesnt really have anything

to do with fascia in particular, except insofar as

fascia has nerves in it, just like everything else.

We have no idea whether or not any of that


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actually constitutes a meaningful mechanism

for a therapy. I can also make someone

twitch their quadriceps by bonking theirpatellar tendon: does it matter, other than as a

test of the reflex itself?

Releases are probably mostly just trivial tissue

noise in the hands-on experience, not a

pivotal event in therapy. Or, if they are moremeaningful, they are nearly impossible to

interpret. Its not that nothings going on its

that nothing in particularand knowable is

going on. But we have trouble grappling with

that, so we round it off to something more

specific and definite and meaningful, an

oversimplification that is more poetic than

biologic. I have no objection to using release

as a description of an experience, but I think it

is quite misleading to pretend that it describes

a particular biological event with clinical

meaning and value which is exactlyhow

most therapists imagine it, which is the only

thing that really needs explaining. (And thats


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not difficult: it boils down to a thick stew of

good intentions, ego, and the human habit of

imposing simplistic explanations on chaoticsystems.)

Funny. Not actually possible. But funny!(Drawing byClaude Serre.)

Does stimulating fascia reducepost-exercise muscle soreness?

Perhaps but the clinical relevance

ofthis data is tenuous at best so low that Iwould never normally be interested in this

paper. In fact, I would never have chosen to

read it myself, because I dont think its good
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enough science. I spent some time on it only as

an gesture of good faith to a critic, who

supplied the paper as an example of basicfascia science that matters. It was probably not

a good choice for that purpose.

In vitro modeling of repetitive motion injuryand myofascial releaseMeltzer et al.Journal of Bodywork & Movement

Therapies. Volume 14, Number 2, p162-71. Apr 2010.

This is a test tube study showing that naked

cells handled stress better (fewer signs of

harm) if they were treated with simulated

myofascial release (MFR). A meaningful,

accurate simulation of manual therapy onnaked cells is an amusing notion, and its clear

that what happened to those cells differs

dramatically from what would happen in a real

living body.

Even if true and reproducible, this data wouldmainly support the rationale for MFR

specifically forpost-exercise soreness

something of a dead end for clinical relevance,
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because exercise-induced soreness has little to

do with the main claims of fascial release

therapy, which primarily concerns correctingpostural asymmetries, eliminating alleged

restrictions, and treating chronic pain.

Post-exercise soreness is comparatively trivial,

and patients usually dont seek therapy for

it.21 Theres a lot of research showing thatexercise-induced soreness is basically

invincible anyway.22A meaningful,accurate simulation ofmanual therapy on naked

cells is an amusing notion.Forthis property of fascia to be clinically relevant,

it would have to imply that MFR might be able

to treat chronic pain from other causes not

the transient annoyance of soreness after a

game of soccer.

This isnt a rejection ofall possible clinical

relevance of the data. My point is that there


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are so many problems that its relevance is

watered down to quite a thin sauce way too

thin.

I do concede that the paper shows some

evidence that fibroblasts have interesting and

perhaps positive responses to mechanical

forces. That is inherently interesting biology,

and perhaps well worth investigating further but its a long reach to postulate any clinical

relevance to what most therapists do, most of

the time, with patients fascia.

Reach is what the authors do, however. I

suspect they are deeply interested in validating

the notion that fascia is important, because

they seem to be seeking evidence to support

their pre-conceptions typical ofThe National

Center for Complementary and Alternative

Medicine-funded research, and a hallmark oflow quality science. Its quite likely that if

neutral researchers with no interest in
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fascial therapy did this experiment they

would not get or report the same results.

Does it matter that fascia containsmuscle cells?

The next example of fascia science was

suggested to me by Gil Hedley. Since he clearly

believed me to be ignorant of fascia science

and in dire need of educating, I asked him to

recommend some reading to me a favourite

paper showing something interesting and

clinically relevant about fascia. As expected, herecommended a paper I was already familiar

with, because it is something of a classic of

fascia science: Robert Schleips 2006

dissertation on the contractile properties of

fascia. Much more interesting stuff than the

previous two examples. I will get into much

more detail about this paper than the first two.

Fascia is able to contract in a smooth muscle-like manner and thereby influence


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musculoskeletal mechanicsSchleip et al.Proceedings of the 5th World Congressof Biomechanics, Munich. Volume, Number, p51-54.2006.

Schleip and colleagues convincingly showed

that fascia contains muscle cells and that they

can contract slowly and weakly. That is

undeniably interesting biology! But the point of

this analysis is to ask: Does it

even matterwhether its right or wrong? Is it

clinically relevant? Does it improve how we do

therapy? Can we use the knowledge to affect

the body with hands? That is the question.

