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Fascia: The Most Overlooked Part of the Human Body, Now Perhaps the Most Talked About Technique in Manual Therapy

BY MAGNUS & BOBBI EKLUND


Why Massage Therapists Want to Work with Fascia, and Why Clients Want to Receive it

“Over two decades ago, I learned about someone who was the only massage therapist in her town for many years. Upon meeting her, she mentioned that she had stopped practicing due to carpal tunnel syndrome. She strongly suggested that I would likely experience the same issue. I was determined not to accept her prediction. This motivated me to focus on my body mechanics at the massage table. Throughout my career, while using oils and lotions, I did experience occasional aches and pains. At times, I struggled with back discomfort and questioned the long-term sustainability of my career in massage therapy. Eventually, I discovered a solution through dry work and synergetic myofascial therapy developed by Magnus Eklund. By going through the training to learn this work my body aligned and opened in a way I had not felt before. Finally, I could easily stand at the table in a strong stance with ease. The body mechanics I learned and continue to develop evolve my practice every day. The techniques encourage a flow and creativity I’ve not experienced with any other modality.” B.E.


Fascia is a three-dimensional web like network with properties such as collagen, protein, and water. It is 75% water. It should be very open and pliable providing glide between tissues, but it doesn’t always and many factors contribute to this tissue becoming stiff. The connective tissue surrounds and supports all muscles, nerves, bones, arteries, veins as well as, the internal organs, the brain, and the spinal cord. Injuries, surgeries, trauma, and poor posture are among factors that can cause restrictions in fascia, known as adhesions or what is now being termed densification. Fascia is one continuous network throughout the body consisting of about 20% of its mass.  It is the largest sensory and feedback organ allowing us to sense our environment and have a sense of self. In fact, the vibration of sound passes through the fascial network as it is transmitting faster than nerve conduction. 


Fascial layers have an ability to slide as we move by use of a liquid called hyaluronan.  Healthy fascia can slide up to 75%, and unhealthy rigid fascia below 50%. When the fascia dries up and tightens around muscles it can limit our ability to move freely. Fascial manual techniques are a very effective way to improve this sliding capacity in the fascial layers. 

Fascia tends to shorten and become dense with inactivity which can affect the function of muscles and cause nerve impingements. The often-painful knots we feel in a human body are often sticky and thick fascia. When we apply pressure to the tissue of the body we can change the consistency from a solid gel state to a fluid, elastic and hydrated state. This means when you move after a session your body feels spacious.


In the past, modern medicine thought fascia was a sort of packing material with not much function. Manual osteopaths and other practitioners realized in the early 1900’s that fascia had more sophisticated function in the structural support of the body. Fascia plays a role in not just functional movement and structural support but also in metabolism and all basic functions of the body. Without fascia contracting in a supportive way the muscles could not contract effectively, and bones and joints would not be a solid structural system. Fascia holds everything together in a tensegrity system. This term comes from two words: tension and integrity. It is a structural principle describing how fascia holds the body together in its shape and position. (1)


When we find tension in one area of the body, including tightness and non-pliability, we see it causes tension in other parts of the body. This can cause structural misalignments such as forward head posture, spinal deviations, pain, and limited flexibility. It even causes instability and creates a sense of limited space and freedom in the body. For instance, in forward head posture the weakness in the neck flexors and lower and middle trapezius along with serratus anterior, will cause upper trapezius and levator scapula in the upper back, and pectorals to be tight, and in a state of constant contraction. The body would then fight gravity by being out of structural balance as the brain is receiving information from proprioceptors and sending signals back to muscles to keep the head on top of shoulders at all costs. This would feel like you are fighting gravity just to keep your head up. Imagine the strain if you must be moving all day like this.


Since fascia is a key organ of sensory perception which means that the nerves of the CNS, and specifically sensory nerves located in the fascia respond to stress. The sympathetic nervous system (the involuntary nervous system that connects your brain to every organ in your body) is triggered by a fight or flight response when you are under physical or emotional stress. When this happens, it causes chemicals to be released which, contract blood vessels, reducing blood flow and therefore creating pain sensations in the fascia. Again, this could explain why back pain worsens when people are under stress.

Synergetic Structural Integration is manual fascial therapy. We use a deep slow scooping technique. When applied at the correct layer these techniques ease pain and change the state of the nervous system in the body from sympathetic to parasympathetic. Dr Robert Schleip in Germany is conducting scientific research on thoracolumbar fascia and low back pain. He demonstrates how deep, slow, specific manual fascial techniques improves fascial glide and reduces pain.

​Here is what a session typically looks like: The client is dressed in shorts and a sports bra (for women) and no lotion. We begin with a postural analysis and functional movement check. The information gained is a part of creating a strategy for the session. This also, gives us a gauge of comparison when the session is complete. We begin based upon what we have determined from the assessment. The client may be seated initially then move to the table prone, supine or side lying, all in one session. Often, we continue the assessment on the table checking for joint range of motion. It’s very important to instruct the client to breathe. As therapists, when we slow down the breath, our mind also slows its thinking, which allows us to cultivate the feel for what should come next in the session. If the client finds it difficult to breathe as we are working with them then that’s a clear sign, we need to adjust the technique of scooping which is lifting the tissue and creating the expansiveness we are seeking to accomplish.


We may ask the client to move in a session for example, while seated, the therapist working upper trapezius will ask the client to rotate their head to the opposite side. This helps us stay within the fascial network and work with ease. We teach students not to force the tissue to move.

Ultimately, we assist people in fighting gravity by structurally balancing and integrating muscles and fascia, and thereby improving posture, which leads to functional movement. We don’t have clients who want a relaxation massage, we have those who need more mobility, more functionality, and alignment of the body. What is weaved throughout the entire system of this body that we all have is the fascial network. This is what we work on and affect. We have developed Synergetic Structural Integration to be a benefit to the client as well as the therapist. The body mechanics that go along with this system are unique and leaves the therapist feeling strong and energized. While the client stands up and claims they are out of pain, or they are no longer fighting gravity, and it’s now easy to be in the body.  This is longevity and that’s our goal, for you and your clients!


Bobbi and I teach continuing education workshops with manual fascial techniques and functional movement assessments in the USA and internationally. Once a year we offer a 300-hour program in Synergetic Structural Integration.


Sources:

1) Fascia and Tensegrity the Quintessence of a Unified Systems Conception – Sharkey 2020 Anatomy, Fascia – Bordini, Mahabadi, Varacello 2023

2) Active Contraction of the thoracolumbar fascia – indications of a new factor in low back pain-research with implications for manual therapy Schleip, Werner, Klingler, Lehmann-Horn 2004

Fascia as a multi-purpose structure of connective tissue – dysfunction, diagnostics and treatment.Mika, Olesky, Fede, Pirri, Stecco 2024

Fascia is able to actively contract and may thereby influence musculoskeletal dynamics: A histochemical and mechanographic investigation. Schleip 2019

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