The Bands That Bind Us

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The Bands That Bind Us
Our muscles are covered in a connective tissue called fascia. Mostly made of collagen, this fascia surrounds and holds every organ, blood vessel, bone, nerve fiber, and muscle in place. When healthy, it allows the muscles to move freely alongside other structures, but may thicken and stiffen in areas where it is repeatedly exposed to stress. Sedentary behavior, dehydration, and poor posture can also contribute to unhealthy fascia which can ultimately lead to pain and immobility.

Let’s take a closer look at this connective tissue by going back to the very beginning, when we were once developing embryos in the womb. Our framework as human beings stems from a single network of tissue established in the early stages of development. Throughout our time in utero, this connective tissue embeds itself within the growing systems of the fetus. For example, imagine how a sheet of paper is folded and manipulated into origami. The sheet of paper changes into a three dimensional figure without ever being torn or taped back together. It is a continuation of the same piece of matter. Just like the paper being folded and refolded, fascia becomes intertwined within our cells and transforms the growing embryo into the human beings we are today.

Fascia, along with our muscles and other connective tissues, create a balance of tension which holds our bones into place. It is the harmony of these very structures that allows us to move but also provides us with stability. Injuries, faulty posture, or movement compensations can disrupt this balance. The most important thing to remember is that our bodies adapt to our movement patterns (or lack of movement patterns). For example, if you sit all day or continue to hold certain postures, overtime the myofascial lines will adaptively shorten. You might notice it becomes difficult to move out of those positions/postures because of the internal tug-o-war created by the tight fascial tissues. Or even worse, you might not even realize your movements are changing or compensating until you notice pain.

At Complete Physical Therapy, we make it a priority to address limitations caused by muscular or myofascial restrictions. There are seven main myofascial meridians/tracks (12 total) that join and diverge (branch off) fascia throughout the body, tacked down along bony attachments. If a part of the track is under stress, stiff, or injured, it can affect the entire meridian and how the body moves. Recognize that the location of the pain isn’t always the source of the pain.

Let’s look at each of these lines in a little more detail. Having difficulty bending over? Can’t touch your toes? Experiencing back pain or have tight hamstrings/calf muscles? The Superficial Back Line (SBL) connects and protects the entire back surface of the body from the bottom of the feet to the top of the head. It supports the body in a full upright position, but too much tension along the muscles of our posterior (back side) can lead to dysfunction. Common ailments caused by the SBL include plantar fasciitis, achilles tendinopathy, tight hamstrings, back pain, neck pain, and headaches.

Opposite of the SBL is the Superficial Front Line (SFL). Its function is to create forward-bending through the trunk and hips, and works to balance out the SBL. Chronic contracture (tightness/shortening) of the Superficial Front Line (SFL) creates postural problems and can even restrict your breathing. For example, tight hip flexors in the front can pull the lumbar spine (low back) into flexion, putting you in a very slouched position. Over time this can lead to muscular strain and even disturb the discs in your spine. It may also pull your head forward, resulting in poor positioning of your neck and shoulders. Ouch!

Along the sides of our body lies the Lateral Line (LL). This fascial line holds us straight and upright by balancing the front and back of the body, also stabilizing us from excessive lateral (sideways) movement. It essentially prevents us from buckling and acts as a brake during lateral and rotational movement. Dysfunction within the LL might be to blame if you feel yourself shifting to one side during functional movements such as walking, squatting, etc. Tension along this track can lead to tight hip abductors (muscles that move your leg to the side) and IT band syndrome.

The next fascial line is called the Spiral Line (SPL) and its job is to aid in rotational movements and to steady the trunk and leg to keep it from folding into rotational collapse. Those who play sports, especially one sided sports such as golf and hockey, may notice shortening and locking of muscles on one side and weakened muscles on the other side. Habitual patterns such as crossing the leg or holding a toddler on one hip can also affect this line. Those who perform repetitive rotation activities such as sweeping, shoveling, or digging can be vulnerable to dysfunction. It also connects the arch of the foot to the pelvis and helps with proper tracking of the knee. The SPL is a great example of how the hip, knee, and foot influence each other. Pain in the knee could be due to dysfunction in the hip or foot/ankle!

The Arm Lines contain four different tracks that run from the shoulder to the arm, all the way to the hand. It helps bring things toward us, pushes things away, and stabilizes our body. The mobility of the scapula (shoulder blade) is crucial to the many services that our arms and hands provide. Therefore, tight muscles throughout the chest, shoulder, and scapula (ex: pec minor, trapezius, serratus anterior, and rhomboids) can negatively affect breathing, neck, head postures, and how the arm moves overhead. Those with chronically bad posture are vulnerable to dysfunctions such as rotator cuff impingement, cervical radiculopathy, lateral epicondylitis, carpal tunnel, and thoracic outlet syndrome; to name a few.