It is also a question that Dr. Schleip and hiscolleagues have addressed themelves on their

website, FasciaResearch.de. What follows is my

own analysis, which is generally consistent with

theirs. However, interested readers should

definitely have a look at theirarticle: it is

readable and chock full of useful perspective,

answering questions like Does fascia contract

in response to emotional stress? and Can

fascia contract on its own?
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Fascia Contractility FAQ, a webpage onwww.fasciaresearch.de.

Important update: Dr. Schleip has read thisarticle and corresponded with me about it

amiably, and expressed clear agreement with

my main point. Although he also had some

thoughtful criticisms, we agree on what

matters, and he shares my frustration with

clinical overconfidence in fascia. I invited him

to make a statement for my readers about this:

look for it at the end of this part of the

discussion.

Fascia strong like bull! Or mouse?

Before we get to clinical relevance, Ill quickly

explain what Schleip et al. found: a kind of

muscle cell in rat fascia, which they described

as rather unexpected.23 They also tried out

various methods of stimulating them in

vitro (test tube) and found that, by golly, those
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muscle cells did what muscle cells do: they

contracted! Slow, weak contractions. But they

contracted.

Perspective

By any measure, fascial contractionsare dramatically less powerful than muscular

contractions. If anything, this diagram gives fartoo much credit to the power of fascia, which

would barely register at all if depictedmore accurately.

Its certainly not difficult research to

understand.


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Some important context that fascia fans will

appreciate: for a long time, fascia was and

often still is incorrectlythought of as a fairlylifeless, inert substance, the Saran Wrap of

biology. I still hear various educated people

referring to it in this way. However, massage

therapists and chiropractors (in particular) are

prone to swinging to the opposite extreme and

talking about fascia as though it is more

interesting than a lifetime subscription

to National Geographic. The truth is

somewhere in the middle.24 Dr. Schleips

research demonstrates this. Fascia is not inert.

But neither is it all that lively at least not in

terms of contractility. We are not talking about

a lotof muscle cells here. If you had

blueberries with your cereal in the same

proportion, youd be disappointed not

enough blueberries! Its just a few muscle cells

scattered throughout the fascia. Theres so few

that they are visible only when you

look veryclosely and injustthe right way.


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Nor are we talking about particularly strong

contractions. Fascia isnt going to be ripping

apart any chains with its bare hands. Themaximum force generated by a small bundle of

contractile rat fascia was around 35mN.25 In

plain English thats not very dang much or

the somewhat more precise about what it

takes to set an AA battery rolling on a nice

smooth surface. (It took me a long time to

work that out. I have a weird job.) Thats not

bad for a bundle of rat fascia, perhaps, but it

doesnt really hold a candle to middle-of-the-

night charlie horses either.

Compared to the power of muscle contraction,

fascia power barely even registers.

The bull versus mouse comparison is a little

unfair though, because its not just a matter

ofstrong versus weak. Although fascialcontractions may be weak compared to

muscles, they could nevertheless

bepowerful in another way their effects
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might, for instance, accumulate over time to

produce contractures (permanent seizing up

of tissues). So its still worth considering howthese contractions might be clinically relevant.

Do weak fascial contractionsmatter?

Schleip et al.s basic finding seems sound

enough, and I see no reason at this time to

dispute the observation that fascia can

contract. If theres anything wrong with their

research methods, I dont know what it is. Butfor the property they described to matter to

therapists who are choosing to focus their

therapeutic attention on fascia

for anybiological property to be clinically

relevant it must be significant enough to

have an effect on health. (It then must also be

something that we can do something about,

but lets start with it mattering in the first

place.)


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Schleip et al. characterized the raw power of

fascial contraction quite differently than I just

did. I deliberately made it sound trivial, withinthe bounds of their numbers.26 In their words,

however, in the large sheets of fascia in the

low back, the contraction could be strong

enough to influence low back stability

and other aspects of human

biomechanics.

Stability? Even if you exaggerate their

numbers, they would still only account for a

small fraction of the postural muscle power

involved in dynamic spinal stabilization, never

mind the generally mind-blowing structural

toughness and resilience of the human spine.

The idea that low back stability could be

affected in any way by such a small, slow-

motion force is a bit much for me to

swallow.2728And thats based on an estimate of

the theoretical maximum force generated by

the biggest, thickest blankets of fascia in
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human anatomy. In most places in the body,

fascia is much less substantial tough for its

weight, but mostly quite thin and wispy, and alot of it even microscopic.29 The forces

generated must be dwarfed by that of muscle

itself in rough proportion to the number and

size of contractile cells involved.

