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  • 7/30/2019 Does Fascia Matter


    Does Fascia Matter?

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

    11,000 words, updated Feb 20th, 2013 Whats new?byPaul Ingraham, Vancouver, Canada



    Sheets of fascia can contract a bit like muscle but how strongly? Enough to make a difference?

    Does fascia sheets and webs of connective

    tissue have any properties that are relevant

    to healing and therapy? Are there good
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    reasons to do manual therapy (massage

    particularly) that is aimed at fascia? Fascia

    gets discussed in therapy offices a lot thesedays. It is supposedly the key to many a

    therapeutic puzzle, and is now routinely

    targeted by therapists of all kinds. 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 aboutwhyfascia 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 common.

    This problem was captured perfectly for me by

    something a massage therapist said to me on

    my 40th birthday in 2011. I was getting a

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    massage (because I really do love massage).

    The therapist was doing fascial work, of course

    you cant get a massage in Vancouver thesedays without getting some. She was using

    some mildly uncomfortable pulling and twisting

    techniques, trying to manipulate my fascia,

    instead of using the more satisfying Swedish

    styles I was craving. She launched into an

    awkward explanation of her technique, but

    words failed her:

    Well, your problem2 is fascia. The fascia is thething you have to do something with. If you fixthe fascia, everything gets more well, thefascia will make everything better.


    Deja vu? Feel like youve seen this here

    before? You probably have. This is a like newcompilation of most of the fascia writing Ivedone over the last year about four oldarticles merged into one, with some re-writing

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    and new information. You can now buy a $5lecture version from Movement Lectures.


    1. Introduction

    2. 1.1Barely known to science!3. 1.2En garde!The fascia science challenge

    4. Sloppy fascia reasoning

    5. Rewritten Feb 20 '13

    2.1Electrified by piezoelectricity6. 2.2Fuzzy logic: Gil Hedleys fuzz speech

    7. NEW Feb 19 '132.3Idas idea about thixotropy

    8. NEW Jul 31 '12

    2.4The acupuncture connection: is fascia actuallymagic?

    9. 2.5Not so exotic after all

    10. Real fascia science that supposedlymatters

    11. 3.1Fascia is much too tough to release12. NEW Feb 15 '13

    3.2Release may not even be real13. 3.3Does stimulating fascia reduce post-exercise

    muscle soreness?
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    14. Minor update Aug 30 '12

    3.4Does it matter that fascia contains muscle cells?15. Minor update Aug 30 '12

    3.5Fascia strong like bull! Or mouse?

    16. 3.6Do weak fascial contractions matter?17. 3.7No clinical relevance at all? Not even a teensy

    bit?18. 3.8Is fascial contraction even interesting?19. 3.9What does Dr. Schleip think?

    20. ConclusionsResults of the Fascia Science Challenge so far

    21. 4.1To be continued

    22. Appendices

    23. 5.1Further Reading24. 5.2Whats new in this article?25. 5.3Notes

    Barely known to science!

    There is a lot of fascia research going on these

    days. However, because none of that research

    is clearlyclinically relevant some of it mightbe, but its all quite debatable theres also a

    lot of speculating about whyfascia is

    important, which leads to some claims that it
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    has clinically relevant properties and functions

    that are still barely known to science. For

    instance, perhaps fascia can actively sinch uplike a corset around muscles, or maybe it is the

    medium of a liquid crystal communication

    system, or even maybe it melts like butter

    when you move. Who knows!

    In the history of science and medicine, guessestend to fill knowledge gaps and the guesses

    usually turn out to be wrong. Exotic and new

    biology is also not very usefulbiology. No one

    can get safe, effective, reliable treatment

    protocols out of poorly understood biology. If

    you could, the biology wouldnt be poorly

    understood anymore, and youd probably be

    famous for pushing back the frontiers of human

    knowledge.Exotic and newbiology is not also not veryuseful biology.

    Some fascia research is truly intriguing, and

    what many researchers are saying about fascia

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    is reasonable and not an awkward reach

    beyond where the data can take us.

    Unfortunately, far too many therapistsfascinated by fascia are reaching beyond what

    the science can actually support today way

    beyond and it is doubtful that it ever will. In

    some cases, in fact, we already know enough

    to know that a property, even if it is confirmed,

    is not really all that useful.

    Please beware the implication of therapeutic

    significance from scraps of basic biology. It is

    easy to sound cool talking about new biology

    because biology is cool. It is quite hard to make

    biology useful. Few basic biology facts ever

    become the basis for any kind of treatment.

    Certainly a lot of fascia science is right, but I

    question whether or not itmatters that it is


    In fact, on one occasion, a rather pedanticexperimental psychologist was telling himabout a long, complicated experiment he haddone, incorporating all the proper controls andusing considerable technical virtuosity. When

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    he saw Cricks exasperated expression he said,but Dr. Crick, we have got it right we knowits right, Cricks response was, The point is

    not whether its right. The point is: doesit even matterwhether its right orwrong?

    V.S. Ramachandran,telling a story aboutFrancis Crick

    En garde! The fascia sciencechallenge

    Fascia is biologically interesting! All biology is.

    But clinical relevance is the central question of

    this article: if fascia science cannot

    actually inform treatmentin some practical

    ways, then it makes no sense to be fascinated

    by it in a therapeutic context. You might as

    well get excited about the biology of the

    immune system, or olfaction, or epigenetics,

    for all they have to do with hands-on healing.

    Reader suggestions and feedback are welcome, bothcritical and supportive. However, hate mail will be
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    ignored. I receive a quite a bit of hate mail on thistopic.Please think twice before you hit send.

    Fascia enthusiasts routinely denounce this

    article, accusing me of ignorance of the current

    Science of Fascia. Thats understandable.

    However, I am pretty up on massage-related

    research its my full-time job so I feel

    confident challenging critics to cite

    even one example of fascia researchwith clear,

    direct relevance to what happens in treatment.

    If such a thing exists, I will be happy to publicly

    discuss it, and acknowledge my oversight. I

    could be wrong about fascia. I even hope that I

    am. Maybe it is important to manipulate fasciaspecifically.

    This article covers three main examples of

    allegedly clinically relevant fascia research

    below. (That may not sound like much, but the

    article is already several thousand words long,so be careful what you wish for.) I will add

    more in time. All three are actually good

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    examples of fascia science withpoorclinical

    relevance. We do not have a winner yet.

    Before we get to that, though, Id like to start

    with a couple stranger examples of sloppy

    fascia science piezoelectricity and fuzz!

    and some of the general issues with fascial


    There is a crack in everythingThats how the light gets in.

