FASCIAL ADHESIONS

Have you ever tried to watch a movie from the front row? Difficult isn’t it.  Miserable as well.  Today’s Medical education, with its huge emphasis on technology, can be a lot like watching a movie from the front row.

Because the practice of medicine is predicated on taking the body and dividing it, subdividing it, and dividing it some more, it tends to give student doctors a “front row” perspective of anatomy and physiology.  Think about it; we have kidney specialists (nephrologists), heart specialists (cardiologists), nerve specialists (neurologists), butt specialists (proctologists), muscle and joint specialists (orthopedists), stomach specialists (gastroenterologists) etc, etc, etc, etc, etc.

Unfortunately, this model is out of date.   It fails miserably as far as really advancing our understanding of the human body because you never really get to see the big picture.  For one, it cannot explain how the whole organism is greater than the sum of its individual parts.  What do I mean by this?  For instance, Hydrogen (an explosive gas) + Oxygen (a flammable gas) = Water (H2O), a liquid — the foundation of all life — that is used to quench fire.

The problem with using outdated models that “reduce” and subdivide the human body into increasingly smaller parts is that the big picture is frequently missed — spend some time on our “Blog Roll” (right margin) and you’ll quickly understand what I mean.  The movie ends without the student doctor ever moving from the front row.  And unless doctors are willing to step outside of “the box” of their formal educational model (something they are encouraged not to do), the “Big Picture” is rarely grasped.

Doctors use this same philosophy and thought process when trying to explain the musculoskeletal system.  Fascia is one of the best examples that I can think of concerning this phenomenon.  Doctors frequently miss the forest for the trees because the books they learned from (that were themselves written by other doctors trained with the same reductionist philosophy) show hundreds of pictures of individual muscles —- without ever showing or explaining the fascia.

Go to virtually any anatomy text book and take a look. The fascia is almost always removed so that we can see the really “important” stuff.   But never forget that removed = ignored.  And after all; if the medical text books are not talking about fascia, showing us lots of pictures of fascia, or explaining how fascia works; exactly how important can it really be? 

Because the illustrator for the famous textbook (Henry VanDyke Carter) left the fascia intact in a large number of his drawings, is the big reason that most of the anatomical images on my site come from Gray’s Anatomy.  Even though the first edition of his renowned textbook was written over 155 years ago, Henry Gray is still considered one of the greatest anatomists the world has ever seen.

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fWHAT IS FASCIA?

Fasciae (plural) are the tough layers of fibrous, collagen-based connective tissues that permeate the human body.  If you are a deer hunter, you have seen fascia and know what it is. It is the thin, white, cellophane-like, membrane that wraps itself tightly around the muscles. Around here folks call it “Striffin” or “Silver Skin“.  But there is far more to fascia than what is readily observed while butchering.

Fascia surrounds individual muscles, muscle bundles within individual muscles, groups of muscles, blood vessels, and nerves.  It binds these structures together in much the same manner that plastic wrap is used to hold the contents of your Hoagie together. Fascia consists of several extremely thin layers, and is the tissue where the musculoskeletal system, circulatory system, and nervous system all converge. It extends from the top of the head to the tip of the toes, and like ligaments and tendons, contains closely packed bundles of wavy collagen fibers that line up in an organized and parallel fashion (PICTURES HERE).  Subsequently, healthy fasciae are flexible tissues that are able to resist great tensile forces.  Unhealthy fascia?  We’ll get to that shortly.

Fascia forms a whole-body, continuous, 3-D matrix of structural support. Its connections extend to all fibrous (elastic) connective tissues, including APONEUROSIS, LIGAMENTS, TENDONS, RETINACULUM, joint capsules, organ and blood vessel sheaths, the epineurium (nerve sheaths), the meninges (spinal cord sheaths), the periosteum (sheath that surrounds bones), as well as the membranes that surround MUSCLES.

Among the different kinds of tissues that are involved in the body’s “elastic” framework (chiefly ligaments, tendons, muscles, etc); fascia has received the least scientific attention – probably because in most regions of the body it cannot be imaged with even the most technologically advanced imaging techniques such as MRI (hey, out of sight, out of mind). Nevertheless, fascia plays a major (albeit poorly understood) role in joint stability / instability, PROPRIOCEPTION, coordination, strength, joint motion, as well as PAIN SYNDROMES of all kinds. It can even be involved in DISEASE PROCESSES.

