Fantastic Fascia and how to help it age!

A question for you: are you keeping your fascia flexible and doing all you can to help it age well? If you’re thinking ‘Susan, what IS fascia?’ don’t worry. That’s exactly where I was a few months ago. But I’ve been busy learning more about this fascinating connective tissue – pronounced ‘fasha’ - that supports pretty much everything inside our bodies: muscles, tendons, ligaments, tissues, organs, nerves, joints and bones. I’m certainly not an expert and I’d love to know your experiences of helping your fascia age well. Comments below, as always.

I talked to midlife women’s strength and fitness trainer Sarah Best about fascia and she had a great metaphor, ‘Think of it like a spiderman suit,’ she said. ‘It covers the whole body and moves when we move. But with age, stress and a sedentary lifestyle, it stiffens up. We need to manipulate it to keep it moving.’

Galen of Pergamon, the prolific Ancient Roman physician known as the father of modern medicine, first named fascia. But for centuries this white, stringy tissue was discarded as an unnecessary impediment during dissections of the human body. Nineteenth century British surgeon Erasmus Wilson valued it more, describing it as a natural bandage.

HOW IT WORKS

In recent years this ‘natural bandage’ has been linked to immune function, menopause, inflammation and ageing. It contains hundreds of millions of nerve endings connecting body and brain: when it stiffens and hardens this can lead to chronic pain. When we say ‘my knee’s sore’, what we could really be saying is ‘the fascia around my knee is sore’.

Fascia both causes inflammation when it stiffens, and responses to inflammation by stiffening, creating a vicious circle as we age.

In a healthy state, fascia is spongey and moist, keeping our bodies lubricated, and acting like a shock absorber. Between each layer is a liquid called hyaluronan which helps fascia glide and stretch when we move (if you’ve ever bought a moisturiser or serum containing hyaluronic acid, it’s the same stuff). When this dries out, fascia stiffens and causes us pain. It also responds to hormone levels, particularly oestrogen, which helps keep fascia flexible. When oestrogen levels decline at menopause, fascia is more likely to stiffen up. This may explain why women are more likely to suffer myofascial pain.

FASCIA AND THE IMMUNE SYSTEM

The immune system makes use of fascia to support our health. Channels carrying lymph (a clear liquid which provides nutrients to cells and sweeps away viruses and bacteria) run through fascia. When it’s healthy and spongey, lymph can move easily. When fascia is stiff and hard, lymph is blocked, our immune system is impaired and less able to fight inflammation. Harvard medical professor, Helene Langevin, described fascia as ‘the home of the immune system’. She started her career studying acupuncture, and the concept of the chi/qi energy meridians in Traditional Chinese Medicine parallels the lines of fascia running across the body.

MYOFASCIAL PAIN

For many people, fascia is associated with myofascial pain and/or the debilitating condition plantar fasciitis. Myofascial pain syndrome is a localised chronic condition caused by inflammation - it affects muscles and the fascia around them. It’s estimated that up to 85% of us will experience it at some time. Pain and stiffness, knots in muscles and reduced range of motion are all symptoms. It’s often underdiagnosed and overlooked and can also impact sleep and mood.

Plantar fasciitis is the painful inflammation of the thick fascia that runs the length of our feet which we use with every step. It can cause shooting pains in the heel, particularly first thing in the morning when we get up. There are lots of causes: I know too much walking in the wrong shoes (when will I ever learn?) causes my feet to tighten up and get sore. I found some good exercises on an NHS website here to stretch out my feet.

HOW TO STRETCH YOUR FASCIA

Fascia stays flexible when we move it. Walking – our favourite type of movement! – is a rhythmic exercise which helps keep fascia elastic. And if you’ve ever used a foam roller in the gym or at home, then you’re working your fascia. Sarah Best suggests active stretches like folding from the waist while cradling your arms, threading the needle and ‘cat & cow’ on all fours to keep fascia lubricated. Five minutes before bed is enough to make a difference.

In my research, I’ve learnt that working our fascia to release it doesn’t involve stretching our body to it’s furthest limits. Quite the opposite, in fact. Fascia release relies on contraction in a process known as pandiculation. When we contract muscle, and then release it under tension by adding compression, our fascia is released. Look at the photo above – it appears that I’m stretching the left side of my neck because that’s elongated. But I’m actually working on the fascia in the right side of my neck which is contracted. I’m trying to straighten my neck but my hand is putting it under tension because my head is pushing into it. So I’m keeping the fascia contracted as I straighten up. I'll post a video on our Instagram @agewellproject soon.

I took a short course called the Two-Week Fascia Miracle – it’s 15 minutes a day for two weeks -  via the Daily Om platform. I’m not sure I’d describe it as a miracle, but I do feel lighter and looser when I’ve done the exercises. The instructor is called Erin Tietz. She has a YouTube channel, alliteratively called Fascia Fix, with lots of free exercises if you want to give it a try.