
Fascia encases tissues and organs and may have widespread effects (2019) - andrewl
https://www.washingtonpost.com/national/health-science/everywhere-in-your-body-is-tissue-called-fascia-scientists-are-unlocking-its-secrets/2019/01/25/e0414e3e-f4e0-11e8-80d0-f7e1948d55f4_story.html
======
tomhoward
Over the years I've written here several times about my efforts to explain and
overcome mysterious chronic health impairments including fatigue/lethargy and
tension/pain.

In recent times, my research and experimentation has led me to explanations
and treatments that focus on the fascia, and whilst I've not yet achieved full
recovery (a recovery time of several years is par for the course with these
kinds of issues), this approach does seem to be helping to improve my
conditions.

The approaches I've been undertaking include yoga/pilates-type stretching
exercises and specific types of massage that seek to break up fascia
"adhesions" [1].

I'm being careful not to make any specific claims of diagnoses or remedies, as
I'm fully aware from my own experience (and background as a scientifically-
minded person) that this this whole topic is nascent in terms of solid
scientific evidence, and rife with pseudoscience.

But it does seem clear to me that there is "something there", and that more
research into this topic could likely lead to explanations and remedies for
conditions like "chronic pain" and "chronic fatigue", which many people
currently endure for years or for life without understanding or relief.

[1] It's not the only work I've been doing; as I've written about here before,
diet, cardio exercise and emotional work have all been part of my regimen for
some years, but since introducing the practices that focus on fascia, my
condition has improved faster and in different ways.

~~~
prox
Even as much as a disalignment of a degree forward or backward rotation in the
pelvis, caused by sitting for a long time and thereby shortening the back
muscle, or hunching forward, can cause stress on other systems in the body.

Here is a little fun exercise to show the effect of fascia : bend over,
straight legs and see how far your hands go, just measuring how close you get
to your feet (they don’t have to touch, don’t push yourself, just see where
you end up) Now take a tennisbal or small round object and stand or move with
one foot on it for a while, and roll a bit especially on the arch of the foot,
like a massage. Now do the exercise again, bending over with your hands
towards your feet and see what happens.

~~~
pharke
For that experiment to be valid you'd probably want to do a control where you
try the stretch, then wait doing nothing for the same amount of time that you
would roll your feet and try again and another where you just rotate your
ankle in the same way you would if you had a tennis ball under it. Taking your
baseline reading one day and trying the tennis ball plus stretch the next day
or week would be good too.

This wouldn't really convince me because I find any additional stretching
helps with my reach and I'm more likely to chalk it up to a warm up effect or
maybe some other effect on the the tendons or muscles. I don't see any
particular reason to attribute it to fascia release.

~~~
loceng
But you haven't said anything here that discount that it could be, at least in
part, due to fascia release.

------
Ididntdothis
I think things like the work with fascia suffer from people feeling the need
to explain something with scientific terms. For a few years I was involved in
the yoga community and noticed a lot of practices where something that was
clearly beneficial to a lot of people got explained with clearly very
questionable science terms.

I am not sure why that is. Will you get ignored when you demonstrate something
that works but say “I have no idea why or how it works” ?

~~~
burlesona
This is a good observation. I think that “it works but we don’t know why” is
appealing to a small slice of well-educated people who are comfortable with
complexity and the limits of knowledge, but otherwise off-putting.

For most people I think that “it works but we don’t know why,” translates to
“it doesn’t really work.” Thus a fake explanation adds credibility and
believability. And if it _does_ work, then people feel reassured and confident
in the fake explanation.

It’s all pretty tricky human psychology though.

~~~
Ididntdothis
Is this specific to medicine? In physics it’s perfectly ok to say “ here is an
observation which can’t be explained with our current knowledge “. See dark
matter and dark energy.

The story of Ignaz Semmelweis seems to indicate that medicine is different
from physics in that aspect.

~~~
1_over_n
Placebo effects are very real and any drugs efficacy will include _some_
placebo effect

[https://en.wikipedia.org/wiki/Placebo#Placebo-
controlled_stu...](https://en.wikipedia.org/wiki/Placebo#Placebo-
controlled_studies)

~~~
Ididntdothis
That’s another thing I wonder about. What’s so wrong about the placebo effect?
If it makes people feel better we should embrace it. I think a lot of things
like yoga work because they are done in positive environments by positive
people. Whereas a lot of regular medicine is performed in pretty negative
circumstances. So the same treatment may not work in a doctors office but it
may work in a yoga studio.

