FASCIAL ADHESIONS

Have you ever tried to watch a movie from the front row? Difficult
isnt it. Miserable as well. Todays Medical education, with its
huge emphasis on TECHNOLOGY and DIAGNOSTICS, can be a
lot like watching a movie from the front row.

Because the practice of medicine is predicated on taking the body

and dividing it, subdividing it, and dividing it some more, it tends to
give student doctors a front row perspective of anatomy and
physiology. Think about it; we have kidney specialists
(nephrologists), heart specialists (cardiologists), nerve specialists
(neurologists), butt specialists (proctologists), muscle and joint
specialists (orthopedists), stomach specialists (gastroenterologists),
arthritis specialists (rheumatologists), etc, etc, etc, etc, etc.
Unfortunately, this model is out of date. It fails miserably as far as
really advancing our understanding of the human body because you
never really get to see the BIG PICTURE. For one, it cannot
explain how the whole organism is greater than the sum of its
individual parts. What do I mean by this? For instance, Hydrogen
(an explosive gas) + Oxygen (a flammable gas) = Water (H2O), a
liquid the foundation of all life that is used to quench fire.
The problem with using outdated models that reduce and
subdivide the human body into increasingly smaller parts is that the
big picture is frequently missed spend some time on our Blog
Roll (right margin) and youll quickly understand what I
mean. The movie ends without the student doctor ever moving from
the front row. And unless doctors are willing to step outside of the
box of their formal educational model (something they are
encouraged not to do by THE POWERS THAT BE), the Big
Picture is rarely grasped.
Doctors use this same philosophy and thought process when trying
to explain the musculoskeletal system. Fascia is one of the best
examples that I can think of concerning this phenomenon. Doctors
frequently miss the forest for the trees because the books they
learned from doctors (that were taught by other doctors) trained in
the same reductionist philosophy. Furthermore, they use books that
show hundreds of pictures of individual muscles - without ever
really showing or explaining the fascia.

Go to virtually any anatomy text book and take a look. The fascia is
almost always removed so that we can see the really important
tissues underneath. But never forget that removed = ignored. And
after all; if the medical text books are not talking about fascia,
showing us lots of pictures of fascia, or explaining how fascia
works; exactly how important can it really be?
Because the illustrator for the famous anatomy textbook of all time
(Henry VanDyke Carter) left the fascia intact in a large number of
his drawings; most of the anatomical drawings on my site come
from Grays Anatomy. Even though the first edition of his
renowned textbook was written over 155 years ago, Henry Gray is
still considered one of the greatest anatomists the world has ever
seen.

WHAT IS FASCIA?
Fasciae (plural) are the tough layers of fibrous, collagen-based
connective tissues that permeate the human body. If you are a
DEER HUNTER, you have seen fascia and know what it is. It is
the thin, white, cellophane-like, membrane that wraps itself tightly
around the muscles. Around here folks call it Striffin or Silver
Skin. But there is far more to fascia than what is readily observed
while butchering.
Fascia surrounds individual muscles, muscle bundles within
individual muscles, groups of muscles, blood vessels, and nerves. It
binds these structures together in much the same manner that plastic
wrap is used to hold the contents of your Hoagie together. Fascia
consists of several extremely thin layers, and is the tissue where the
musculoskeletal system, circulatory system, and nervous system all
converge. It extends from the top of the head to the tip of the toes,
and like ligaments and tendons, contains closely packed bundles of
wavy collagen fibers that line up in an organized and parallel

fashion (PICTURES HERE). Subsequently, healthy fasciae are

flexible tissues that are able to resist great tensile forces. Unhealthy
fascia? Well get to that shortly.
Fascia forms a whole-body, continuous, 3-D matrix of structural
support. Its connections extend to all fibrous (elastic) connective
tissues, including APONEUROSIS, LIGAMENTS, TENDONS,
RETINACULUM, joint capsules, organ and blood vessel sheaths,
the epineurium (nerve sheaths), the meninges (spinal cord sheaths),
the periosteum (sheath that surrounds bones), as well as the
membranes that surround MUSCLES.
Among the different kinds of tissues that are involved in the bodys
elastic framework (chiefly ligaments, tendons, muscles, etc);
fascia has received the least scientific attention probably because
in most regions of the body it cannot be imaged with even the most
technologically advanced imaging techniques such as MRI (hey, out
of sight, out of mind). Nevertheless, fascia plays a major (albeit
poorly understood) role in joint stability / instability,
PROPRIOCEPTION, coordination, strength, joint motion, as well
as PAIN SYNDROMES of all kinds. It can even be involved in
DISEASE PROCESSES.