That fascial contractions might influence other

aspects of human biomechanics is a bit

vague. A general example of such aspects

might be that contracting fascia could be

involved in biomechanical asymmetries

tighter on one side than the other. The validity

of such a concern depends on just how

sensitive you think human biomechanics are to

forces so subtle that no one really had any idea

that fascia contraction was even happening

before this study. As regular readers here will

know, I think biomechanics are over-rated as afactor in all kinds of pain problems, and theres

extensive evidence that human beings are

wonderfully adaptable and cope surprisingly


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well even with gross deformities, never mind

subtle assymetries and imbalances. I make

that case in great detail in another article.30The wording of the conclusions of Schleip et

al.s paper is synonymous with saying that

fascial contraction is relevant

only ifstructuralism is a useful mode for doing

and thinking about therapy. Also, their

phrasing shows a strong bias in favour of the

importance of fascia. And the study was

funded by the International Society of

Biomechanics, the Rolf Institute of Structural

Integration, and the European Rolfing

Association.31

Weak, slow fascial contractions strike me as

being scientifically valid and interesting, but

clinically minor. Once again, far from making

me interested in fascia as a target for therapy,

fascia science is convincing me of just the

opposite.


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No clinical relevance at all? Noteven a teensy bit?

If it makes anyone feel better about all this, Im

happy to concede that fascial contractility

might be a little bit clinically relevant. Other

evidence might even reveal something

important although that would surprise me.

It doesnt hurt my main point to make these

concessions. To make mypoint, all I have to

establish is that the clinical relevance is

debatable and probably minor at best, rather

than the slam dunk it would have to be to

support even half of the excitement aboutfascia you see in the therapy industry today.32

What about fascia and trigger points?Schleip etal. dont bring trigger points (muscle knots) into thisdiscussion, but a lot of other people certainly have. Thenotion is that a trigger point is being squeezed andsustained by clenching fascia, but this clinical conceptsuffers even more than other examples from the relative

weakness of fascial contractions. I explore this specificclaim of clinical relevance in detail in my trigger pointstutorial.

In his original dissertation, Schleip limited his

speculation about clinical implications to the
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broad generalization that it can influence

musculoskeletal mechanics, such as spinal

stability. In a follow-up paper for MedicalHypotheses,33 he and several colleagues

generally suggest that fascial contractility is a

factor in muscle stiffness. The high water mark

for potential clinical relevance is spelled out in

this passage:

This offers the possibility of a newunderstanding for many pathologies thatinvolve a chronically increased myofascialtonus. Examples include conditions such astorticollis, low back pain associated withparaspinal compartment syndrome, tension

headaches, and others. Similarly a decreasedfascial tone could be a contributing factor inconditions that are often associated withdecreased myofascial tension, such as in backpain due to segmental spinal instability,peripartum pelvic pain, or fibromyalgia. Whileusually other factors play a major role aswell in these pathologies, it is possible thattheir progress could be influenced additionallyby the regulation of fascial tissue tone


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The emphasized phrase is key its an

understatement. For instance, other factors

dont usually play a major role in thoseconditions, they always do. And the role of

those factors isnt just major, but probably

nearly total relative to the

presumably minor(and still unconfirmed)

contribution of a little fascial tension. Some of

the items listed are particularly implausible to

me. Ive already mentioned how hyperbolic it is

to suggest that fascia could have any serious

impact on spinal stability.

Another peculiar item here is fibromyalgia, a

fascinating condition that might conceivably be

affected in some small way by fascial

contraction, but which is overwhelmingly a

nasty disease of the nervous system.

Suggesting it as a main example34 of how

fascial contraction might matter makes about

as much sense to me as saying that people

with cancer might have some contracted fascia

would it matter if they did?


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The most interesting item listed is

compartment syndrome, which is

decidedly nota common complication or causeof back pain, but certainly is a problem

(especially in the shins).35 Compartment

syndrome is excessive pressure in a fascial

compartment, like a sausage swollen in its

wrapping. If fascia were to start squeezing a

compartment for some reason, it might be a

problem. It is the one item listed where there is

a clear, direct and logical connection between

fascia can contract and a way that it could

contribute significantly to a health

problem. Thatis clinical relevance. And yet

there is still a clear problem with the scale of

the forces here. Compartment syndrome is by

definition only a problem when the pressure is

significant,probably dramatically exceeding

the maximum force with which fascia couldsqueeze the compartment. Visualize a hot

water heater that isnt venting pressure the

valve is busted, and its in danger of blowing.