~~~
Smoosh
The problem isn't the placebo effect per se. Nor with it's application as a
treatment. It's with misleading people as to what is actually helping them.
For example selling magical crystals to adjust your aura. I don't know about
studies and evidence specific to yoga, but would suspect it's benefits are a
combination of real and placebo. Thus it isn't all placebo effect as there is
a foundation of actual therapeutic benefit.

------
dr_dshiv
Whenever anything "smells" like pop pseudoscience, I think we should apply
scientific resources to build an evidence base. As opposed to getting scared.

I've been doing empirical research on "the vibe" for that reason. It is
commonly enough discussed in popular culture and is clearly valuable. Yet,
there is almost nothing scholarly written about it. To me, as a scientist,
that says "low hanging fruit." Any association with the esoteric will create a
kind of forcefield around it, so many fewer scientists will have studied it.
But, in my opinion, the topics are avoided for the wrong reasons.

~~~
carapace
If you're in the SF Bay Area and want to "do science" to Reiki "energy" I'm
available. I don't know what the phenomenon _is_ but it engenders pretty
dramatic physiological changes in a way that should be easy to measure
somehow.

~~~
sizzle
I've heard about this topic. Got any good links so I can learn more? Thanks.

~~~
carapace
Actually, no. I haven't kept up with the community at all. I just looked at
[https://www.reiki.org](https://www.reiki.org) and they seem to be pretty
solid.

------
modwest
> As the only tissue that modifies its consistency when under stress (it’s
> your body’s shape-shifter, of sorts), fascia is [...]

the cervix also modifies itself under stress (child birth), stimulated by
oxytocin (aka cervical ripening) or other hormones

~~~
TheSpiceIsLife
I’d argue that the properties of most / all tissues undergo changes when
subject to stress.

Stress ramps up blood pressure, causes changes in the properties of blood
directly, increases inflammation, down regulates the immune system and healing
in general, increases muscle tension generally, constricts blood vessels,
causes changes in hormones and cell signalling molecules in general.

~~~
yorwba
"Stress" as in physics, not the biological sense.

------
jnwatson
"He suggests that stiff fascia decreases lymphatic fluid flow and can
contribute to swelling in the limbs."

The first thing I thought that sounded like was ancient Chinese medicine and
the Meridian system. [1]

Next I thought of the reflexology diagrams of areas of the bottom of the foot
being connected to different parts of the body. The foot is a body part
particularly rich in fascia.

[1]
[https://en.wikipedia.org/wiki/Meridian_(Chinese_medicine)](https://en.wikipedia.org/wiki/Meridian_\(Chinese_medicine\))

~~~
ilaksh
You know what else can contribute to swelling in the limbs? Heart failure.
Massages might help with circulation a little, but no amount of massaging is
going to correct a serious cardiovascular problem.

I believe that connective tissues do have real function and massages could
have some mild health benefits. But I don't like this article because it
doesn't sound like science. And there are quite a few people promoting pseudo-
scientific ideas that can influence patients to put off effective treatments.

~~~
tomhoward
> I don't like this article because it doesn't sound like science

The article is specifically about the fact that the scientific community has
little knowledge or consensus about this topic, but that hypotheses are being
formulated and research undertaken.

This is the epitome of how science progresses in as-yet unexplored fields.

> there are quite a few people promoting pseudo-scientific ideas that can
> influence patients to put off effective treatments

Perhaps you should provide evidence that measures up to your own standards:
what data is there to demonstrate that significant numbers of people have died
of cardiovascular illness because they tried to treat serious limb swelling
with just massage?

On the flipside, here's some relevant data:

– "Drug overdose deaths involving prescription opioids rose from 3,442 in 1999
to 17,029 in 2017" [1]

– "Orthopedic pain (34.8%) was the primary reason for an opioid prescription,
followed by [...], back pain (14.0%), and headache (12.9%)" [2]

If it turns out that fascia-related issues are frequently a factor in these
kinds of chronic pain conditions, which currently seems at least somewhat
plausible, it may well turn out to be a scandal that this topic has not yet
been more heavily researched, given that many people outside the
pharmaceutical sector of the health industry have been talking about it for
years or even decades.

[1] [https://www.drugabuse.gov/related-topics/trends-
statistics/o...](https://www.drugabuse.gov/related-topics/trends-
statistics/overdose-death-rates)

[2]
[https://www.ajpmonline.org/article/S0749-3797(19)30216-8/pdf](https://www.ajpmonline.org/article/S0749-3797\(19\)30216-8/pdf)