Critical Functions of Healthy Fascia:

It binds and holds muscles together compactly.

It ensures proper alignment of the muscle fibers, blood vessels,

nerves, and other tissues within the muscle itself.

It transmits forces and loads evenly throughout the entire

muscle.

It creates a uniformly smooth surface that essentially

lubricates the various surfaces that come in contact with
each other during movement.

It allows the muscle to change shape as they lengthen or

shorten.

I included this picture of the Groin Region from Grays Anatomy to show you just
how much fascia there is in the groin.

Collagen
Collagen is the building block of all connective tissues. Some
collagen-based connective tissues like bone and most cartilages, are
part of your bodys load-bearing framework. Their purpose is to
withstand compressive forces, while grossly maintaining the bodys
shape.

Collagens Triple Helix Structure by User Vossman

On the other hand, you have the Elastic, Collagen-Based,

Connective Tissues, whose chief job is to resist the tensile forces
that are constantly trying to pull joints apart whenever movement or
muscle contraction takes place. These tissues dont need to be able
to bear heavy loads, but instead, must be able to stretch and elast (at
least to a slight degree) while resisting tearing. Of these elastic
collagen-based connective tissues, fascia is the most elastic.
As long as the individual collagen fibers that make up the fascia, are
aligned in parallel fashion to each other, the tissue is stretchy and
elastic (think about long hair that has been combed out. If you run a
comb or brush through it, it glides smoothly and unrestricted.)
But what happens when fascia is injured?

When fascia is stretched beyond its normal load-bearing capacity, it

begins to tear. Bear in mind that these tears are so microscopic that
they never show up on an x-ray, and only on rare occasions will they
show up on an MRI (possibly in the Plantar Fascia on the bottom of
the foot see above). Fascial tears can be caused by sports injuries,
repetitive trauma, car wrecks, postural distortions, falls, child
bearing, abuse, etc, etc, etc. Oftentimes people have no idea how
they ended up with Fascial Injuries, which often result in FASCIAL
ADHESIONS (sometimes known as FASCIAL
DENSIFICATIONS see below).

Fascial adhesions

Whenever a muscle is impacted (contact sports, falls, abuse, etc) or

overused / injured (lifting weights, running, over-training, heavy or
repetitive jobs, etc), collagen microfibers form in between adjacent
layers of fascia to bind them together so that the muscles can
heal. These microfibers are sort of like natures internal cast.
Unfortunately, these casts do not automatically go away after the
area has healed, and they tend to accumulate over time. This means
that over time, the elastic, collagen-based tissues (particularly
muscles and fascia) get increasingly stiffer and less stretchy. If you
are over the age of 35 or 40, you have likely figured this out the hard
way!
Think of the collagen found in fascia in terms of a Slinky. In normal
collagen, there are waves. A slinky is no different. The coils of a
slinky act like waves and give it the ability to elast and stretch in
response to tensile forces. As long as the load is not too great to
overcome the tissues tensile strength, it can spring back - and
things are peachy.

However, if the most elastic of the collagen-based tissue (fascia) is

forced to resist more tension than it can handle, tissue failure begins
to occur. The tissue increasingly loses its ability to stretch and
elast. Think of this as a slinky that has been stretched out to the
point of failure. The material has not necessarily broken, but it has
been stretched far enough that it is not going to spring back like it
should. This leads to tangles, which is a whole other problem unto
itself. We have all experienced a mangled Slinky before. This is
similar to a Fascial Adhesion!

