Does Fascia Matter?

A great link – long but very good Does Fascia Matter?

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

Does fascia — sheets and webs of connective tissue — have any properties that are relevant to healing and therapy? Are there good reasons to do manual therapy (massage particularly) that is “aimed” at fascia specifically? Fascia gets discussed in therapy offices a lot these days. It is supposedly the key to many a therapeutic puzzle, and is now routinely targeted by therapists of all kinds. Fascia is fashionable. 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 about why fascia 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 too common.

This problem was captured perfectly for me by something a massage therapist said to me on my 40th birthday. I was getting a massage (because I really do love massage). The therapist was doing fascial work, of course — you can’t get a massage in Vancouver these days without getting some. She was using some mildly uncomfortable pulling and twisting techniques, trying to “manipulate” my fascia, instead of using the more satisfying, relaxing Swedish styles I was craving. She launched into an awkward explanation of her technique, but words failed her:

Well, your problem is fascia. [I didn’t have a problem.2] The fascia is the thing you have to do something with. If you fix the fascia, everything gets more … well, the fascia will make everything better.

Somehow. I wish I could say this was an unusually murky explanation of fascial therapy, but I’ve heard explanations like that quite a few times over the years.


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