54/78

The pressure inside is immense, and it would

make no practical difference if the hot water

heater itself was a little larger or smaller.Again, fascial contraction is probably not nearly

strong enough to matter. Still, at least its easy

to see how it could matter in principle, and the

numbers mightfavour fascial contraction as

factor.

So you see how this goes: for one candidate

example after another, the clinical relevance of

fascial contraction is dubious or minor.

Is fascial contraction eveninteresting?

One of the lower moments in biology history

was the labelling of non-coding DNA as junk

DNA in 1972. The first time anyone with ascrap of imagination heard that, they thought,

Yeah, right. As biologists slowly figured out

what all that junk is for,36 there was a lot of


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Well, yeah, okay, thats more like it. Of

course. Its interesting science, but in some

ways those discoveries are still overshadowedby the way were all not so very surprised.

Similarly, the presence of muscle cells in fascia

is no shocker. I never believed fascia was

entirely inert any more than I believed in the

junkiness of any DNA. If you spend much time

studying biology, it quickly becomes apparent

that there are no sharp lines or divisions, and

that we consist of an incomprehensibly diverse

and interconnected community of

cells. That connective tissue

has a small population ofmuscle cells strikes me asblindinglyunsurprising.Muscleblends exquisitely into tendon, with no clear

demarcation at the cellular level: at the

microscopic level, its like walking through the

overlapping zone of two heavily integrated

adjacent neighbourhoods, and the further you


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go away from the muscle, the fewer muscle

cells you see, and the more fibroblasts and

their fibres. That connective tissue has a smallpopulation of muscle cells strikes me as

blindingly unsurprising. Fascia surrounds and

fractally wraps every muscle inside and out, for

crying out loud how could it nothave a few

muscle cells and overlapping properties?

I didnt know that before it was confirmed, but I

certainly dont find it particularly surprising. I

suspect that the slightly contractile properties

of fascia are simply at one end of a continuum

of motor function. Our muscular system is

overwhelmingly our primary means of reacting

to stimuli the major output of our nervous

systems and in general terms the slight

contractility of fascia is probably just the

fringes of that functionality, a little bit more of

the same. There are probably some subtle

differences, but they are subtle and arcane and

ultimately just a slight variation on the

biological theme ofmuscularity. Im not saying


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its completely uninteresting, but its

overshadowed by the much more interesting

muscular system as a whole, about whichfascia is simply a mildly intriguing subtopic.

And, in terms of clinical relevance, the

muscular system itself is in turnovershadowed

by neurology.

What does Dr. Schleip think?

Recently Dr. Schleip read my article and wrote

to express his basic agreement with my key

point about his research: Your comments onthe small size of fascial contractions are right

on, at least when viewing these within the

periods of seconds to minutes, as is usually

applicable for bodywork techniques. He also

wanted me to know that he shares my

annoyance with the over-zealous claims and

projections of therapists doing fascial work.

He is not thrilled with the way his research is
http://saveyourself.ca/articles/pain-is-an-opinion.phphttp://saveyourself.ca/articles/pain-is-an-opinion.phphttp://saveyourself.ca/articles/pain-is-an-opinion.phphttp://saveyourself.ca/articles/pain-is-an-opinion.php


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being used to justify premature overconfidence

in fascial therapy.

He also offered some thoughtful criticism on

some specific points (and I made some

changes, and will probably make more).

Nevertheless, he had no major objections, and

was generally pleased with what he read here:

You have my respect for your detailed andcritical analysis of the present work on fascia.

Most of the people who criticize you have not

done a portion of your reading work and could

certainly learn a lot from the debate you

started.

I invited him to make a statement for my

readers about this. Here is it in full, with some

emphasized highlights:

I share your emotional frustration with

the current trend among bodyworkers ofattributing anything wonderful orastonishing to the properties of fascia. Infact, our Fascia Research Group at UlmUniversity has been receiving an almostexponentially increasing number of inquiries
http://fasciaresearch.de/http://fasciaresearch.de/http://fasciaresearch.de/http://fasciaresearch.de/


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from enthusiastic healers (and martial artteachers) worldwide who wish that we wouldsanctify their claims that fascial contraction

provides the explanation for their observedmiracle powers. While I do tend to believe thatthe fascial net plays much larger roles inhuman functioning than previously assumed inorthopedic medicine, I am afraid that suchover-zealous claims and projections areundermining the seriousness of theinvestigationand academic rigor thatcharacterizes the work of the current leaders infascia research, such as P. Huijing, H. Langevin,T. Findley, P. Standley and A. Vleeming.