FASCIAL ADHESIONS
UP CLOSE & PERSONAL
Bottom Line: If something causes fascia to exceed its normal tensile
capacity, there will be a disruption or micro-tearing of individual
collagen fibers. This in turn leads to fascial scarring and adhesion
/ restriction.
Think of fascial scarring in another way. Put both of your hands flat
on a table in front of you, and slide the fingers of one hand back and
forth between the fingers of the other. This is similar to the way
fascia works, and is what gives all of the elastic connective tissues
including fascia, ligaments, tendons, etc, an incredible amount of
stretchiness and flexibility. Normally functioning fascial
membranes are not only arranged in a very organized and parallel
manner, but if you were to look at them on edge, they are flat and
smooth - like a piece of paper.
Once fascia is injured (stretched, pulled, torn, etc.), the microscopic
fibers become disrupted and deranged. Instead of fibers running
parallel to each other in an organized fashion with their normal
degree of elasticity / flexibility, the fibers now run every possible
direction in all three dimensions and have an extremely diminished
amount of organization and elasticity. Interlock the fingers from
one hand with the fingers from the other, only now do it with the
fingers pointed in all directions. Now try to slide the hands back and
forth. See the difference in flexibility?
Also notice that when the fingers are interlocked randomly, they will
no longer lay flat on the table. Facial Adhesions act in much the
same way. When fascia is injured, individual fibers run every which
direction, in all three dimensions. This means that the fascial
membranes no longer lay flat like a piece of paper. Instead, they are

more like a wadded up or crumpled piece of paper. Unfortunately,

injured fascia frequently heals in this tangled, twisted, and waddedup manner.
We can also think of this fascial scarring and adhesion in terms of
hair. Remember our example of well-manicured hair that a comb or
brush glides through easily? Now think of the exact opposite. Think
of a HAIR TANGLE. What happens to hair that is not well taken
care of, or was slept on wet? Instead of the individual hair follicles
lying parallel to each other in a neat and orderly fashion, they
become tangled with the individual hair fibers running in every
conceivable direction. The result is a tangled mess a ball of
hair that takes forever just get a comb or brush through it. Hair
balls can be so restrictive that just trying to get a comb through it,
pulls and causes great pain. This is even more true with
fascia. Most people are unaware that..

FASCIA IS THOUGHT TO BE THE SINGLE

MOST PAIN-SENSITIVE TISSUE IN THE ENTIRE
BODY
When the organization of the parallel collagen fibers of fascia are
disrupted by injury, a host of really bad things begin to happen. The
first thing that occurs is restriction of joint motion. Understand that
if you have tissue restriction, you will automatically have some
degree of loss of normal joint motion in the corresponding area(s) of
the body. Also understand that loss of normal joint motion virtually
assures you that sooner or later there will be pain - even if you are
not yet experiencing pain. Unfortunately, pain is not the only thing
associated with loss of normal joint motion. One of the biggies is
degeneration.
Loss of, or abnormal joint motion, is the known cause of localized
joint degeneration. When I speak of localized joint degeneration, I
am talking about things like calcium deposits, bone spurring, and

loss of articular cartilage or disc height. Degeneration is a great

example of a vicious cycle: Loss of joint motion causes joint
degeneration and joint degeneration causes loss of normal joint
motion. Repeat. As this cycle spins around and around, it causes
pain.
STOP! Think for just a moment. Pain is frequently nothing more
than a by-product of the vicious cycle. This is why pain pills and
other similar measures (drugs), mask symptoms of Chronic Pain
(ineffectively, I might add) without ever addressing its underlying
cause. And on top of this, some of the most popular musculoskeletal drugs (corticosteroids for instance) actually increase the
degenerative effect (HERE). In many cases of Chronic Pain, the
underlying cause is Subluxation, Fascial Restriction, and
microscopic Scar Tissue.
Think for a moment how problematic this whole scenario is. Fascia
is the single most pain-sensitive tissue in the body yet it does
not image well with even the most advanced imaging technologies
such as MRI! What does this mean? Those of you who have dealt
with Chronic Pain long enough, know exactly what it means!
It means that when you go visit various doctors (orthopedists, pain
specialists, neurologists, etc) they run all sorts of tests, and then look
at you as though you are crazy. Or maybe they look at you like
youre a drug seeker, or trying to get Social Security Disability. Or
maybe they just chalk it up to hard work and too many sports. Or
maybe they just tell you that you have arthritis or Fibromyalgia
just to get you out of their office. Or maybe they used that old and
trusted standby, After all Mrs. Smith, you just arent as young as
you used to be.
Whatever the case, the result is almost always the same. A blank
stare and the recommendation for more pills - or maybe even
Corticosteroid Injections. The latest trend for Chronic Pain patients
involves putting them on SSRIs (anti-depression drugs) while