    Leonard Cohen, Anthem

    PART 2


    Electrified by piezoelectricity

    A popular notion is that piezoelectric effect

    an electric charge generated by flexing crystals

    is at work in fascia, and an extrapolation
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    that it is also the mechanism for fascial

    release. It is hardly clear that this is actually

    the case. It has never been more thanspeculation. The first part is possible but

    unproven. The second part goes much too far

    and is demonstrably false and clearly

    contradicted by modern researchers.

    Crystalline properties are a pre-requisite forpeizoelectricity. To get a piezoelectric spark,

    you have to have crystals. In the famous 1987

    bookJobs Body which I read three times,

    back in the day Juhan proposes that

    connective tissue may behave like a liquid

    crystal.3 A strong emphasis on may: this has

    never actually been shown to be the case.

    Juhan was speculating. This doesnt mean that

    there is no piezoelectric effect in fascia, and

    there are plenty of problems with the idea, but

    its not totally out to lunch. Wedo know that

    piezoelectricity sparks fly when bone is

    flexed and stressed, and this guides the slow

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    remodelling of bone,4 which is super cool. Its a

    terribly clever system!

    Its also a great example of a

    clinically irrelevantbiological property. It has

    nothing to do with anything a manual therapist

    could ever do to a bone. It is beautifully

    evolved to change bone extremely slowly in

    response to extremely specific stimuli which,presumably, cannot remotely be simulated by

    manual therapy. Trying to affect that system

    with your hands is quite futile. Thats going to

    be the case for the great majority of

    physiological systems, known and unknown

    even if you understand them, it doesnt mean

    you can use them, or affect them with your


    Maybe fascia does something similar to bone

    with piezeoelectric effect. It wouldnt shockme. But no one has ever demonstrated that it

    actually does. Indeed, no one has even tried to

    find that property of fascia, as far as I can tell.

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    Some people have run with the idea like its a

    proven fact, though. For instance, James

    Oschman states unequivocally andoverconfidently that connective tissue is

    piezoelectric, a fact that can be used as a firm

    foundation for the furtherspeculation that it

    accounts for the fascial releases.5

    Is this a straw man? Nope. A straw man would be

    an idea that no one actually believes or takes seriously and therefore meaningless to criticize. Certainly noteveryone interested in fascia thinks that fascialpiezeoelectricity is real or important. However, enough dothat its no straw man! It may not represent the bestthinking in the field, but it is certainly out there.

    And its simply inconsistent with the reality of

    fascial plasticity, which we do know quite a lot

    about. Theres no point in speculating

    abouthow fascia responds quickly to

    manipulation, because it cantand doesnt: its

    too tough and slow-changing.6 In contrast to

    the total absence of research into fascial

    piezeoelectricity, the properties of fascial

    plasticity are well studied, and there simply is

    no short term change in fascia to explain! It

    cant respond to the pressures of massage
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    therapy any more than bone can. In addition to

    the footnote, this will be substantiated in

    various ways throughout the rest of the article.

    Could piezoelectricity be at work in some other

    way in fascia?Anythings possible. But now

    were cruising into pure guess work. Do we

    know anything at all about it, let alone the

    physiological intricacies of such aphenomenon? Do we know why it evolved?

    What it does, how it does it? Can we affect it?

    And, if we dont know these things, how can we

    possibly use it to devise a reliable therapy?

    Obviously we cannot.

    Fuzzy logic: Gil Hedleys fuzzspeech

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    Another fine example of imprecise scientific

    enthusiasm is Gil Hedleys extremely popular

    fuzz speech. In this video with a bazillon

    views, Hedley plays fast and loose with a

    dissection observation: there are cobwebby

    layers of fine, loose connective tissue between

    thicker sheets of fascia. The anatomy is

    interesting anatomy is always interesting

    but Gil Hedleys interpretations are dubious.

    His leaps of logic are charismatic, but also

    large and precarious.

    That stiff feeling you have is the solidifying of

    the fuzz, Hedley confidently explains. He

    thoroughly makes the case that fuzz explains

    the sensation of stiffness.
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    At best, that is an unsafe assumption, and one

    that ignores many other highly relevant factors

    like neurology, say, or the fact that heslooking at a dead person. He does not know

    what happens to that tissue in a living body. In

    fact, that fuzzy texture only manifestspost

    mortem according to biotensegrity expert,

    Dr. Steven Levin.7 This is a very interesting

    passage, worth reading carefully, but note the

    emphasized phrase particularly:

    In Guimberteaus video, Strolling Under TheSkin, what you see there is that the fuzzystuff is really dynamic tissue that is underconstant change. Tissues dont slide, there isno shear, they reconfigure with eachmovement. The dynamics of a cell ceases withdeath. Ca++ [calcium ions] flood into the celland it stiffens thats rigor mortis. It startswithin minutes of death, as soon as thecirculating ATP [energy molecule] runs out. Thefuzz is connective tissue that is stiffened

    during rigor mortis, and it doesnt happenunless you die. It occurs within minutes ofdeath, and you can almost watch it happen. Itis like snot hardening. The mucus booger thatcomes out of your nose quickly hardens and

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    becomes quite stiff; at death, the mucus thatconnects all our tissues, does the same.

    All that melting the fuzz is conjecture based

    on misinterpreted observations on dead tissue.Even so called fresh cadavers are but poorplayers in the game of life.

    Almost any amount of normal movement is

    sufficient to sustain a normal range of motion.

    Fuzz solidification either isnt happening ordoesnt matter, because its effortless to move

    through. Also, there are other explanations for

    the sensation of stiffness: better, evidence-

    based, and un-fuzzy explanations. I discuss

    them in some detail in Quite a Stretch.

    Idas idea about thixotropy

    A shabby, decades-old idea is still often

    seriously cited as the explanation for howfascial therapy works: because it softens fascia

    with thixotropic effect. The idea came from
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    Ida Rolf (founder of Rolfing). Fascia

    researcher Robert Schleip:8

    Many of the current training schools whichfocus on myofascial treatment have beenprofoundly influenced by Rolf (1977). In herown work Rolf applied considerable manual orelbow pressure to fascial sheets in order tochange their density and arrangement. Rolfsown explanation was that connective tissue is

    a colloidal substance in which the groundsubstance can be influenced by the applicationof energy (heat or mechanical pressure) tochange its aggregate form from a more densegel state to a more fluid sol state.

    A quick look at how thixotropy works in human

    physiology shows that this just doesnt add up.The thixotropic effect is nifty physiology, but

    its not a therapeutic effect in itself, nor is it

    the mechanism of one. Idas idea was wrong.

