Myofascia is one of the most under-appreciated structures of the body. This fascia is the thin pliable “dense connective tissue” layer that surrounds muscles, nerves, arteries and veins. This lining’s purpose is to allow these structures to to slide effortlessly between each other with every movement. As your muscles pull on your bones the nerves, arteries and veins must remain patent and un-constricted in order to allow blood flow and for nerves to properly conduct signals. Even the muscles themselves must be able to slide past one another, with as little friction as possible. This thin film like substance allows for these mechanisms to take place. In recent years, research has shown that fascia is highly innervated (has many nerve connections) and is much more related to chronic pain states, than previously thought.
Obviously this is an image of a steak. Animals indeed differ from humans, in terms of anatomy, but the basics are still the same. They still have fascia just like we do. The arrows indicate the two best examples. “Marbling” in meat is fatty deposits in the tissue. That isn’t fascia. The appearance is very simliar, but the consistency isn’t. Fascia can be thicker in some areas (right arrow) and thinner in others (left arrow) but the purpose remains the same. Its job is to prevent friction between major muscle groups. “Marbling” exists between muscle fibers.
Chronic muscle strains may occur when muscles become damaged repeatedly. The fibers that were once straight become twisted and tangled together. If the muscle heals this way, the bundle of muscle fibers cannot stretch as well as they did when they were previously straight and flexible. This causes the muscle to shorten, become more rigid (in the damaged area, due to scar tissue) and create more stress on the other still pliable parts of the muscle. The more damaged the muscle becomes, the more stress gets applied to the flexible parts. The fibers in the immediate vicinity, adjacent to the scarred muscle, have to stretch even more to compensate for the rigid portion, and as such, were thought to generate much of the pain from muscle strains. This does explain immediate trigger point pain areas, but not referral pain, or pain that travels from the injured area, to a much more distal area.
Myofascia was previously not taken into account with this previous pain patterning. While the chronic muscular impairment mentioned is still a valid pain generator, it typically only applies to generalized area, as the scarred area will not cause pain to travel far from its source. There are multiple layers of muscle throughout the body and myofascial interweaves between these muscle layers, forming one large mesh work of tissue that covers the body from head to toe. This tissue is very thin and very easily damaged. When it becomes damaged, it becomes dense, causing layer itself to stretch and slide like it’s suppose to, which doesn’t allow the muscle to slide as effectively. This places tremendous strain on the nerves that supply the fascia itself, as well as causes friction with the muscles, which adds more inflammation to the body.
When the nerves connected to the fascia become damaged, they cause pain to be felt, in that particular area. The most interesting part of fascia, in terms of chronic pain, is that an area in the lower lumbar area could be damaged, which could cause a strain on the nerves connected to fascia in the upper neck. Due to myofascia’s mesh like consistency, if one area is damaged, another area gets stretched more. That doesn’t necessarily mean that pain will be experienced exact location, of the original site of injury, like muscular injuries. This is one of the many ways that low back pain, could manifest in the form of headaches. Poorly functional, damaged gluteal muscles can cause sacroiliac pain, as well as shoulder pain.
Fascia is greatly overlooked, as many doctors tend to chase after the symptoms of pain, and start where they feel the pain should be, within the muscle where the pain is felt. This method of thinking does work in some instances, but fascial damage needs to be taken into account much more often. Treatment for fascial pain patterning is typically very easy; however, treatments do take time, as there are typically more than one area of injury.
Here at Herrington Family Chiropractic, LLC, I utilize therapeutic ultrasound, electric muscle stimulation, myofascial release technique, cold laser and instrument assisted soft tissue massage, which are all effective forms of treating this type of condition. By having different methods of treatment, I can best cater to my patient’s needs and comfort levels. Proper treatment is important, but proper assessment is even more so. I pride myself on being able to isolate the source of your pain, and utilize the best treatment for you, the patient. Click the Contact Us link at the top to call and schedule an appointment.