~~~
pharke
If there's little knowledge or consensus then we should be cautiously
optimistic about any perceived progress, we shouldn't run headlong into X
fixes everything territory. It's important to keep in mind that we may not
know why something works because that is also how science progresses, it's the
motivation to continue refining a process or experiment until we have fully
explained the method of action. Doing this often leads to important
improvements in the method of application.

The epitome of how science progresses is diligently applying the scientific
method (repeatedly) and not fucking with the results to generate hype or feed
a pet theory.

The biggest news out of this is that stretching and exercise are still good
for your health and you should do them more often. Massage probably won't hurt
but if you have serious health problems you should probably still see a
doctor.

~~~
tomhoward
> we shouldn't run headlong into X fixes everything territory

Nobody in the article or this discussion thread has said we should do this, or
said anything else that seriously contradicts anything you've said.

Not a single person has said anything to contradict the notion that you should
see a doctor if you have serious health problems.

The article is very clearly about early stage observations and preliminary
research.

These grave warnings are an unnecessary downer in a discussion that should be
focused on interesting possibilities.

------
torstenvl
[https://outline.com/CpFycx](https://outline.com/CpFycx)

------
car
While I have no experience with, or would endorse it, the practice of
‘rolfing’ should be mentioned in this context. It specifically targets fascias
with manipulations.

[https://en.wikipedia.org/wiki/Rolfing](https://en.wikipedia.org/wiki/Rolfing)

~~~
ThePowerOfFuet
I went in with an open mind, then

> It is based on Rolf's ideas about how the human body's "energy field" can
> benefit when aligned with the Earth's gravitational field

Nope.

~~~
floatingatoll
I went in with an open mind in 1775^, then

> My reader will not wonder, that, after having ascertained the superior
> goodness of dephlogisticated air by mice living in it, and the other tests
> above mentioned, I should have the curiosity to taste it myself.

Nope.

It’s important to remember that unbelievable beliefs associated with
observations do not implicitly negate the observations, especially when it
comes to understudied areas of the human body.

What we know about the vagus nerve today seemed insane and nonsensical fifty
years ago, but historical writings for hundreds of years are filled with tales
of drinking magic elixirs that change people’s mind and body. Magic? Probably
not. Valid? Possibly so.

Further study is required, if only to separate the magic from the biology.

^ [https://thoracickey.com/joseph-priestley-oxygen-and-the-
enli...](https://thoracickey.com/joseph-priestley-oxygen-and-the-
enlightenment/)

------
melling
I remember once reading about fascia and RSI. Can’t find a great article but
here’s a quick one:

[http://www.rsi.org.uk/whatis/damaged_muscles.html](http://www.rsi.org.uk/whatis/damaged_muscles.html)

And something called trigger point therapy:

[https://www.mayoclinic.org/diseases-conditions/myofascial-
pa...](https://www.mayoclinic.org/diseases-conditions/myofascial-pain-
syndrome/symptoms-causes/syc-20375444)

------
vonnik
Some research indicates that acupuncture's effects operate through fascia:
[https://www.sciencedirect.com/science/article/abs/pii/S13608...](https://www.sciencedirect.com/science/article/abs/pii/S1360859210000422)

------
loceng
From my own experience with "energy" I seem to be able to have a higher
resolution experience with than most, along with my experience as a client for
acupuncture, physiotherapy, osteopathy, and other - I think it will be an
uphill battle to come to a scientific consensus as I don't believe we
currently have tools to adequately measure what is happening on the subtle
level of how energy flows or for what information flows (or becomes
stuck/blocked). And what purpose is it flowing? It is just some form of static
that we've evolved to ground literally into the ground - whether as a form of
waste or perhaps more - and perhaps our rubber soled shoes most of society now
wears for the majority of our days, at least when we're most active, plays a
role in tension building and fascia-related dis-ease occurring and
progressing?

Edit: Thanks for the downvotes and supporting philosophy and an open
discussion for what hasn't been proven! You'd almost certainly also downvote
theoretical physicists and people historically who brainstormed as to possible
reasons the planets moved the way they did or other physics properties -
examples of which exist where they wrote about where they had part of the idea
right but not fully. How about adding to the conversation instead of being
lazy and downvoting to suppress topics you don't seemingly have experience
with? You know you could say "I don't have the same experience" or "I
experience things this way". Or perhaps if you don't have any understanding or
experience of related to things then maybe stay out of the conversation?