The next set of fascial lines, called the Functional Lines, play a big role in movements performed during athletic or sporting events. They act to extend the levers of the arms to the opposite leg and help create rotational movement. This counterbalance between arm/shoulder and opposite hip provides us with the momentum needed for paddling a kayak, throwing a baseball, swinging a tennis racket, hurdling, kicking a football, and even the basic act of walking.

Breathing, for the most part, is an involuntary action we rarely think about. Lucky for us, the fascial tissues within the Deep Front Line (DFL) help control our breathing patterns by stabilizing the chest and allowing for expansion and relaxation of the diaphragm. Spanning from the underside of the foot, passing through the lower leg, to the inside of the thigh, up through the front of the hip joint, pelvis, and lumbar spine, the DFL plays a major role in the body’s support system and comprises the body’s “myofascial core”. Since these structures are so deep, dysfunctions of the DFL are not always apparent from the surface, but overtime can lead to larger problems.

Keep these fascial lines healthy and moving freely by stretching! Stretching helps to realign collagen fibers in the fascia that deposit themselves in a thick, disorganized manner. It also creates length and space in areas where collagen has shortened and drawn the tissue inward. Scar tissue cannot be removed but it can be remodeled. Things to consider when stretching:

  • Synchronize your stretching with your breathing. Instead of letting time dictate how long you hold a stretch, listen to your body and use your breath to know what feels tight. Move into the stretch on your exhalation and gently release the stretch on your inhalation, allowing the breath to move through the body like a wave.

  • Remember that fascia is three dimensional. Stretch into multiple planes of movement and different angles (rotational and diagonal patterns).

  • The order in which you stretch makes a difference. Start with deeper muscles that are closer to the joint before stretching the more superficial muscles. Also, prioritize muscles that are severely tight. In some cases these muscles can get so tight they inhibit muscles on the opposite side of a joint from functioning properly.

  • Hydration is important! Fascia is ⅔ water. Think of fascia acting like a sponge. Stretching refreshes and renews tissue by eliminating waste fluid and bringing in blood, oxygen, and nutrients. Water also aids in lubrication for fascia to support tissue structure and movement.

  • Stretching should not hurt but it’s okay for it to be uncomfortable. If you stretch too hard you can tear healthy tissue. If you quickly pull into a deep stretch your body has a reflex that will elicit a sudden contraction (this is your body’s way of telling you to stop further stretching). This, in return, will cause you to feel more tight afterward.

Another way to address tight fascia is through myofascial release techniques, also known as trigger point therapy. To perform this, the therapist applies firm, sustained pressure to a region of pain or tightness. The sustained hold creates an ischemic release, blocking blood flow temporarily. Once pressure is alleviated, a rush of oxygen and nutrients circulates through the area which promotes healing. Other benefits include reduction in hypersensitivity and improved proprioception (our body’s awareness and ability to sense position, location, orientation, and movement). The good news is that you can perform these releases independently using myofascial tools! The most commonly used tools at CPT are the lacrosse ball and the foam roller. Both items are designed to restore sliding surfaces, release trigger points, and remodel scar tissue. Use the following recommendations as you navigate the world of myofascial release:

  • Start by slowly moving the myofascial tool along area of tightness

  • Stop at tender or painful trigger points and let the the lacrosse ball/foam roller slowly sink into the area (you may use the wall or ground to tack the lacrosse ball to your body)

  • Hold up to 60 seconds or until you start to notice the muscle release (or notice a reduction in discomfort and/or softening of the tissues)

  • Add in active movement of the associated body part

If you are chronically stiff and sore, we can help teach you ways to release tight muscles and fascia with stretching and the use of these myofascial tools. Because fascia is so three dimensional and so intertwined throughout the body, you might also notice how it can be affecting other stubborn aches and pains throughout the body. Call us today at (402) 483-0006 to set up an appointment.

Sources:

“Anatomy Trains” by Thomas W. Myer
“Stretch to Win” by Ann Fredrick and Chris Fredrick
https://www.tuneupfitness.com/blog/fascia-myofascial-release/#smfrbenefits
https://absolutehealthperformance.com.au/myofascial-meridians-lateral-line-walking-straight-line/
https://thelynomethod.com/2016/12/22/is-a-locked-spiral-pattern-the-cause-of-your-injury/
https://coachkevincarr.files.wordpress.com/2010/10/anatomytrainsoverview.pdf
https://www.youtube.com/user/superhealthfoodbook – Christopher Hole
https://basicmedicalkey.com/ – for pictures