As a bodywork clinician myself, I have learnedthat there is hardly a more dangerousattitude among therapists than the hero

healer/manipulator who is damn sureabout his diagnosis and supposedtreatment effects . This of course applies asmuch to fascia-oriented therapists as it does tothose who base their work on supposedneuromuscular or other physiological effects,

most of which are still unproven. There

is hardly a more dangerousattitude among therapiststhan the hero healer who is


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damn sure about hisdiagnosis & supposed

treatment effects.While scientistscan learn a whole lot from the intuitive andexperiential wisdom of complementarytherapists, particularly about the non-fragmented and connecting properties of thefascial net, we bodyworkers can learn at leastas much from the careful, questioning

approach of good scientists, who are willingto doubt their own assumptions and torefrain from premature confidence andover interpretation of their findings. It isthis mutual learning and interdisciplinaryenrichment which in my opinion characterizesthe best qualities of the current fascia research

field, as expressed in the international FasciaCongress series and associated activities.

Again, Dr. Schleip and I do not agree about

everything but that is unimportant

compared to our shared values and

commitment to cautiously reservingjudgement. We have each placed our bets on

this topic, but not closed our minds. I fully

support and endorse his enthusiasm to explore


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the biology and he supports and endorses

the value of my critical analysis.

PART 4

CONCLUSIONS

Results of the FasciaScience Challenge so far

Piezeoelectricity may occur in fascia,but its clinical relevance is nil not enoughis known about it to even speculate abouthow it could be exploited in manual therapy.

Gil Hedleys theory that congealingfascial fuzz causes stiffness issimplistic and wrong. It is not a plausibleexplanation for the sensation of stiffness, ora mechanism of action for fascial therapy orstretching.

Fascial meridians relate fascialtherapy to the meridians of acupuncture,which dont exist or even if they do

cant actually be exploited for anytherapeutic effect even by acupuncturists.

Chaudhry et al showed that fascia istoo tough to release. Indeed, even thinfascia is so tough that it is basically
http://saveyourself.ca/bibliography.php?chaudhry08http://saveyourself.ca/bibliography.php?chaudhry08http://saveyourself.ca/bibliography.php?chaudhry08http://saveyourself.ca/bibliography.php?chaudhry08


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inconceivable that it could be physicallychanged (stretched, loosened) without vicegrips. This directly contradicts a major

popular rationale for fascial manipulation,and is only clinically relevant to fascialtherapy insofar as it presents evidence thatdiscourages and undermines existingcommon practices and beliefs.

Meltzer et al concluded that stimulatedfibroblasts might be happier

fibroblasts specifically, they might bemore resistant to post-exercise soreness.The results of this test tube study arequestionable, but even if you take the dataand interpretation at face value, it is a longreach from a test tube study to clinicalreality. Treating post-exercise muscle

soreness is not even a common goal formanual therapy.

Schleip et al established that fascia iscontractile to a trivial degree, but not thatit matters. It is somehat unsurprisingbiologically, and clinically trivial. It is not afactor in any of the common problems most

manual therapists work with maybe noneat all and even if it was it is somewhatunlikely that hands-on therapy could relax it.
http://saveyourself.ca/bibliography.php?meltzerhttp://saveyourself.ca/bibliography.php?meltzerhttp://saveyourself.ca/bibliography.php?meltzerhttp://saveyourself.ca/bibliography.php?schleip-fascia-contractionhttp://saveyourself.ca/bibliography.php?schleip-fascia-contractionhttp://saveyourself.ca/bibliography.php?schleip-fascia-contractionhttp://saveyourself.ca/bibliography.php?meltzerhttp://saveyourself.ca/bibliography.php?schleip-fascia-contraction


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To be continued

There is more fascia science, and I will extend

this article with more analysis in the future. I

honestly hope that there is clinically relevant

fascia science that would be terrific. So far,

however, I see no good reason for therapists to

be fascinated by fascia and to make it a target

tissue.

Other alleged fascial properties and clinical

relevance issues I intend to address eventually

(definitely not a complete list):

The claim that connective tissue is acolloidal substance in which the groundsubstance can be melted by heat ormechanical deformation (thixotropy), andthat this is the basis of a therapeuticrelease. Done February 2013.

The claim that fascia is a liquid crystal.

While it certainly has some elements of truthin it, the relevance to therapy is extremelydubious. This is closely related to thepiezeoelectricity claim already covered bythe article, but there is more to say about


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the liquid crystal idea specifically. DoneFebruary 2013.

The claim that fascia containsmemories in some sense. I will likelydispute both the property and its relevance.