~~~
samatman
I upvoted you for the first paragraph, against my long-standing practice of
refusing to boost anyone who complains about downvotes.

Don't do that here. Just accept it; sometimes it's on you, sometimes it's on
them, complaining never helps.

~~~
loceng
I wholeheartedly disagree with downvote mechanism - it's a terrible mechanism
for guiding toward civil conversation, and the fact that even talking about
that is artificially frowned upon is absurd. If people have an issue with
something - if it's well thought out enough reason by a person who would
otherwise downvote, then if they're not willing to even spend the effort to
articulate it into words - which would 1) help them think through their logic,
develop their own critical thinking, perhaps catch incongruence, and 2) offer
an opportunity of a different perspective to the person they're responding to.
The ease of someone downvoting, the laziness of it, doesn't match real world
conversations.

------
catoc
This is mostly nonsense.

eg : "If you talk to most surgeons, they would think of it as ‘what you cut
through'"

Surgeons actively use fascia to ease peeling off one structure of the other.
They actively use fascia as conduit from an incision to deeper parts of the
body; literally, to stick a hand in.

Eg: most of the article uses the term "fascia" in away akin to an "organ",
i.e.: "fascia is everywhere".

That means the author did not fully grasp the concept (if at all).

Think of "fascia" (plural) as "sheets". You have many such "sheets" in your
body. (I know that term and this concept were mentioned in the article; but
not in away that conveyed a useful or fully correct understanding).

The existence of fascia has long since been known. Testut and Latarjet
extensively described fascial anatomy... in the end of the 18th century!

Fascia are known pathways for spread of disease. Fascia cause compartment-
syndrome in limbs.

etc.

It's fascianating :-) how this is now described as something new and almost
magical...

------
carapace
Kind of a tangent but does anyone know the name of the recently discovered
sub-dermal tissue? It a network of fine capillaries (that have something other
than blood in them) IIRC.

It wasn't discovered previously because it shrivels or thins out after death,
something like that.

I remember reading about it a few years ago. It was like we had found a new
organ.

~~~
Scipio_Afri
I think you’re thinking of Interstitium

“ Meet Your Interstitium, a Newfound "Organ" These fluid-filled spaces were
found in the body’s connective tissue”

[https://www.scientificamerican.com/article/meet-your-
interst...](https://www.scientificamerican.com/article/meet-your-interstitium-
a-newfound-organ/)

~~~
carapace
Bingo! Thank you! :-)

------
mailslot
Aren’t a lot of top athletes into therapies related to this?

~~~
gherkinnn
Top athletes of all sorts seem to try treatments that aren’t scientifically
proven to actually work and yet they continue being employed.

Compression, dry needling, tape, and so on. And despite scientists rolling
their eyes, the athletes seem happy.

As am I. And quite frankly, that’s good enough for me. Though I won’t claim
it’s not placebo. And I won’t claim it will work for everybody.

In sports where there’s little to no money to be made, you’ll find even more
of these anecdotes. It’s quite amusing, really.

------
myth_drannon
One of the popular alternative cerebral palsy therapies that is called ABR
which also works on trying to improve fascia.

------
shrthnd
Makes me think of the practice of "silk reeling."