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Critical Functions of Healthy Fascia:

  • It binds and holds muscles together compactly.
  • It ensures proper alignment of the muscle fibers, blood vessels, nerves, and other tissues within the muscle itself.
  • It transmits forces and loads evenly throughout the entire muscle.
  • It creates a uniformly smooth surface that essentially “lubricatesthe various surfaces that come in contact with each other during movement.
  • It allows the muscle to change shape as they lengthen or shorten.

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Fascia

I included this picture of the “Groin Region” from Gray’s Anatomy to show you just how much fascia there is in the groin.

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Collagen

Collagen is the building block of all connective tissues. Some collagen-based connective tissues like bone and most cartilages, are part of your body’s load-bearing framework. Their purpose is to withstand compressive forces, while grossly maintaining the body’s shape.

Collagen’s Triple Helix Structure by User Vossman

On the other hand, you have the Elastic, Collagen-Based, Connective Tissues, whose chief job is to resist the tensile forces that are constantly trying to pull joints apart whenever movement or muscle contraction takes place. These tissues don’t need to be able to bear heavy loads, but instead, must be able to stretch and elast (at least to a slight degree) while resisting tearing. Of these “elastic” collagen-based connective tissues, fascia is the most elastic.

As long as the individual collagen fibers that make up the fascia, are aligned in parallel fashion to each other, the tissue is stretchy and elastic (think about long hair that has been combed out. If you run a comb or brush through it, it glides — smoothly and unrestricted.) But what happens when fascia is injured?

When fascia is stretched beyond its normal load-bearing capacity, it begins to tear. Bear in mind that these tears are so microscopic that they never show up on an x-ray, and only on rare occasions will they show up on an MRI (possibly in the Plantar Fascia on the bottom of the foot). Fascial tears can be caused by sports injuries, repetitive trauma, car wrecks, postural distortions, falls, child bearing, abuse, etc, etc, etc. Oftentimes people have no idea how they ended up with Fascial Injuries, which often result in Fascial Adhesions.

Whenever a muscle is impacted (contact sports, falls, abuse, etc) or overused / injured (lifting weights, running, over-training, heavy or repetitive jobs, etc), collagen microfibers form in between adjacent layers of fascia to bind them together so that the muscles can heal.  These microfibers are sort of like nature’s internal cast. 

Unfortunately, these “casts” do not automatically go away after the area has healed, and they tend to accumulate over time.  This means that over time, the elastic, collagen-based tissues (particularly muscles and fascia) get increasingly stiffer and less stretchy.  If you are over the age of 35 or 40, you realize this all too well!

Think of the collagen found in fascia in terms of a Slinky.  In normal collagen, there are waves.  A slinky is no different.  The coils of a slinky act like waves and give it the ability to elast and stretch in response to tensile forces.  As long as the load is not too great to overcome the tissue’s tensile strength, it can spring back —- and things are peachy.


However, if the most elastic of the collagen-based tissue (fascia) is forced to resist more tension than it can handle, tissue failure begins to occur.  The tissue increasingly loses its ability to stretch and elast.  Think of this as a slinky that has been stretched out to the point of failure.  The material has not necessarily broken, but it has been stretched far enough that it is not going to “spring” back like it should.  This leads to tangles, which is a whole other problem unto itself.  We have all experienced a mangled Slinky before.  This is similar to a Fascial Adhesion!

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FASCIAL ADHESIONS

UP CLOSE & PERSONAL

Bottom Line: If something causes fascia to exceed its normal tensile capacity, there will be a disruption or “micro-tearing” of individual collagen fibers.  This in turn leads to fascial “scarring” and adhesion / restriction.

Think of fascial scarring in another way.  Put both of your hands flat on a table in front of you, and slide the fingers of one hand back and forth between the fingers of the other.  This is similar to the way fascia works, and is what gives all of the elastic connective tissues including fascia, ligaments, tendons, etc, an incredible amount of stretchiness and flexibility.  Normally functioning fascial membranes are not only arranged in a very organized and parallel manner, but if you were to look at them on edge, they are flat and smooth —- like a piece of paper.

Once fascia is injured (stretched, pulled, torn, etc.), the microscopic fibers become disrupted and deranged.   Instead of fibers running parallel to each other in an organized fashion with their normal degree of elasticity / flexibility, the fibers now run every possible direction in all three dimensions and have an extremely diminished amount of organization and elasticity.  Interlock the fingers from one hand with the fingers from the other, only now do it with the fingers pointed in all directions.  Now try to slide the hands back and forth.  See the difference in flexibility?