The claim that fascia is structurallyimportant and tensegrity is interesting(agree), and that this is clinically relevant(disagree). Much of my rebuttal on this score

already exists in my articleabout structuralism.

PART 5

APPENDICES

Further Reading

SYYour Back Is Not Out and Your LegLength is Fine The story of the obsessionwith crookedness in physical therapy andtreatment for chronic pain.
http://saveyourself.ca/articles/structuralism.phphttp://saveyourself.ca/articles/structuralism.phphttp://saveyourself.ca/articles/structuralism.phphttp://saveyourself.ca/articles/structuralism.phphttp://saveyourself.ca/about-salamander.phphttp://saveyourself.ca/articles/structuralism.phphttp://saveyourself.ca/articles/structuralism.phphttp://saveyourself.ca/articles/structuralism.php


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SYPain is an Opinion What recentpain science can do for your chronic painright now. The role of the nervous system in

chronic pain is the major alternative tofocussing on fascia. It has much clearerclinical relevance.

SYDoes Massage Therapy Work? Areview of the science of massage therapy such as it is.

SYTrigger Points & Myofascial PainSyndrome A guide to the science ofmuscle pain, with reviews of every possibleself-treatment and therapy option, even forthe most difficult cases. Includes a sectionon the relationship between fascia andtrigger points (e-book customers only).

Greg Lehman, a chiropractor andphysiotherapist has a thoughtful new fasciaarticle, Fascia Science: Stretching thepower of manual therapy.

Todd Hargrove, a Rolfer and writer(BetterMovement.org), has a good postonfascia and foam rolling and fascia underthe microscope.

If We Cannot Stretch Fascia, What AreWe Doing?, a webpage on www.massage-stlouis.com. Massage therapist Alice
http://saveyourself.ca/articles/pain-is-an-opinion.phphttp://saveyourself.ca/articles/pain-is-an-opinion.phphttp://saveyourself.ca/articles/reality-checks/does-massage-work.phphttp://saveyourself.ca/articles/reality-checks/does-massage-work.phphttp://saveyourself.ca/tutorials/trigger-points.phphttp://saveyourself.ca/tutorials/trigger-points.phphttp://saveyourself.ca/tutorials/trigger-points.phphttp://www.thebodymechanic.ca/http://www.thebodymechanic.ca/http://www.thebodymechanic.ca/2012/10/26/fascia-science-stretching-the-relevance-of-the-gluteus-maximus-and-latissimus-dorsi-sling/http://www.thebodymechanic.ca/2012/10/26/fascia-science-stretching-the-relevance-of-the-gluteus-maximus-and-latissimus-dorsi-sling/http://www.bettermovement.org/http://www.bettermovement.org/http://www.bettermovement.org/2011/fascia-pixels-picture-pinker/http://www.bettermovement.org/2011/fascia-pixels-picture-pinker/http://www.bettermovement.org/2011/fascia-pixels-picture-pinker/http://www.massage-stlouis.com/if-we-cannot-stretch-fascia-what-are-we-doinghttp://www.massage-stlouis.com/if-we-cannot-stretch-fascia-what-are-we-doinghttp://saveyourself.ca/articles/pain-is-an-opinion.phphttp://saveyourself.ca/articles/reality-checks/does-massage-work.phphttp://saveyourself.ca/tutorials/trigger-points.phphttp://saveyourself.ca/tutorials/trigger-points.phphttp://www.thebodymechanic.ca/http://www.thebodymechanic.ca/http://www.thebodymechanic.ca/2012/10/26/fascia-science-stretching-the-relevance-of-the-gluteus-maximus-and-latissimus-dorsi-sling/http://www.thebodymechanic.ca/2012/10/26/fascia-science-stretching-the-relevance-of-the-gluteus-maximus-and-latissimus-dorsi-sling/http://www.bettermovement.org/http://www.bettermovement.org/http://www.bettermovement.org/2011/fascia-pixels-picture-pinker/http://www.bettermovement.org/2011/fascia-pixels-picture-pinker/http://www.bettermovement.org/2011/fascia-pixels-picture-pinker/http://www.massage-stlouis.com/if-we-cannot-stretch-fascia-what-are-we-doinghttp://www.massage-stlouis.com/if-we-cannot-stretch-fascia-what-are-we-doing


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Sanvitos clear summary of Dr. RobertSchleips theory that fascial release maybe attributable to changes in muscle tone

stimulated by mechanoreceptors in fasciaand other soft tissues, and not by plasticdeformation of fascia.

Whats new in this article?

Rewritten (Feb 20 '13, section #2.1) A

major editing job, particularly to include the

much more specific idea that piezoelectricity

accounts for releases. See section

#2.1,Electrified by piezoelectricity.

