If you have worked with a manual therapist, you've probably heard of fascia at least once. Fascia is a connective tissue that surrounds and supports muscles, organs, blood vessels, and nerves throughout the body. It forms a continuous web of fibrous tissue that helps maintain structural integrity, provides protection, and facilitates movement. It is now well known that fascia is important for overall mobility, flexibility, function, and pain relief. For this reason, fascial remodeling is becoming a major target for many manual therapies.
Whenever I provide a manual fascial remodeling therapy, my clients ask if they need to continuously rely on the manual therapy to keep their fascia healthy or can they use exercises to keep their fascia happy. The purpose of this article is to give them organized information as to how to promote fascial health through exercises.
Before we delve into maintaining healthful fascia, let's talk about what it means to have healthy fascia. Healthy fascia is highly elastic, allowing it to stretch and return to its original shape. This elasticity is largely due to the formation of collagen and the presence of elastic fibers. In a healthy state, collagen fibers are wavy and arranged in a lattice-like structure. However, when there is a lack of exercise or physical activity, these collagen fibers become disorganized and lose their wavy pattern. This leads to a decrease in the fascia’s ability to recoil, contributing to premature aging and a decline in its natural functions.
Fortunately, the fascial function can be regained with proper exercises (Wood et al. 1988; Jarvinen et al. 2002; Reeves et al. 2006). The key to recovering the fascial function is to improve sensory control of refined movement, engage in non-habitual positions and movements while utilizing the full joint range of motion, and rehydrate the fascial tissues (Muller and Schleip, 2012). The following are examples of the exercises that can improve fascial function.
Elastic recoil exercises
Elastic recoil exercise means that the movement starts with a preparatory counter-movement in the opposing direction before the main movement begins. As a result, a catapult effect is created as if a pre-tensioned slingshot is released. Easy examples are throwing a baseball or tennis swing in which a wind-up motion is followed by propelled follow through. Exercises can be designed by mimicking these motions with particular emphasis on timing and rhythm of the movement. When jumping or hopping is involved, special attention needs to be paid to smooth execution of movement and soft landing. This will also develop sensory control of refined motion. The type of movement and targetted joint motion should be determined after a careful assessment of the stability of the joint to minimize the chances of injury. Seek help from an experienced movement specialist (kinesiologist or exercise physiologist) if you are unsure about it.
Dynamic stretching of multi-joint muscles
Stretching the muscles that cross over several joints effectively stimulates fascial membranes. These movements are often shown in yoga poses. Dynamic stretching involves soft mindful bounces. Muscles and tissues should be warmed up before the dynamic stretching. Jerking or abrupt movement should be avoided. The movement should be composed of smooth alternating acceleration and deceleration.
Foam rolling
Foam rolling can be useful for temporarily squeezing out fluid from fascial tissues, similar to wringing out a sponge, which is then followed by improved rehydration. However, the firmness of the roller and the amount of body weight applied need to be carefully adjusted for each person. When used correctly, with slow and precise movements in the right direction, foam rolling can help apply the right amount of pressure and provide beneficial effects to the tissues. Foam rolling has been shown to improve range of motion and arterial flow. Slow rolling is used to treat scars, hypertonic muscles and adhesions. On the other hand, rapid and vigorous rolling aims to produce collagen in weakend and loose tissues.
It is important to note that fascial remodeling through exercise takes a long time (6~24 months) but yields long-lasting results. Training should be consistent. Only a few minutes of appropriate exercises, performed once or twice per week is sufficient for collagen remodeling. Consecutive intense workouts should be avoided to minimize the risk of injury.
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