Also notice that when the fingers are interlocked randomly, they will no longer lay flat on the table.  Facial Adhesions act in much the same way.  When fascia is injured, individual fibers run every which direction, in all three dimensions.  This means that the fascial membranes no longer lay flat like a piece of paper.  Instead, they are more like a wadded up or crumpled piece of paper.  Unfortunately, injured fascia frequently heals in this tangled, twisted, and wadded-up manner.

We can also think of this fascial scarring and adhesion in terms of hair. Remember our example of well-manicured hair that a comb or brush glides through easily? Now think of the exact opposite. Think of a hair tangle. What happens to hair that is not well taken care of, or was slept on wet? Instead of the individual hair follicles lying parallel to each other in a neat and orderly fashion, they become tangled with the individual hair fibers running in every conceivable direction. The result is a tangled mess —— a ball of hair that takes forever just get a comb or brush through it. “Hair balls” can be so restrictive that just trying to get a comb through it, pulls and causes great pain.  This is even more true with fascia.  Most people are unaware that……..

FASCIA IS THOUGHT TO BE THE SINGLE MOST PAIN-SENSITIVE TISSUE IN THE ENTIRE BODY

When the organization of the parallel collagen fibers of fascia are disrupted by injury, a host of really bad things begin to happen. The first thing that occurs is restriction of joint motion. Understand that if you have tissue restriction, you will automatically have some degree of loss of normal joint motion in the corresponding area(s) of the body. Also understand that loss of normal joint motion virtually assures you that sooner or later there will be pain —- even if you are not yet experiencing pain. Unfortunately, pain is not the only thing associated with loss of normal joint motion.  One of the biggies is degeneration.

Loss of, or abnormal joint motion, is the known cause of localized joint degeneration. When I speak of localized joint degeneration, I am talking about things like calcium deposits, bone spurring, and loss of articular cartilage or disc height.  Degeneration is a great example of a “vicious cycle“: Loss of joint motion causes joint degeneration —– and joint degeneration causes loss of normal joint motion. Repeat. As this cycle spins around and around, it causes pain.

STOP! Think for just a moment. Pain is frequently nothing more than a by-product of the vicious cycle. This is why pain pills and other similar measures (drugs), mask symptoms of Chronic Pain (ineffectively, I might add) without ever addressing its underlying cause.  And on top of this, some of the most popular musculo-skeletal drugs (corticosteroids for instance) actually increase the degenerative effect.  In many cases of Chronic Pain, the underlying cause is Subluxation, Fascial Restriction, and microscopic Scar Tissue.

Think for a moment how problematic this whole scenario is. Fascia is the single most pain-sensitive tissue in the body —— yet it does not image well with even the most advanced imaging technologies such as MRI! What does this mean? Those of you who have dealt with Chronic Pain long enough, know exactly what it means!

It means that when you go visit various doctors (orthopedists, pain specialists, neurologists, etc) they run all sorts of tests, and then look at you as though you are crazy. Or maybe they look at you like you’re a drug seeker, or trying to get Social Security Disability.  Or maybe they just chalk it up to hard work and too many sports.  Or maybe they just tell you that you have “arthritis” or “Fibromyalgia” just to get you out of their office.  Or maybe they used that old and trusted standby, “After all Mrs. Smith, you just aren’t as young as you used to be.

Whatever the case, the result is almost always the same. A blank stare and the recommendation for more pills —- or maybe even Corticosteroid Injections The latest trend for Chronic Pain patients involves putting them on SSRI’s (anti-depression drugs) while trying to convince them that their Chronic Pain is the result of Clinical Depression; when just the opposite has been proven to be closer to the truth.  (Chronic Pain is far more likely to cause Depression than the opposite).

Oh, and how about your doctor kick you a few more times while you are down.   Scientific studies have repeatedly shown that beyond the wide array of side-effects to the kidney, liver, and heart; both NSAIDS, and cortico-steroids actually deteriorate collagen-based tissues —– severely and rapidly.  This is why doctors will ration the amount of cortisone you can have, even if it helps your pain.

The Journal of Bone and Joint Surgery published a study over a decade ago that said if a person has more than one cortico-steroid injection in the same joint, over the course of their lifetime, their chance of developing premature deterioration of the affected joint is (gulp) 100%.