New section (Feb 19 '13, section

#2.3) No notes. Just a new section. See

section #2.3,Idas idea about thixotropy.

New section (Feb 15 '13, section

#3.2) No notes. Just a new section. Seesection #3.2,Release may not even be real.

Minor update (Jan 31 '13) Several minor

additions and edits.
http://saveyourself.ca/articles/does-fascia-matter.php#sec_piezohttp://saveyourself.ca/articles/does-fascia-matter.php#sec_piezohttp://saveyourself.ca/articles/does-fascia-matter.php#sec_thixotropyhttp://saveyourself.ca/articles/does-fascia-matter.php#sec_thixotropyhttp://saveyourself.ca/articles/does-fascia-matter.php#sec_thixotropyhttp://saveyourself.ca/articles/does-fascia-matter.php#sec_releasehttp://saveyourself.ca/articles/does-fascia-matter.php#sec_releasehttp://saveyourself.ca/articles/does-fascia-matter.php#sec_releasehttp://saveyourself.ca/articles/does-fascia-matter.php#sec_piezohttp://saveyourself.ca/articles/does-fascia-matter.php#sec_piezohttp://saveyourself.ca/articles/does-fascia-matter.php#sec_thixotropyhttp://saveyourself.ca/articles/does-fascia-matter.php#sec_thixotropyhttp://saveyourself.ca/articles/does-fascia-matter.php#sec_thixotropyhttp://saveyourself.ca/articles/does-fascia-matter.php#sec_releasehttp://saveyourself.ca/articles/does-fascia-matter.php#sec_releasehttp://saveyourself.ca/articles/does-fascia-matter.php#sec_release


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Minor update (Aug 30 '12, section

#3.5) Added some acknowledgement that

fascia contractility may still have some slow-motion power even if it is quite weak. Ill

probably expand on this soon. See section

#3.5, Fascia strong like bull! Or mouse?

Minor update (Aug 30 '12, section

#3.4) Added a very useful link toFasciaResearch.de. See section #3.4, Does it

matter that fascia contains muscle cells?

New section (Jul 31 '12, section

#2.4) No notes. Just a new section. See

section #2.4,The acupuncture connection: is

fascia actually magic?

Major update (Jul 25 '12) Article launched

as a compilation of about four previous articles

on this topic, with revisions and some new

information.

Notes
http://saveyourself.ca/articles/does-fascia-matter.php#sec_stronghttp://saveyourself.ca/articles/does-fascia-matter.php#sec_stronghttp://saveyourself.ca/articles/does-fascia-matter.php#sec_stronghttp://saveyourself.ca/articles/does-fascia-matter.php#sec_contracthttp://saveyourself.ca/articles/does-fascia-matter.php#sec_contracthttp://saveyourself.ca/articles/does-fascia-matter.php#sec_contracthttp://saveyourself.ca/articles/does-fascia-matter.php#sec_contracthttp://saveyourself.ca/articles/does-fascia-matter.php#sec_acupuncturehttp://saveyourself.ca/articles/does-fascia-matter.php#sec_acupuncturehttp://saveyourself.ca/articles/does-fascia-matter.php#sec_acupuncturehttp://saveyourself.ca/articles/does-fascia-matter.php#sec_acupuncturehttp://saveyourself.ca/articles/does-fascia-matter.php#sec_stronghttp://saveyourself.ca/articles/does-fascia-matter.php#sec_stronghttp://saveyourself.ca/articles/does-fascia-matter.php#sec_stronghttp://saveyourself.ca/articles/does-fascia-matter.php#sec_contracthttp://saveyourself.ca/articles/does-fascia-matter.php#sec_contracthttp://saveyourself.ca/articles/does-fascia-matter.php#sec_contracthttp://saveyourself.ca/articles/does-fascia-matter.php#sec_contracthttp://saveyourself.ca/articles/does-fascia-matter.php#sec_acupuncturehttp://saveyourself.ca/articles/does-fascia-matter.php#sec_acupuncturehttp://saveyourself.ca/articles/does-fascia-matter.php#sec_acupuncturehttp://saveyourself.ca/articles/does-fascia-matter.php#sec_acupuncture


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1. It is quite negative. I have fun takingtherapy seriously. Criticism and deconstruction ofideas is normal and healthy and necessary fortherapy professions to grow and change.BACK TO TEXT

