I have just returned from Manchester after attending the 1st international conference on myofascial pain to be held in Britain. It was intense yet incredibly stimulating as it is not often you see this calibre of international soft tissue pain experts together in one room. The main subject was FASCIA – a part of the human body that has often been over looked by many professions, however growing evidence suggest that it may hold the answers as to why some people experience chronic pain. We all know someone who is stuck in a chronic pain cycle – “my dodgy hip” or “my knee is playing up again”.
When I explain to my patients what fascia is, I use the example of the white film encasing and running between the segments of a piece of red meat – that is in fact fascia. Fascia is a seamless web of connective tissue that covers and connects the muscles, organs, and skeletal structures in our body. For many years anatomists have sliced through this external covering to see the muscles and organs beneath, it is now recognised that this fascial covering is incredibly important as it forms part of the tensile connection between your muscles, nerves and even organs. This fascial network, has a key role in transmitting force throughout the body and is what connects your head to your heel! So for example when you contract your stomach muscles the fascia tightens and you feel a whole network of other muscles contracting in your back, sides and even hips.
We had the privilege of listening to Prof. S. Mense’s review his current research, he is considered a world authority on muscle pain and has published over 180 scientific articles. More recently his work has taken him to fascia as a generator of pain. Identifying that the free nerve endings within fascia may play a key role in chronic pain. For years people have looked to joints, tendons, muscles as being the main source of musculoskeletal pain and fascia as a pain free structure that could only cause restriction and lack of flexibility. Now we know that this is not true. This knowledge should improve patient care and the quality of life of many pain suffers.
I have started to implement fascial treatment into my practice with good results, a patient who attended with tennis elbow, who had tried other therapies, found great relief from a handful of treatments. We treated not only the area of pain but also the fascial network from hand to upper back on both sides not just the symptomatic side. Also the results have been evident with patients suffering from plantar fascitis, by treating the fascia network from the foot to the base of the skull, rather than just the foot, the results have been really positive. Again with my hip pain patients where pain is not only from the osteoarthritic joint, but also the surrounding soft tissues, releasing the full fascial network resulted in a reduction of pain and increased mobility.
I realise this may not excite many of you, but for myself what was so interesting about the conference was the science and grounded research that was being presented and then how this can be applied in clinical practice. Enabling us as clinicians we can start to assess and treat people for restrictions and pain within their fascia. Needless to say I am starting an exciting journey with fascia…