trying to convince them that their Chronic Pain is the result of

Clinical Depression; when just the opposite has been proven to be
closer to the truth. (Chronic Pain is far more likely to cause
Depression than the opposite).
Oh, and how about your doctor kick you a few more times while you
are down. Scientific studies have repeatedly shown that beyond the
wide array of side-effects to the kidney, liver, and heart; both
NSAIDS, and cortico-steroids actually deteriorate collagen-based
tissues severely and rapidly. This is why doctors will ration the
amount of cortisone you can have, even if it helps your pain.
The Journal of Bone and Joint Surgery published a study over a
decade ago that said if a person has more than one cortico-steroid
injection in the same joint, over the course of their lifetime, their
chance of developing premature deterioration of the affected joint is
(gulp) 100%.

EFFECTIVELY HANDLING
FASCIAL ADHESIONS
The question always comes up, If fascia cannot be imaged with
advanced techniques such as MRI, how in the world does a
chiropractor from the rural Ozark region of southern Missouri
image it? Plainly stated; I dont. I examine the areas that I believe
to be affected by Fascial Adhesions (15 years of experience has
helped me know what to look for), and I start treating. Every year I
get more proficient at knowing what to look for, finding it, and
fixing it. What am I using to fix it? Glad you asked. I simply call
TISSUE REMODELING.

WARNING

BRUISING AHEAD
Because our Tissue Remodeling Treatment consists of actually
breaking the Fascial Adhesions and subsequent tissue restrictions
that cause so many symptoms, there is often some bruising
associated with the technique. Microscopic scarring is dense,
inelastic, random, and unorganized tissue not what anyone
really wants. If you have been paying attention, you are aware that
scar tissue is not exactly an optimum situation. Nonetheless, scars
(even the microscopic kind) are living tissue with a blood supply.
This means that when I break the adhesion, I also break the blood
supply. There will be some internal leaking of red blood cells from
the scars capillary bed into the surrounding tissue. Please dont
panic. In plain English, this means that you will have a bruise.
When I break Fascial Adhesions, it is not uncommon that this
bruising can be really really (really)ugly. Dont worry it really is
OK. See our BRUISING & PICTURES PAGE. You can also visit
our VIDEO TESTIMONIAL PAGE as well.
Although there are people out there doing similar things, I have yet
to find anyone doing things quite like I am doing. This is why our
results (click on the link above) are so radically different than those
that most others are getting.

CONCLUSION
Fascia is the fabric that it woven throughout every part of our body
to hold us together. Perpetually disregarded by the medical
community as unimportant (hey, after all it does not show up on
MRIs), fascia is beginning to take its rightful place at the forefront

of both cutting-edge medical research and cutting-edge treatment

(particularly in the field of Sports Injuries and Chronic Pain
Syndromes). It should! Fascia is arguably the most prevalent
connective tissue in the body.
Other than the nerve system, is there another body system that
CONNECTS THE DISTANT PARTS OF THE BODY
TOGETHER in such an intimate manner? I say no! Fascia covers
the body from the top of the head (Epicranial Aponeurosis) to the
bottom of the feet (Plantar Fascia), and everything in between.
When there is a tightening or restriction of the fascia in one place, it
can cause pain and dysfunction in distant and seemingly unrelated
locations. And the kicker is that problems in the fasciae not only
cause pain, they cause the nerve system to misfire. As you can
imagine, the problems associated with a misfiring nerve system are
many and potentially severe.
also be aware that what is true about fascia is true about the other
Elastic, Collagen-Based Connective Tissues as well. Yes, ligaments
are injured and respond to treatment in a similar manner to fascia.
We also know from medical research that an almost identical tissue
model can be applied for the treatment and healing process of people
dealing with certain tendon issues as well. This is good news
because tendon problems are a leading reason for musculo-skeletal
doctor visits - and Chronic Pain. To better understand the Fascia,
HERE is a post that organizes dozens of articles on the topic.