Edit: pithiness

------
magwa101
Top top top athletes know how to harness their fascia for "super" human
strength. Bruce Lee and the 1" punch is the best example.

~~~
yorwba
[https://www.popularmechanics.com/science/health/a3093/the-
sc...](https://www.popularmechanics.com/science/health/a3093/the-science-of-
bruce-lees-one-inch-punch-16814527/) suggests that the one-inch punch is
enabled by simultaneously releasing energy from multiple muscles, all
contributing to the movement of the fist. What do fascia have to do with that?

------
bobowzki
This article and discussion is just packed with pseudoscience. Not what I was
expecting at hackernews. What does "releasing the fascia" even mean?

I'm an MD, I have performed a lot of dissections of and through fascias. It's
absolutely interesting, there's A LOT we don't now. Let's not reduce the
complexity to "releasing the fascia".

~~~
tomhoward
> It's absolutely interesting, there's A LOT we don't [k]now

Thanks for conceding that, as a mainstream medical professional.

But maybe give people a break.

Given that there's a lot we don't know, it's fair enough for laypeople to talk
about it in fuzzy terms and use metaphors that make sense to them, until your
profession has more detailed knowledge to share.

As one of the many people who has suffered severe pain and debilitating
illness for many years, which has not responded to conventional medical
treatment but has responded in interesting ways to various practices that
purport to address problems with the fascia, I appeal to you to dial down the
know-all attitude and be part of a good-faith discussion from which we can all
learn and benefit.

EDIT: In response to your question “ _What does "releasing the fascia" even
mean?_”, this quote from a recent medical journal paper [1] may suggest an
answer:

 _There are some researchers who suggest strongly that any change in the
viscoelasticity of the fascial system activates the nociceptors.3,12 The
hyaluronic acid becomes adhesive and less lubricated, altering the lines of
forces within the various fascial layers.3 This mechanism could be one of the
causes of articular stiffness and pain in the morning.11 In fact, the
stiffness experienced by some patients when they wake up in the morning could
be related not with the joint but with the fascial system: if there is a minor
quantity of hyaluronic acid or when it is not equally distributed, the tissue
is dehydrated and has less possibility of sliding.3,11,12_

So as I understand it, what people refer to as "releasing the fascia"
describes a mechanism to detach adhesions that form between the fascia layers
due to this reduced viscoelasticity.

I claim no expertise on this topic and cannot vouch for the medical validity
of this paper; I just learn what I can from the material available, and apply
it to my own healing efforts where it may be applicable.

[1]
[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4173815/](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4173815/)

~~~
fnord77
> Thanks for conceding that, as a mainstream medical professional.

when my GF started med school, she was told "half of what we teach you here
will be proven wrong"

I don't think anyone in the medical profession actually thinks they know
everything or that a lot is unknown.

~~~
tomhoward
No doubt! Given this, it'd be much better if my parent commenter had brought
that kind of humility and a spirit of acceptance and constructiveness to the
discussion.

~~~
bobowzki
Sorry if I sounded unnecessarily hard, that wasn't my intention. Another
commenter mentioned that 50% of what we learn in med school is wrong, I'd say
it's probably much higher than 50%.

------
WaitWaitWha
Where is the BEEF?

Any surgeon or occupational therapist can talk about fascia for hours. There
is nothing new in this article that has not been known for decades if not
centuries. (search Scholar pre-1700 and there are plenty talking about
fascia.)

To draw a parallel, it is like writing an article about using bank debit
cards, instead of writing checks. Or, dealing with an automated teller machine
instead walking into a bank to get cash.

------
thimkerbell
I see much speculation in this article, but no actual evidence-based
understanding.

~~~
kingkawn
speculation is how we choose what to evidence to look for

~~~
DoingIsLearning
The problem is not choice but a lack of evidence.

~~~
tomhoward
A significant portion of the article is literally about painstaking work that
is being done to start building a body of evidence.

Anecdote and informal observation has always been, and must necessarily be, a
prior stage to formal evidence-gathering.

That the evidence-gathering is only starting to happen now indicates nothing
about what the outcomes may be.

But the fact that there continue to be vast numbers of people suffering
"mystery" and "incurable" illnesses means there really needs to be far more of
this kind of observation and early-stage evidence gathering.

I'd invite you to do some reflecting on what motivates you to be so dismissive
of research that could turn out to have huge benefits for huge numbers of
people.

