Fascia is a complicated structure. Dismissed for years as just outer covering of muscle, we now know its a very important part of your movement system.
Fascia is one of biggest missing links in Low back Pain:
The low back is covered in fascia. This structure is called the Thoraco-Lumbar Fascia. It is in every anatomy drawing and yet is rarely spoken of as a cause of low back pain, sciatica and disc pain. Each muscle is also wrapped in fascia(not just covered by it), and then that fascia links to the next muscle neighbor. In the picture above reference how the fascia attaches and creates a “spring” mechanism between the latissimus and the gluteal muscles. I can’t tell you how many chronic back pain patients we have fixed at Mountain Movement by addressing the fascia.
When you think of back pain you have to consider fascia connections into the feet and up to the shoulder, hands and head! It really is all connected. These ares may not be the sole cause, but there are always multiple factors in a tricky back pain case. We often see tight “calves” or gastrocnemius muscles pulling up all the way to the back fascia.
Think of a spider web, when you pull on one end, vibrations and movement are felt throughout the entire flexible structure. This is the way fascia function is being studied and postulated.
So many are having to resort to no longer moving, medications, injections and surgeries in modern day health care for the treatment of low back pain. Having dealt with debilitating back and neck pain myself I am firmly aware of how crippling it can be. Life altering would be a good word to describe it.
Even with it being one of biggest reasons people seek medical care, we still only prescribe muscle relaxers, pain medication and tell the patient to rest. Even though there are much more comprehensive approaches to back pain disability available.
Even those attempting more comprehensive care often don’t address the big picture. Chiropractors perform a Joint Manipulation, and most Physical therapists help the patient strengthen muscles. Only a small group understand the importance of fascia and movement patterns.
Fascia is even being studied as one of the primary mechanism of acupuncture. As the needle goes in it stimulates neural pathways that talk to the brain. Fascia is being designated as an organ and could possibly be a matrix in which immune complexes travel.
Fascia is Supportive:
Fascia links your muscles together. Muscles acting in isolation only happen in a lab or on a model. Our bodies use the fascia that flows from one muscle to the next as a way to link up a whole “chain” of muscles to perform complex movements.
Without the fascia there would be no container for the muscle and no linking and flowing movements.
Fascia is Springlike:
Fascia has a malleable quality that is now postulated to allow us to do the very dynamic movements of walking, running and throwing. If you look closely at a great pitcher they are winding up their arm and at the mid point of the throw their arm resembles a sling shot. The fascia is wound and will allow for the ball to be propelled at 100 mph.
Fascia can then be seen within the physics of a catapult, creating a whipping motion for more spring. Many experts are postulating that great athletes have very special “fascia” creating that much more spring in their movements. It has also been likened to a spider web, where a pull on one area of a fascia will create changes throughout the entire “webbing.”
If it’s not malleable- It won’t spring.
After we sit in poor postures, or have an injury the fascia mobility can change. Since the fascia is made of cells they can bind together and become more dense to deal with the stress put upon them.
To a trained practitioner this is easy to find on palpation. There is a drastic difference in feel between a spasmed muscle and tight fascia. Mapping out the tight fascia and treating it can restore the springlike capacity to the tissue. This allows the spring, or catapult like behaviour to take place during walking, lifting etc.
In areas where we place excessive load or in areas of loss of motion. The fascia will adapt and not be able to spring, and may eventually get adhesions and tightness in it.
This fascia meeting point is no mistake in it’s location. This fascial meeting place is there because it is the meeting point for the upper limbs and lower limbs that are swinging to “wind up” and create forward propulsion.
This area gets very “dull” upon palpation meaning it has been overused for years and no longer has a spring like capacity.
With dynamic mobilzation with a specialized table, hands on myofascial therapy, and tool based fascia mobilization we can repair the “springlike” mechansim of the low back fascia.
This helps Chiropractic Adjustments hold longer, helps rehab exercises no longer hurt, and the patient often finds themselves finally able to put on their shoes without pain after years of pain.
Different lines for different functions.
Many of the lines have been mapped out by Thomas Myer in his now famous book Anatomy Trains. These lines help muscle sync up together to perform the movements we are designed to do.
Anterior (Deep and Superficial) line: The Fascia Line made of the Rectus femoris(Quad), the Hip flexor (psoas major and iliacus), and the diaphragm is a common area the doctor finds as a “secret” cause of low back pain.
These two lines link more muscles together but for simplicities sake of the article we will go over this small part.
Our sitting society creates “tightness” in the fascia and excess muscle signals in the front of the thigh and hip flexor. These muscles pull the spine and pelvis forward, creating a counter response of the low back muscles.
Think of a pulley “pulling” or winding your body forward. You have reflexes built into your body to correct forward posture, so you will “overarch” your low back to keep yourself upright. This will cause the low back fascia to become tight.
Back Pain Care is Too Simplified:
So many today get images (xrays, MRI’s) and treatment right at the point of pain, but many practitioners fail to look at the front of the body! As well, some simple Fascial therapy that brings the shoulder and gluteal muscles into the picture can drastically improve the cases success rate.
By teaching a patient several simple movements and doing myofascial therapy on the front of the body we have helped many “unsolvable” cases. By helping the patient engage their shoulder to their hips by way of the core, the fascia can create the mix of winding and springing it needs for pain free walking.
To Read about the other factors in low back pain in this series:
Take Homes for Fascia Imbalance:
Think bigger if you are dealing with low back pain that is chronic. Look up a practitioner that understands fascia.
You may even have to form a team of practitioners.
A fascial massage therapist, PT, or a Chiropractor all working together.
The treatment cannot just be hands on, but also active movement instruction as well. Someone teaching exercises to you to balance the fascia and muscle system is also a crucial part of comprehensive care.
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