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EFFECTIVELY HANDLING FASCIAL ADHESIONS

The question always comes up, “If fascia cannot be imaged with advanced techniques such as MRI, how in the world does a chiropractor from the rural Ozark region of southern Missouri image it?”  Plainly stated; I don’t.  I examine the areas that I believe to be affected by Fascial Adhesions (15 years of experience has helped me know what to look for), and I start treating.  Every year I get more proficient at knowing what to look for, finding it, and fixing it.  What am I using to fix it?  Glad you asked. 

I use something that I call I.I.R.E.C-B.C.T. (Instrument Induced Remodeling of the Elastic, Collagen-Based Connective Tissues).  In the office, I simply call it “Tissue Remodeling”.

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WARNING

BRUISING AHEAD

Because our “Tissue Remodeling Treatment” consists of actually breaking the Fascial Adhesions and subsequent tissue restrictions that cause so many symptoms, there is often some bruising associated with the technique. Microscopic scarring is dense, inelastic, random, and unorganized tissue —– not what anyone really wants.  If you have been paying attention, you are aware that scar tissue is not exactly an “optimum” situation.  Nonetheless, scars (even the microscopic kind) are living tissue with a blood supply.

This means that when I “break” the adhesion, I also break the blood supply.  There will be some internal leaking of red blood cells from the scar’s capillary bed into the surrounding tissue. Please don’t panic.  In plain English, this means that you will have a bruise. When I break Fascial Adhesions, it is not uncommon that this bruising can be really really (really)ugly. Don’t worry — it really is OK.  See our BRUISING & PICTURES PAGE. You can also visit our VIDEO TESTIMONIAL PAGE as well. 

Although there are people out there doing similar things, I have yet to find anyone doing things quite like I am doing. This is why our results (click on the link above) are so radically different than those that most others are getting.


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CONCLUSION

Fascia is the fabric that it woven throughout every part of our body to hold us together.  Perpetually disregarded by the medical community as “unimportant” (hey, after all it does not show up on MRI’s), fascia is beginning to take its rightful place at the forefront of both cutting-edge medical research and cutting-edge treatment (particularly in the field of Sports Injuries and Chronic Pain Syndromes).  It should!  Fascia is arguably the most prevalent tissue in the body. 

Other than the nerve system, is there another body system that connects the distant parts of the body together in such an intimate manner?  I say no!  Fascia covers the body from the top of the head (Epicranial Aponeurosis) to the bottom of the feet (Plantar Fascia), and everything in between. 

When there is a tightening or restriction of the fascia in one place, it can cause pain and dysfunction in distant and seemingly unrelated locations.  And the kicker is that problems in the fasciae not only cause pain, they cause the nerve system to misfire.  As you can imagine, the problems associated with a misfiring nerve system are many and potentially severe. 

also be aware that what is true about fascia is true about the other Elastic, Collagen-Based Connective Tissues as well.  Yes, ligaments are injured and respond to treatment in a similar manner to fascia. We also know from medical research that an almost identical tissue model can be applied for the treatment and healing process of people dealing with certain tendon issues as well.  This is good news because tendon problems are a leading reason for musculo-skeletal doctor visits —- and Chronic Pain.

TENDINITIS, TENDINOSIS, & TENDINOPATHIES

63 responses to “FASCIAL ADHESIONS

  1. SUE GOODMAN

    Dr Russ,
    Please can you tell me is fascia tough?
    if it is torn in half can it repair its self or would you need surgery, the fascia down the middle of your back in the thoracic area the fascia that goes down covering your spine?

  2. Trace Maltsberger

    I am mainly right handed but use my left when my right is out of commission. I also have double jointed thumbs. Lately, my right shoulder down to my elbow down to my fingers has been very painful to move. I went to the doctor and he told me that I have just worn out my arm. I have been a gardener all my life. I am 50 yrs of age and garden on the weekends. I refuse to believe that. Where do I start to find out what is really wrong?

