Background

The fascia research team at the University of Padua in Italy led by Dr Carola Stecco are at the cutting edge of anatomical understanding of the intricacies of the fascial system In the body. Dr Stecco, who once described her initial research as being locked in a cadaver lab dissecting bodies for 6 months, is much respected as one of the leading fascia researchers in the world. She has produced many research papers as well as a comprehensive Functional Atlas of the Human Fascial System. Not for the faint-hearted this contains many detailed images of dissected bodies demonstrating the amazing interconnectedness of the fascial system.

In a recent webinar, Dr Catarina Fede from her team gave a fascinating presentation of the latest research findings into the superficial fascia. Bear with me here, I am not about to plunge into a detailed and nerdy anatomical description of the properties of fascia, but I do want to share what she said about the implications for pain which I think we can all relate to.

Introducing the Superficial Fascia

The superficial fascia is the top layer of fascia, located just under the skin. It used to be thought of as just a separator between the skin and everything else underneath it, but now it is understood to be a dense network of tissue in its own right that acts as an elastic protective container for blood and lymph vessels and nerves.

Safely supported by the superficial fascia, blood and lymph vessels criss-cross in all directions. All of these structures can freely move and allow blood and lymph to flow around the body. There are also many nerve endings in the superficial fascia particularly those linked to proprioception (our sense of spatial awareness) and pain. These sensory nerve endings form part of our autonomic nervous system, the part that works tirelessly in the background to maintain our overall health and immunity.

Impact of surgery and stress

Sometimes things can go wrong in the body that change the natural balance in the superficial fascia. This could be due to surgery where the tissue is cut, to injury or even to chronic stress. Surgery, injury and the scar tissue these create can have a major impact on blood and lymph flow if the fascial container surrounding them becomes restricted and more rigid. Chronic stress can have a similar effect as it changes the tone of the fascia which can also make it more rigid.

Over time it is easy to see how changes like these to the superficial fascia can lead to conditions such as lymphodema and problems with circulation where fluid literally gets squeezed out of some areas and stuck in others. Restricted fluid flow can also lead to problems with regulation of heat contributing to conditions such as Raynaulds.

Wherever there are restrictions in the superficial fascia this will impact on the many nerve endings contained within it causing them to trigger repeatedly as they become irritated. This can be a significant source of chronic pain in conditions such as fibromyalgia.

Implications for myofascial release therapy

It is possible to work with the superficial fascia using light touch treatment such as light myofascial release or manual lymphatic drainage. Gentle stretching can also have a similar beneficial effect. Releasing the superficial fascia in this way helps to improve lymph flow, reduce chronic stress and boost the immune response.