    Thixotropy is an obscure physical property of

    certain slimy body fluids that get thinner whenagitated or stressed. You can easily observe

    thixotropic effect in beach sand, near the

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    waters edge: stamp your feet in the sand, and

    it starts to liquify.

    What makes these substances gooey andslimy? Why, a family of carbohydrate molecules, ofcourse: the glycosaminoglycans. Also known as the snotmolecule. Think of any movie monster with tons of ropysaliva thats glycosaminoglycans!

    Thixotropic fluids in the human body include

    synovial fluid in joints, mucus, semen, and the

    gelatinous and poorly-named goo called

    ground substance the stuff that gristly

    connective tissue fibres are embedded in like

    bits of coconut in Jello. Ground substance is the

    most plentiful thixotropic substance in the


    But thixotropy is minor, slow, and temporary,

    and fascia is too tough to change.

    Fascial sheets are incredibly tough, and

    you cantchange their density and

    arrangement quickly or easily. And thixotropy

    just isnt fastenough to explain the relatively

    speedy, dramatic effects on tissues that
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    therapists claim to achieve. Dr. Schleip: either

    much longer amounts of time or significantly

    more force are required for permanentdeformation of dense connective

    tissues.9 Thixotropy might slowly make fascia

    morepliable, but not stretchier. If thixotropy

    had the power to increase the extensibility of

    connective tissue, then we would become

    obviously more flexible just from sitting in a

    sauna Ive tested this repeatedly and never

    observed any increase in flexibility just from

    being hot.10

    Even if it works in some small way, thixotropic

    effect is going to be temporary, fading within

    seconds or minutes after hands are

    removed. When the stimulationstops, so does thethixotropy, and a therapy

    cant work if the affectedtissue immediately revertsto its previous state.Thixotropy

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    will stop when the stimulation stops but a

    therapy cant work if the affected tissue

    immediately reverts to its previous state. Dr.Schleip calls this the reversibility problem

    and definitely not an attractive implication of

    this model for the practitioner.

    Last but not least, thixotropic effect is simply

    aminoreffect. Its occurring a little bit all thetime, with or without massage. Massage surely

    does induce it a little, but just as surely

    much less than ordinary physical activity like

    with circulation. Massage therapists are very

    fond of claiming that massage increases

    circulation, but if it does so at all, the effect is

    much smaller than what exercise does!

    Perspective matters. Another similar thought

    experiment: if sustained pressures or sheering

    could significantly change connective tissue,

    then working a chair all day long or any

    long-duration posture would also deform

    your fascia.

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    The idea of thixotropy is hardly state-of-the-art

    thinking about fascia, but it is certainly still

    prevalent among therapists practicing fascially-focussed therapy, and trying to explain what

    they do. Unfortunately, it was never even a

    good idea in the first place, even decades ago.

    The acupuncture connection: isfascia actually magic?

    Another disconcertingly popular notion about

    why fascia matters is that the meridians of

    Chinese medicine correspond directly to fascialanatomy and function. If you polled therapists

    doing fascial manipulation, I think you would

    find that a great many believe that they are

    doing the same thing that an acupuncturist is

    doing just in a different way. They believe

    that fascial therapy works for the same reasons

    acupuncture works.

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    Indeed, most fascial therapists probably

    believe that acupuncture works. And therein

    lies the problem. Unfortunately for fascialrelease therapy, acupuncture is not a good

    ally: it has been failing many fair, good quality

    scientific tests for years now, and is simply not

    what it seems to be.

    Acupuncture as we know it today is not soancient after all: its current form is a modern

    invention of the pediatrician Cheng Danan (

    , 1899-1957) in the early 1930s1112Formost of history, acupuncture

    existed primarily as amethod of bloodletting exactly like the prescientificmedieval Europeanpractice.Before that, for most of history, itexisted primarily as a method ofbloodletting

    exactly like the prescientific medieval

    European practice. And then theres the myth

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    of acupunctures popularity.13 Even its alleged

    popularity and widespread use in China is quite

    trumped up it is, for instance, not actuallyused for anaesthesia.14These are rather

    embarrassing facts for acupuncture.

    Acupuncture is obsolete Eastern folk medicine

    propped up by Western hype and wishful

    thinking. The proposed association betweenfascial meridians and the chi meridians of

    traditional Chinese medicine is meaningless.

    Even if meridians and all the other rubric of

    acupuncture were real, though, acupuncturists

    are unable to demonstrate their power clearly:

    their needles are consistently no more helpful

    than placebos. Even pro-acupuncture

    researchers have repeatedly admitted that the

    effect of the needles is small at best. And if the

    acupuncturists cant manipulate these

    meridians effectively enough to achieve clearly

    measurable effects, why would pulling on

    fascia be able to do it?

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    Acupuncture lore has no business in a serious

    discussion about fascia and its possible

    importance in therapy.SYDoes Acupuncture Work for Pain? Areview of modern acupuncture evidence andmyths, particularly with regards to treating lowback pain and other common pain problems

    Not so exotic after all

    Piezoelectricity, fuzz, and fascial meridians are

    three good examples of popular but poor

    reasons why fascia supposedly matters. There

    are other reasons, both better and worse, and

    discussion of genuine fascia science is still

    coming. But first I want to make it clear that

    common fascia talk often fails to even reach

    the level of being science-y. Despite all the

    talk of exotic properties of fascia, fasciasclinical importance is usually expressed only in

    terms of a couple extremely simplistic

    rationales, which dont seem exotic at all:
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    1. its everywhere and connects everything(well, yeah),

    2. and it gets tight (not clear, see below).

    A strong theme in fascial therapy is the

    emphasis on the interconnectedness of

    anatomy via fascia, always making the point

    that pulling on any one part of fascia affects

    the whole body, like pulling on the corner of asweater affects all the threads. (That sweater

    analogy appears virtually everywhere online

    that fascia is mentioned. It gets really

    tiresome, actually. Didnt think it mattered

    much ten years ago. Still dont.)

    The main idea of fascial therapy is that the

    stuff can get tight and restrictive, like clothing

    a size too small, and needs to be released,

    and that therapists can achieve this by various

    methods of yanking on it. The yanking may be

    extremely intense, too some flavours of

    fascial therapy are among the most painful of

    all hands-on techniques.15

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    And thats what fascial therapy boils down to

    most of the time, in the wild. I have personally

    encountered lots of talking about fascia that isexactly this rudimentary and even worse,

    like the example I quoted in the introduction

    The fascia will make everything better! Many

    therapists are perfectly capable of discussing

    the topic more intelligently, of course, but low

    quality reasoning and communication about

    fascia is distressingly common (and my

    exposure is quite extensive, due to the large

    volume of email I receive).

    Consider this gem of simplistic rationalization,

    reported by Barrett Dorko, PT:

    Restricted fascia is full of pockets. When thetissue starts to release, these pockets areopened up. When these pockets open, thesensations that were trapped in them arereleased.

    Such overconfident, poor quality clinical

    reasoning isnt universal just excessively
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    common within the culture of fascia


    Now, lets get to some real fascia science.

    The greatest enemy ofknowledge is not ignorance, itis the illusion of knowledge.

    Stephen Hawking

    PART 3



    Fascia is much too tough torelease

    Manual therapists need notfeel threatened by the newsthat we cannot stretch fascia.

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    If We Cannot Stretch Fascia,What Are We Doing? AliceSanvito, Massage Therapist

    My original challenge to readers (in the fall of

    2011) to suggest fascia science that supports

    fascial therapy was kicked off with a fine

    example: one that is just about the exact

    opposite of what I asked for, underminding the

    clinical relevance of fascia rather thansupporting it. Despite the extraordinary

    number of comments I received on early

    versions of this article, few readers answered

    my challenge directly. Of the handful of

    scientific papers that were suggested to me,

    this was the most interesting:

    Three-dimensional mathematical model fordeformation of human fasciae in manualtherapyChaudhry et al.Journal of the American Osteopathic

    Association. Volume 108, Number 8, p379-90. Aug


    The Chaudhry et al article is indeed clinically

    relevant to fascial therapy but not in a
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    supportive way. This fascia science actually

    contradicts the big idea of fascial therapy.

    The main pointof manipulating fascia16 is

    tophysically change it in some way to

    achieve what is usually described as a

    release. Although the concept of release may

    correspond to some other physiological

    phenomenon another discussion itcertainly cannot be explained in general by

    physically changing the fascia.

    What Chaudhry and colleagues showed is that

    fascia is much too tough to release"

    (mechanical deformation17) by stretching it.

    Although they oddly imply in their summary

    that it might be possible to do so with the

    superficial nasal fascia, the main textof the

    paper makes it clear that even that thin tissue

    is extremely tough, and would only

    mechanically deform if subjected to

    surprisingly intense forces. This is consistent

    with well-established properties of fascia,

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    namely that its extremelytough stuff.

    Collagen is like that.

    If I could write my own conclusion to this

    paper, it would go more like this:

    CONCLUSION: You cannot change thestructure of fascia, because it is tougher thanKevlar. If the stuff were thicker, people wouldbe bulletproof.18

    CLINICAL IMPLICATIONS: If you want tophysically change someone's fascia by force,you're going to have to get medieval. Thisdirectly contradicts a major popular rationalefor fascial manipulation.

    This paper is only clinically relevant to fascialtherapy insofar as it presents evidence that

    discourages and undermines existing common

    practices and beliefs. Therefore, perhaps it was

    a poor choice to cite it in this context.

    Its also just old news that fascia is too tough tochange. For instance, Dr. Robert Schleip

    debunked the idea in his 2003 paper about

    fascial plasticity, and if you dont take his word

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    for it a well-respected fascia researcher

    then whose opinion would be credible enough?

    He dismisses the traditional explanations ofthixotropy and peizoelectric-effect-mediated

    adaptation, and thoroughly describes fascial

    toughness. He concludes that plastic fascial

    change in response to moderate loading is

    impossible to conceive.19

    As strongly stated as that may be, Ill go even

    further. Dr. Schleip (and virtually everyone

    else) assumes that release is a real thing

    that needs explaining. Im not so sure

    Release may not even be real

    In the context of fascial therapy, a release is:

    a palpable, relatively quick change in

    tissue texture

    clinically meaningful (makes some kindof real difference to the patient)

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    somewhat lasting (if it didnt last, whatwould be the point?)

    somewhat predictable (that is, itshappening because of treatment)

    And fascial therapists more or less

    unanimously assume that its fascia,

    specifically, that is doing the releasing.

    No doubt the first thing a quick change intexture happens in the course of manual

    therapy. It is notsafe to assume the rest,

    though. And whats left of the concept of a

    release if you take away the clinically

    meaningful, lasting, and predictable parts?

    What if itsjusta change in texture, a bit of

    movement under the skin?

    Yes, I do have experience. Many readers accuse me ofhaving no practical experience with patients, when inmany cases I clearly have more (and better) than they do.Not that its a contest, but its just so deeply ironic andamusing when people assume that the only possibleexplanation for my opinions is that I must not have anywork experience as a massage therapist. I have a decadeof it, and this fact is readibly available in my bio.

    In my many years working as a massage

    therapist, I felt various and sundry ripplings,
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    twitchings, and shifts under the skin. But in

    order to qualify as releases, those

    movements should have correlated stronglywith my intentions and with the patients

    experience. Sometimes they did, but often they

    did not. So I always thought they were really

    quite random, occurring with great variety

    pretty much no matter what I did, or what

    patients reported.20 So while I certainly felt

    something change, I rarely thought of those

    changes as a meaningful release.

    Dr. Schleips 2003 paper about fascial plasticity

    basically just said that fascia is too tough to

    change, but muscle may react to touch and

    pressures, and that this is probably mediated

    by sensory nerve endings in all soft tissues.

    This is hardly surprising it basically just

    means that people react when poked and

    prodded and it doesnt really have anything

    to do with fascia in particular, except insofar as

    fascia has nerves in it, just like everything else.

    We have no idea whether or not any of that

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    actually constitutes a meaningful mechanism

    for a therapy. I can also make someone

    twitch their quadriceps by bonking theirpatellar tendon: does it matter, other than as a

    test of the reflex itself?

    Releases are probably mostly just trivial tissue

    noise in the hands-on experience, not a

    pivotal event in therapy. Or, if they are moremeaningful, they are nearly impossible to

    interpret. Its not that nothings going on its

    that nothing in particularand knowable is

    going on. But we have trouble grappling with

    that, so we round it off to something more

    specific and definite and meaningful, an

    oversimplification that is more poetic than

    biologic. I have no objection to using release

    as a description of an experience, but I think it

    is quite misleading to pretend that it describes

    a particular biological event with clinical

    meaning and value which is exactlyhow

    most therapists imagine it, which is the only

    thing that really needs explaining. (And thats

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    not difficult: it boils down to a thick stew of

    good intentions, ego, and the human habit of

    imposing simplistic explanations on chaoticsystems.)

    Funny. Not actually possible. But funny!(Drawing byClaude Serre.)

    Does stimulating fascia reducepost-exercise muscle soreness?

    Perhaps but the clinical relevance

    ofthis data is tenuous at best so low that Iwould never normally be interested in this

    paper. In fact, I would never have chosen to

    read it myself, because I dont think its good
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    enough science. I spent some time on it only as

    an gesture of good faith to a critic, who

    supplied the paper as an example of basicfascia science that matters. It was probably not

    a good choice for that purpose.

    In vitro modeling of repetitive motion injuryand myofascial releaseMeltzer et al.Journal of Bodywork & Movement

    Therapies. Volume 14, Number 2, p162-71. Apr 2010.

    This is a test tube study showing that naked

    cells handled stress better (fewer signs of

    harm) if they were treated with simulated

    myofascial release (MFR). A meaningful,

    accurate simulation of manual therapy onnaked cells is an amusing notion, and its clear

    that what happened to those cells differs

    dramatically from what would happen in a real

    living body.

    Even if true and reproducible, this data wouldmainly support the rationale for MFR

    specifically forpost-exercise soreness

    something of a dead end for clinical relevance,
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    because exercise-induced soreness has little to

    do with the main claims of fascial release

    therapy, which primarily concerns correctingpostural asymmetries, eliminating alleged

    restrictions, and treating chronic pain.

    Post-exercise soreness is comparatively trivial,

    and patients usually dont seek therapy for

    it.21 Theres a lot of research showing thatexercise-induced soreness is basically

    invincible anyway.22A meaningful,accurate simulation ofmanual therapy on naked

    cells is an amusing notion.Forthis property of fascia to be clinically relevant,

    it would have to imply that MFR might be able

    to treat chronic pain from other causes not

    the transient annoyance of soreness after a

    game of soccer.

    This isnt a rejection ofall possible clinical

    relevance of the data. My point is that there

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    are so many problems that its relevance is

    watered down to quite a thin sauce way too


    I do concede that the paper shows some

    evidence that fibroblasts have interesting and

    perhaps positive responses to mechanical

    forces. That is inherently interesting biology,

    and perhaps well worth investigating further but its a long reach to postulate any clinical

    relevance to what most therapists do, most of

    the time, with patients fascia.

    Reach is what the authors do, however. I

    suspect they are deeply interested in validating

    the notion that fascia is important, because

    they seem to be seeking evidence to support

    their pre-conceptions typical ofThe National

    Center for Complementary and Alternative

    Medicine-funded research, and a hallmark oflow quality science. Its quite likely that if

    neutral researchers with no interest in
  • 7/30/2019 Does Fascia Matter


    fascial therapy did this experiment they

    would not get or report the same results.

    Does it matter that fascia containsmuscle cells?

    The next example of fascia science was

    suggested to me by Gil Hedley. Since he clearly

    believed me to be ignorant of fascia science

    and in dire need of educating, I asked him to

    recommend some reading to me a favourite

    paper showing something interesting and

    clinically relevant about fascia. As expected, herecommended a paper I was already familiar

    with, because it is something of a classic of

    fascia science: Robert Schleips 2006

    dissertation on the contractile properties of

    fascia. Much more interesting stuff than the

    previous two examples. I will get into much

    more detail about this paper than the first two.

    Fascia is able to contract in a smooth muscle-like manner and thereby influence

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    musculoskeletal mechanicsSchleip et al.Proceedings of the 5th World Congressof Biomechanics, Munich. Volume, Number, p51-54.2006.

    Schleip and colleagues convincingly showed

    that fascia contains muscle cells and that they

    can contract slowly and weakly. That is

    undeniably interesting biology! But the point of

    this analysis is to ask: Does it

    even matterwhether its right or wrong? Is it

    clinically relevant? Does it improve how we do

    therapy? Can we use the knowledge to affect

    the body with hands? That is the question.

    It is also a question that Dr. Schleip and hiscolleagues have addressed themelves on their

    website, What follows is my

    own analysis, which is generally consistent with

    theirs. However, interested readers should

    definitely have a look at theirarticle: it is

    readable and chock full of useful perspective,

    answering questions like Does fascia contract

    in response to emotional stress? and Can

    fascia contract on its own?
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    Fascia Contractility FAQ, a webpage

    Important update: Dr. Schleip has read thisarticle and corresponded with me about it

    amiably, and expressed clear agreement with

    my main point. Although he also had some

    thoughtful criticisms, we agree on what

    matters, and he shares my frustration with

    clinical overconfidence in fascia. I invited him

    to make a statement for my readers about this:

    look for it at the end of this part of the


    Fascia strong like bull! Or mouse?

    Before we get to clinical relevance, Ill quickly

    explain what Schleip et al. found: a kind of

    muscle cell in rat fascia, which they described

    as rather unexpected.23 They also tried out

    various methods of stimulating them in

    vitro (test tube) and found that, by golly, those
  • 7/30/2019 Does Fascia Matter


    muscle cells did what muscle cells do: they

    contracted! Slow, weak contractions. But they



    By any measure, fascial contractionsare dramatically less powerful than muscular

    contractions. If anything, this diagram gives fartoo much credit to the power of fascia, which

    would barely register at all if depictedmore accurately.

    Its certainly not difficult research to


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    Some important context that fascia fans will

    appreciate: for a long time, fascia was and

    often still is incorrectlythought of as a fairlylifeless, inert substance, the Saran Wrap of

    biology. I still hear various educated people

    referring to it in this way. However, massage

    therapists and chiropractors (in particular) are

    prone to swinging to the opposite extreme and

    talking about fascia as though it is more

    interesting than a lifetime subscription

    to National Geographic. The truth is

    somewhere in the middle.24 Dr. Schleips

    research demonstrates this. Fascia is not inert.

    But neither is it all that lively at least not in

    terms of contractility. We are not talking about

    a lotof muscle cells here. If you had

    blueberries with your cereal in the same

    proportion, youd be disappointed not

    enough blueberries! Its just a few muscle cells

    scattered throughout the fascia. Theres so few

    that they are visible only when you

    look veryclosely and injustthe right way.

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    Nor are we talking about particularly strong

    contractions. Fascia isnt going to be ripping

    apart any chains with its bare hands. Themaximum force generated by a small bundle of

    contractile rat fascia was around 35mN.25 In

    plain English thats not very dang much or

    the somewhat more precise about what it

    takes to set an AA battery rolling on a nice

    smooth surface. (It took me a long time to

    work that out. I have a weird job.) Thats not

    bad for a bundle of rat fascia, perhaps, but it

    doesnt really hold a candle to middle-of-the-

    night charlie horses either.

    Compared to the power of muscle contraction,

    fascia power barely even registers.

    The bull versus mouse comparison is a little

    unfair though, because its not just a matter

    ofstrong versus weak. Although fascialcontractions may be weak compared to

    muscles, they could nevertheless

    bepowerful in another way their effects
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    might, for instance, accumulate over time to

    produce contractures (permanent seizing up

    of tissues). So its still worth considering howthese contractions might be clinically relevant.

    Do weak fascial contractionsmatter?

    Schleip et al.s basic finding seems sound

    enough, and I see no reason at this time to

    dispute the observation that fascia can

    contract. If theres anything wrong with their

    research methods, I dont know what it is. Butfor the property they described to matter to

    therapists who are choosing to focus their

    therapeutic attention on fascia

    for anybiological property to be clinically

    relevant it must be significant enough to

    have an effect on health. (It then must also be

    something that we can do something about,

    but lets start with it mattering in the first


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    Schleip et al. characterized the raw power of

    fascial contraction quite differently than I just

    did. I deliberately made it sound trivial, withinthe bounds of their numbers.26 In their words,

    however, in the large sheets of fascia in the

    low back, the contraction could be strong

    enough to influence low back stability

    and other aspects of human


    Stability? Even if you exaggerate their

    numbers, they would still only account for a

    small fraction of the postural muscle power

    involved in dynamic spinal stabilization, never

    mind the generally mind-blowing structural

    toughness and resilience of the human spine.

    The idea that low back stability could be

    affected in any way by such a small, slow-

    motion force is a bit much for me to

    swallow.2728And thats based on an estimate of

    the theoretical maximum force generated by

    the biggest, thickest blankets of fascia in

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    human anatomy. In most places in the body,

    fascia is much less substantial tough for its

    weight, but mostly quite thin and wispy, and alot of it even microscopic.29 The forces

    generated must be dwarfed by that of muscle

    itself in rough proportion to the number and

    size of contractile cells involved.

    That fascial contractions might influence other

    aspects of human biomechanics is a bit

    vague. A general example of such aspects

    might be that contracting fascia could be

    involved in biomechanical asymmetries

    tighter on one side than the other. The validity

    of such a concern depends on just how

    sensitive you think human biomechanics are to

    forces so subtle that no one really had any idea

    that fascia contraction was even happening

    before this study. As regular readers here will

    know, I think biomechanics are over-rated as afactor in all kinds of pain problems, and theres

    extensive evidence that human beings are

    wonderfully adaptable and cope surprisingly

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    well even with gross deformities, never mind

    subtle assymetries and imbalances. I make

    that case in great detail in another article.30The wording of the conclusions of Schleip et

    al.s paper is synonymous with saying that

    fascial contraction is relevant

    only ifstructuralism is a useful mode for doing

    and thinking about therapy. Also, their

    phrasing shows a strong bias in favour of the

    importance of fascia. And the study was

    funded by the International Society of

    Biomechanics, the Rolf Institute of Structural

    Integration, and the European Rolfing


    Weak, slow fascial contractions strike me as

    being scientifically valid and interesting, but

    clinically minor. Once again, far from making

    me interested in fascia as a target for therapy,

    fascia science is convincing me of just the


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    No clinical relevance at all? Noteven a teensy bit?

    If it makes anyone feel better about all this, Im

    happy to concede that fascial contractility

    might be a little bit clinically relevant. Other

    evidence might even reveal something

    important although that would surprise me.

    It doesnt hurt my main point to make these

    concessions. To make mypoint, all I have to

    establish is that the clinical relevance is

    debatable and probably minor at best, rather

    than the slam dunk it would have to be to

    support even half of the excitement aboutfascia you see in the therapy industry today.32

    What about fascia and trigger points?Schleip etal. dont bring trigger points (muscle knots) into thisdiscussion, but a lot of other people certainly have. Thenotion is that a trigger point is being squeezed andsustained by clenching fascia, but this clinical conceptsuffers even more than other examples from the relative

    weakness of fascial contractions. I explore this specificclaim of clinical relevance in detail in my trigger pointstutorial.

    In his original dissertation, Schleip limited his

    speculation about clinical implications to the

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    broad generalization that it can influence

    musculoskeletal mechanics, such as spinal

    stability. In a follow-up paper for MedicalHypotheses,33 he and several colleagues

    generally suggest that fascial contractility is a

    factor in muscle stiffness. The high water mark

    for potential clinical relevance is spelled out in

    this passage:

    This offers the possibility of a newunderstanding for many pathologies thatinvolve a chronically increased myofascialtonus. Examples include conditions such astorticollis, low back pain associated withparaspinal compartment syndrome, tension

    headaches, and others. Similarly a decreasedfascial tone could be a contributing factor inconditions that are often associated withdecreased myofascial tension, such as in backpain due to segmental spinal instability,peripartum pelvic pain, or fibromyalgia. Whileusually other factors play a major role aswell in these pathologies, it is possible thattheir progress could be influenced additionallyby the regulation of fascial tissue tone

  • 7/30/2019 Does Fascia Matter


    The emphasized phrase is key its an

    understatement. For instance, other factors

    dont usually play a major role in thoseconditions, they always do. And the role of

    those factors isnt just major, but probably

    nearly total relative to the

    presumably minor(and still unconfirmed)

    contribution of a little fascial tension. Some of

    the items listed are particularly implausible to

    me. Ive already mentioned how hyperbolic it is

    to suggest that fascia could have any serious

    impact on spinal stability.

    Another peculiar item here is fibromyalgia, a

    fascinating condition that might conceivably be

    affected in some small way by fascial

    contraction, but which is overwhelmingly a

    nasty disease of the nervous system.

    Suggesting it as a main example34 of how

    fascial contraction might matter makes about

    as much sense to me as saying that people

    with cancer might have some contracted fascia

    would it matter if they did?

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    The most interesting item listed is

    compartment syndrome, which is

    decidedly nota common complication or causeof back pain, but certainly is a problem

    (especially in the shins).35 Compartment

    syndrome is excessive pressure in a fascial

    compartment, like a sausage swollen in its

    wrapping. If fascia were to start squeezing a

    compartment for some reason, it might be a

    problem. It is the one item listed where there is

    a clear, direct and logical connection between

    fascia can contract and a way that it could

    contribute significantly to a health

    problem. Thatis clinical relevance. And yet

    there is still a clear problem with the scale of

    the forces here. Compartment syndrome is by

    definition only a problem when the pressure is

    significant,probably dramatically exceeding

    the maximum force with which fascia couldsqueeze the compartment. Visualize a hot

    water heater that isnt venting pressure the

    valve is busted, and its in danger of blowing.

  • 7/30/2019 Does Fascia Matter


    The pressure inside is immense, and it would

    make no practical difference if the hot water

    heater itself was a little larger or smaller.Again, fascial contraction is probably not nearly

    strong enough to matter. Still, at least its easy

    to see how it could matter in principle, and the

    numbers mightfavour fascial contraction as


    So you see how this goes: for one candidate

    example after another, the clinical relevance of

    fascial contraction is dubious or minor.

    Is fascial contraction eveninteresting?

    One of the lower moments in biology history

    was the labelling of non-coding DNA as junk

    DNA in 1972. The first time anyone with ascrap of imagination heard that, they thought,

    Yeah, right. As biologists slowly figured out

    what all that junk is for,36 there was a lot of

  • 7/30/2019 Does Fascia Matter


    Well, yeah, okay, thats more like it. Of

    course. Its interesting science, but in some

    ways those discoveries are still overshadowedby the way were all not so very surprised.

    Similarly, the presence of muscle cells in fascia

    is no shocker. I never believed fascia was

    entirely inert any more than I believed in the

    junkiness of any DNA. If you spend much time

    studying biology, it quickly becomes apparent

    that there are no sharp lines or divisions, and

    that we consist of an incomprehensibly diverse

    and interconnected community of

    cells. That connective tissue

    has a small population ofmuscle cells strikes me asblindinglyunsurprising.Muscleblends exquisitely into tendon, with no clear

    demarcation at the cellular level: at the

    microscopic level, its like walking through the

    overlapping zone of two heavily integrated

    adjacent neighbourhoods, and the further you

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    go away from the muscle, the fewer muscle

    cells you see, and the more fibroblasts and

    their fibres. That connective tissue has a smallpopulation of muscle cells strikes me as

    blindingly unsurprising. Fascia surrounds and

    fractally wraps every muscle inside and out, for

    crying out loud how could it nothave a few

    muscle cells and overlapping properties?

    I didnt know that before it was confirmed, but I

    certainly dont find it particularly surprising. I

    suspect that the slightly contractile properties

    of fascia are simply at one end of a continuum

    of motor function. Our muscular system is

    overwhelmingly our primary means of reacting

    to stimuli the major output of our nervous

    systems and in general terms the slight

    contractility of fascia is probably just the

    fringes of that functionality, a little bit more of

    the same. There are probably some subtle

    differences, but they are subtle and arcane and

    ultimately just a slight variation on the

    biological theme ofmuscularity. Im not saying

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    its completely uninteresting, but its

    overshadowed by the much more interesting

    muscular system as a whole, about whichfascia is simply a mildly intriguing subtopic.

    And, in terms of clinical relevance, the

    muscular system itself is in turnovershadowed

    by neurology.

    What does Dr. Schleip think?

    Recently Dr. Schleip read my article and wrote

    to express his basic agreement with my key

    point about his research: Your comments onthe small size of fascial contractions are right

    on, at least when viewing these within the

    periods of seconds to minutes, as is usually

    applicable for bodywork techniques. He also

    wanted me to know that he shares my

    annoyance with the over-zealous claims and

    projections of therapists doing fascial work.

    He is not thrilled with the way his research is
  • 7/30/2019 Does Fascia Matter


    being used to justify premature overconfidence

    in fascial therapy.

    He also offered some thoughtful criticism on

    some specific points (and I made some

    changes, and will probably make more).

    Nevertheless, he had no major objections, and

    was generally pleased with what he read here:

    You have my respect for your detailed andcritical analysis of the present work on fascia.

    Most of the people who criticize you have not

    done a portion of your reading work and could

    certainly learn a lot from the debate you


    I invited him to make a statement for my

    readers about this. Here is it in full, with some

    emphasized highlights:

    I share your emotional frustration with

    the current trend among bodyworkers ofattributing anything wonderful orastonishing to the properties of fascia. Infact, our Fascia Research Group at UlmUniversity has been receiving an almostexponentially increasing number of inquiries
  • 7/30/2019 Does Fascia Matter


    from enthusiastic healers (and martial artteachers) worldwide who wish that we wouldsanctify their claims that fascial contraction

    provides the explanation for their observedmiracle powers. While I do tend to believe thatthe fascial net plays much larger roles inhuman functioning than previously assumed inorthopedic medicine, I am afraid that suchover-zealous claims and projections areundermining the seriousness of theinvestigationand academic rigor thatcharacterizes the work of the current leaders infascia research, such as P. Huijing, H. Langevin,T. Findley, P. Standley and A. Vleeming.

    As a bodywork clinician myself, I have learnedthat there is hardly a more dangerousattitude among therapists than the hero

    healer/manipulator who is damn sureabout his diagnosis and supposedtreatment effects . This of course applies asmuch to fascia-oriented therapists as it does tothose who base their work on supposedneuromuscular or other physiological effects,

    most of which are still unproven. There

    is hardly a more dangerousattitude among therapiststhan the hero healer who is

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    damn sure about hisdiagnosis & supposed

    treatment effects.While scientistscan learn a whole lot from the intuitive andexperiential wisdom of complementarytherapists, particularly about the non-fragmented and connecting properties of thefascial net, we bodyworkers can learn at leastas much from the careful, questioning

    approach of good scientists, who are willingto doubt their own assumptions and torefrain from premature confidence andover interpretation of their findings. It isthis mutual learning and interdisciplinaryenrichment which in my opinion characterizesthe best qualities of the current fascia research

    field, as expressed in the international FasciaCongress series and associated activities.

    Again, Dr. Schleip and I do not agree about

    everything but that is unimportant

    compared to our shared values and

    commitment to cautiously reservingjudgement. We have each placed our bets on

    this topic, but not closed our minds. I fully

    support and endorse his enthusiasm to explore

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    the biology and he supports and endorses

    the value of my critical analysis.

    PART 4


    Results of the FasciaScience Challenge so far

    Piezeoelectricity may occur in fascia,but its clinical relevance is nil not enoughis known about it to even speculate abouthow it could be exploited in manual therapy.

    Gil Hedleys theory that congealingfascial fuzz causes stiffness issimplistic and wrong. It is not a plausibleexplanation for the sensation of stiffness, ora mechanism of action for fascial therapy orstretching.

    Fascial meridians relate fascialtherapy to the meridians of acupuncture,which dont exist or even if they do

    cant actually be exploited for anytherapeutic effect even by acupuncturists.

    Chaudhry et al showed that fascia istoo tough to release. Indeed, even thinfascia is so tough that it is basically
  • 7/30/2019 Does Fascia Matter


    inconceivable that it could be physicallychanged (stretched, loosened) without vicegrips. This directly contradicts a major

    popular rationale for fascial manipulation,and is only clinically relevant to fascialtherapy insofar as it presents evidence thatdiscourages and undermines existingcommon practices and beliefs.