  3. Chios Cheney

    After a extremely jerking traumatic fall off our cruising sailboat,in which I over stretched my arms, abdomen Rt. Leg and especially lower back and sacroiliac area I am having myofascial pain syndrome problems as you describe to the “T”. Also have muscle knots in which I have been treated
    by trigger point injections for past 7 yrs. Probably at least 500 injections overall. One year after fall I had a ruptured disc L-4-L5 fixed with a discectomy and have a couple more bulging discs in the lumbar area.
    Presently am experiencing the tightness and taught bands as you describe. Am constantly using balls,foam rollers,hard surfaces etc., to get some relief.
    Am retired X-Ray tech. And Ultrasonographer. Much research and diagnosing of muscles being done in Ultrasound right now but have not seen articles in journals on myofascial issues. Only MRI elastography seems to have some promise,but this is still in the research phase. Used primarily for organ fibrosis especially in cirrhosis of the liver and tumor
    Rigidly. Hopefully will also be able to tell fascial stiffness or tightening too.
    Mayo Clinic doing a lot of the work .
    My questions to you are: Am I doing more damage to fascia with pressure Thx.? Does this seem to be a familial problem? Finally does stress and
    Elevated cortisol and the consequential biochemical cascade effect this
    Syndrome? I’ve been told to do Yoga and maybe biofeedback may help.
    Also does multiple needling in the stiff tissue-possibly bring some blood perfusion to thickened fascia.

    Chris.
    From Michigan,USA

    • Hello Chios,

      Pressure on the Fascia as a form of treatment has been around just about as long as the human race. The needling technique you are describing here (“Dry Needling”) helps many people. And finally, ADRENAL FATIGUE does not do any favors to anyone or any healing process. Make sure you check out TODAY’S POST, as it has application to your question.

  4. Sarah

    2 weeks ago I started getting sharp shooting pains in my arm, the front bicep area, when I move my arm out to the side. I rested, iced for about a week with no improvement. Went to the doctors, they said it was most likely tendonitis in my shoulder and gave me a shot of cortisone. That made the pain worse. Now its five days after the shot and the pain is still the same sharp shooting in my arm. Someone mentioned it may have to do with the fascia. How would you know if it was fascia vs tendonitis?

    • Honestly Sarah,

      Sometimes I do not know. Also, it is common that people have both. The cool thing is, since these two tissues are extremely similar to each other, I treat them both in similar fashion. It is not really important to be able to exactly differentiate the two.

      Sincerely,
      Dr. Russ

  5. Judy Burridge

    I had L5-S1 fusion, disctectomy. My surgeon said that I didn’t have the fascia that connects the muscle to the bone, so they had to tear it off to operate. Help me please. 6 months post op, and having problems with no answers. December 3/2014 was surgery date, Dr. A. Woo was my ortho surgeon.. From Saskatoon, Saskatchewan.

  6. Andrea

    I had spinal surgery 21 yrs ago for scoliosis repair with fusion(T12 – L2/3) & I have now suffered with chronic low back pain for 20yrs. Loads of pain at L2/3, down side & back of right leg with huge pain directly next to shin bone of same leg. My right SI joint will not stay where it should and causes me massive grief. All I can say I wish I could see you Dr. Schierling. Dr’s in Australia give me the blank stare & I’ve tried everything & I’m also on disability & on meds 24/7 just to keep me upright. This site tells alot.

    • Hello Andrea,

      Thank you for your comment. Trust me when I tell you that the “blank stare” issue is not confined to Australia, America, or any other country. It is extremely widespread.

      Sincerely,
      Dr. Russ

  7. Emm

    25 years with a problem that remains undiagnosed after many doctor visits. I have been told to learn to live with it and take more depression medication by doctors who do not understand my symptoms. I have constant pulling, spasming, groin pain on the left side. It also pulls internally on that side and if I let, it the left side of my mouth joins in and strongly pulls in rhythmically. I also have nerve electrical type sensations in the sole of my left foot. I have scarring from an episeotomy on the left after childbirth 40 years ago. The muscle at the top of my left leg is tight. I also sometimes feel a sharp stinging pain on the left internally in the gynaecological area and sometimes in the bowel.
    The doctors say that there is no known link between the areas that I have mentioned.
    Does this all sound like fascial scarring? I am in the UK.
    Kind Regards
    Emm

    • Hello Emm,

      All I can say is ‘wow’. I have never heard anything quite like this before. The pulling from the mouth is particularly interesting. As you what this could be, I would be amiss to tell you that I have any real idea. Fascia acts as a second nervous system (HERE). One of the problems with some Fascial Adhesions is that there is almost no way to get to them. I wish I could offer you something better. I would consider seeking out a Functional Neurologist trained by Dr. