The ‘silver skin’ that could be the source of your pain
A backache after a long day at the computer might be the result of tired muscles or stiff joints – but it could also be triggered by a body part you might not have heard about: the fascia.
What is the fascia?
The filmy layer that you see when you cut into a piece of raw chicken or steak is the fascia. This thin connective tissue surrounds and holds every organ, blood vessel, bone, nerve fibre and muscle in place.
The word fascia is derived from the Latin for “band”, and Dr David Cosman of the Cosman Health Group describes it as a “silver skin”.
Until recently, it wasn’t considered important and was dismissed as “packing material” without real purpose. A decade ago fascia was recognised, in some scientific circles, as the body’s largest organ, with our skin coming a close second, and so rich in nerve endings that it’s just as sensitive.
What does it do?
Cosman likens it to a highway system that enables signalling between different parts of the body. “It contains nerves and blood vessels; it’s an active communicating force.”
Healthy fascia, Cosman says, “glides” over the tissue it surrounds and “this enables the nerve endings to experience a change; the sensations are sent to the brain for processing and reflexive activity”.
In its healthy state, fascia is slippery. Unhealthy fascia, Cosman says, has a “sticky relationship” with muscle tissue, so is unable to glide and the nerve endings can’t sense any changes, except for pain nerve endings which feel the impingement of adhered or sticky tissue.
This is “densified” fascia, and can account for different cases of referred or shooting pain, which is often diagnosed as a “pinched nerve”. Nerves can be pinched by many means, but densified fascia as a cause is often overlooked.
What can go wrong?
If the fascia is inhibited in its “gliding” because it’s sticky, it adheres to muscle – this might be the result of injury, but could be due to poor posture. In time, if not dealt with effectively or quickly, these “adhesions” worsen, which make the fascia tighten and contort muscles that it surrounds, which can result in tender spots.
Three factors that could cause fascia adhesions include a sedentary lifestyle, repetitive movement that overworks one body part, and trauma such as injury or surgery.
How can I keep it healthy?
Staying active and hydrated are crucial, Cosman says. Keeping your fascia in top condition requires physical activity, good posture, a healthy weight and diet, sufficient restorative sleep and low stress.
We are largely made up of water – in muscle and fascia, it makes up as much as 75 per cent.
If we don’t drink enough, those fluid ratios are compromised. Water flushes waste out, and another factor that affects the smooth workings of fascia is cellular waste.
“When it is working normally, fascia is full of water and moves freely as we move,” says Amanda Oswald at the UK’s Pain Care Clinic.
It’s important to keep moving throughout the day and not just at the gym, especially given our desk- and device-bound lives.
“Youthfulness is the ability to move freely without pain,” Cosman says. Joints and muscles that are either compensating or overstressed because of adhesions in the fascia can cause painful, uneven torque or tugging on joints. This might be diagnosed as arthritis, but reducing the adhesions – known as myofascial release – can help reduce pain.
Oswald says often this type of pain is overlooked in conventional medicine. Focusing treatment only where symptoms are felt misses the cause. And identifying causes in turn balances behaviour that may contribute to pain – the way we sit to work, for example.
How can we fix the fascia?
Cosman uses a system called the Stecco Method Fascial Manipulation, developed by Italian physiotherapist Luigi Stecco. It uses a patient’s history to help trace the causes and connections of pain, then works on manipulating adhesions and those “densifications” to rebalance soft tissues.
Like every organ in our body, the fascia is supported by good diet. Lauren Roxburgh, a wellness educator based in California, says that foods that contribute to collagen production (especially those rich in vitamin C and zinc) are important as fascia is made up of collagen and, as we age, our body is less able to produce enough.
Collagen is also good for our complexions, so we’re supporting skin on the outside as well as this skin on the inside. She advocates bone broth, which is full of amino acids and collagen, and citrus and colourful peppers, which are high in vitamin C. Other “fascia foods” that support collagen’s production include berries, avocados and, happily, chocolate and red wine.
Intermittent fasting can help reduce inflammation in connective tissue, and help unglue sticky fascia. Eating more alkaline foods – most fruits and vegetables, soybeans and tofu, and some nuts, seeds and legumes – is good for our fascia.
It contains nerves and blood vessels; it’s an active communicating force
DR DAVID COSMAN