2. I didnt actually have any problem. It wassupposed to be a relaxation massage, in a spa.

Yes, she was a Registered Massage Therapist awell-trained and fully certified massage therapist.And thats probably exactly why she feltcompelled to strut her stuff and troubleshoot

my case and talk about fascia.BACK TO TEXT

3. Juhan.Jobs Body. 1998. amazon.com JobsBodyis essentially a physiology textbook withimagination and a soul. Its a hard read, butequally rewarding. On the other hand, Juhanprobably takes some his speculation too far too be

useful or accurate.BACK TO TEXT

4. The full details of how bone responds tostress are spelled out in Dr. HaroldFrostsMechanostat model. For more information,seeTissue Provocation Therapies.BACK TO TEXT

5. This kind of (wild) speculation is hardlyunusual for Oschman: his writings are lacedwith much stranger ideas.BACK TO TEXT
http://saveyourself.ca/articles/does-fascia-matter.php#ref1http://saveyourself.ca/articles/does-fascia-matter.php#ref2http://saveyourself.ca/bibliography.php?juhhttp://www.amazon.com/Jobs-Body-Handbook-Bodywork-Third/dp/1581770995/ref=sr_1_1http://www.amazon.com/Jobs-Body-Handbook-Bodywork-Third/dp/1581770995/ref=sr_1_1http://saveyourself.ca/articles/does-fascia-matter.php#ref3http://en.wikipedia.org/wiki/Utah-Paradigm_of_Bone_physiologyhttp://saveyourself.ca/articles/tissue-provocation-therapies.phphttp://saveyourself.ca/articles/does-fascia-matter.php#ref4http://saveyourself.ca/articles/does-fascia-matter.php#ref5http://saveyourself.ca/articles/does-fascia-matter.php#ref1http://saveyourself.ca/articles/does-fascia-matter.php#ref2http://saveyourself.ca/bibliography.php?juhhttp://www.amazon.com/Jobs-Body-Handbook-Bodywork-Third/dp/1581770995/ref=sr_1_1http://saveyourself.ca/articles/does-fascia-matter.php#ref3http://en.wikipedia.org/wiki/Utah-Paradigm_of_Bone_physiologyhttp://saveyourself.ca/articles/tissue-provocation-therapies.phphttp://saveyourself.ca/articles/does-fascia-matter.php#ref4http://saveyourself.ca/articles/does-fascia-matter.php#ref5


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6. Dr. Robert Schleip, from his 2003article, Fascial plasticity: a new neurobiologicalexplanation:

The half-life span of non-traumatized collagen hasbeen shown to be 300500 days, and the half-lifeof ground substance 1.77 days (Cantu & Grodin1992). While it is definitely conceivable that theproduction of both materials could be influencedby piezoelectricity, both life cycles appear tooslow to account for immediate tissue changes that

are significant enough to be palpated by theworking practitioner.

BACK TO TEXT

7. The quoted passage is from my personalcorrespondence with Dr. Levin, and is used withhis permission. For information about Dr. Levinswork, see Biotensegrity: A new way of modelingbiologic forms.BACK TO TEXT

8. Schleip. Fascial plasticity: a newneurobiological explanation.Journal of Bodywork& Movement Therapies. 2003.BACK TO TEXT

9.

Heres Dr. Schleips full reasoning from hisarticle, Fascial plasticity: a new neurobiologicalexplanation:

In most systems of myofascial manipulation, theduration of an individual stroke or technique on a
http://www.somatics.de/FascialPlasticity/main.htmhttp://www.somatics.de/FascialPlasticity/main.htmhttp://saveyourself.ca/articles/does-fascia-matter.php#ref6http://www.biotensegrity.com/http://www.biotensegrity.com/http://saveyourself.ca/articles/does-fascia-matter.php#ref7http://www.somatics.de/FascialPlasticity/main.htmhttp://www.somatics.de/FascialPlasticity/main.htmhttp://saveyourself.ca/articles/does-fascia-matter.php#ref8http://www.somatics.de/FascialPlasticity/main.htmhttp://www.somatics.de/FascialPlasticity/main.htmhttp://www.somatics.de/FascialPlasticity/main.htmhttp://www.somatics.de/FascialPlasticity/main.htmhttp://saveyourself.ca/articles/does-fascia-matter.php#ref6http://www.biotensegrity.com/http://www.biotensegrity.com/http://saveyourself.ca/articles/does-fascia-matter.php#ref7http://www.somatics.de/FascialPlasticity/main.htmhttp://www.somatics.de/FascialPlasticity/main.htmhttp://saveyourself.ca/articles/does-fascia-matter.php#ref8http://www.somatics.de/FascialPlasticity/main.htmhttp://www.somatics.de/FascialPlasticity/main.htm


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does fascia matter

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