    Meltzer et al concluded that stimulatedfibroblasts might be happier

    fibroblasts specifically, they might bemore resistant to post-exercise soreness.The results of this test tube study arequestionable, but even if you take the dataand interpretation at face value, it is a longreach from a test tube study to clinicalreality. Treating post-exercise muscle

    soreness is not even a common goal formanual therapy.

    Schleip et al established that fascia iscontractile to a trivial degree, but not thatit matters. It is somehat unsurprisingbiologically, and clinically trivial. It is not afactor in any of the common problems most

    manual therapists work with maybe noneat all and even if it was it is somewhatunlikely that hands-on therapy could relax it.
  • 7/30/2019 Does Fascia Matter


    To be continued

    There is more fascia science, and I will extend

    this article with more analysis in the future. I

    honestly hope that there is clinically relevant

    fascia science that would be terrific. So far,

    however, I see no good reason for therapists to

    be fascinated by fascia and to make it a target


    Other alleged fascial properties and clinical

    relevance issues I intend to address eventually

    (definitely not a complete list):

    The claim that connective tissue is acolloidal substance in which the groundsubstance can be melted by heat ormechanical deformation (thixotropy), andthat this is the basis of a therapeuticrelease. Done February 2013.

    The claim that fascia is a liquid crystal.

    While it certainly has some elements of truthin it, the relevance to therapy is extremelydubious. This is closely related to thepiezeoelectricity claim already covered bythe article, but there is more to say about

  • 7/30/2019 Does Fascia Matter


    the liquid crystal idea specifically. DoneFebruary 2013.

    The claim that fascia containsmemories in some sense. I will likelydispute both the property and its relevance.

    The claim that fascia is structurallyimportant and tensegrity is interesting(agree), and that this is clinically relevant(disagree). Much of my rebuttal on this score

    already exists in my articleabout structuralism.

    PART 5


    Further Reading

    SYYour Back Is Not Out and Your LegLength is Fine The story of the obsessionwith crookedness in physical therapy andtreatment for chronic pain.
  • 7/30/2019 Does Fascia Matter


    SYPain is an Opinion What recentpain science can do for your chronic painright now. The role of the nervous system in

    chronic pain is the major alternative tofocussing on fascia. It has much clearerclinical relevance.

    SYDoes Massage Therapy Work? Areview of the science of massage therapy such as it is.

    SYTrigger Points & Myofascial PainSyndrome A guide to the science ofmuscle pain, with reviews of every possibleself-treatment and therapy option, even forthe most difficult cases. Includes a sectionon the relationship between fascia andtrigger points (e-book customers only).

    Greg Lehman, a chiropractor andphysiotherapist has a thoughtful new fasciaarticle, Fascia Science: Stretching thepower of manual therapy.

    Todd Hargrove, a Rolfer and writer(, has a good postonfascia and foam rolling and fascia underthe microscope.

    If We Cannot Stretch Fascia, What AreWe Doing?, a webpage on Massage therapist Alice
  • 7/30/2019 Does Fascia Matter


    Sanvitos clear summary of Dr. RobertSchleips theory that fascial release maybe attributable to changes in muscle tone

    stimulated by mechanoreceptors in fasciaand other soft tissues, and not by plasticdeformation of fascia.

    Whats new in this article?

    Rewritten (Feb 20 '13, section #2.1) A

    major editing job, particularly to include the

    much more specific idea that piezoelectricity

    accounts for releases. See section

    #2.1,Electrified by piezoelectricity.

    New section (Feb 19 '13, section

    #2.3) No notes. Just a new section. See

    section #2.3,Idas idea about thixotropy.

    New section (Feb 15 '13, section

    #3.2) No notes. Just a new section. Seesection #3.2,Release may not even be real.

    Minor update (Jan 31 '13) Several minor

    additions and edits.
  • 7/30/2019 Does Fascia Matter


    Minor update (Aug 30 '12, section

    #3.5) Added some acknowledgement that

    fascia contractility may still have some slow-motion power even if it is quite weak. Ill

    probably expand on this soon. See section

    #3.5, Fascia strong like bull! Or mouse?

    Minor update (Aug 30 '12, section

    #3.4) Added a very useful link See section #3.4, Does it

    matter that fascia contains muscle cells?

    New section (Jul 31 '12, section

    #2.4) No notes. Just a new section. See

    section #2.4,The acupuncture connection: is

    fascia actually magic?

    Major update (Jul 25 '12) Article launched

    as a compilation of about four previous articles

    on this topic, with revisions and some new


  • 7/30/2019 Does Fascia Matter


    1. It is quite negative. I have fun takingtherapy seriously. Criticism and deconstruction ofideas is normal and healthy and necessary fortherapy professions to grow and change.BACK TO TEXT

    2. I didnt actually have any problem. It wassupposed to be a relaxation massage, in a spa.

    Yes, she was a Registered Massage Therapist awell-trained and fully certified massage therapist.And thats probably exactly why she feltcompelled to strut her stuff and troubleshoot

    my case and talk about fascia.BACK TO TEXT

    3. Juhan.Jobs Body. 1998. JobsBodyis essentially a physiology textbook withimagination and a soul. Its a hard read, butequally rewarding. On the other hand, Juhanprobably takes some his speculation too far too be

    useful or accurate.BACK TO TEXT

    4. The full details of how bone responds tostress are spelled out in Dr. HaroldFrostsMechanostat model. For more information,seeTissue Provocation Therapies.BACK TO TEXT

    5. This kind of (wild) speculation is hardlyunusual for Oschman: his writings are lacedwith much stranger ideas.BACK TO TEXT
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    6. Dr. Robert Schleip, from his 2003article, Fascial plasticity: a new neurobiologicalexplanation:

    The half-life span of non-traumatized collagen hasbeen shown to be 300500 days, and the half-lifeof ground substance 1.77 days (Cantu & Grodin1992). While it is definitely conceivable that theproduction of both materials could be influencedby piezoelectricity, both life cycles appear tooslow to account for immediate tissue changes that

    are significant enough to be palpated by theworking practitioner.


    7. The quoted passage is from my personalcorrespondence with Dr. Levin, and is used withhis permission. For information about Dr. Levinswork, see Biotensegrity: A new way of modelingbiologic forms.BACK TO TEXT

    8. Schleip. Fascial plasticity: a newneurobiological explanation.Journal of Bodywork& Movement Therapies. 2003.BACK TO TEXT


    Heres Dr. Schleips full reasoning from hisarticle, Fascial plasticity: a new neurobiologicalexplanation:

    In most systems of myofascial manipulation, theduration of an individual stroke or technique on a
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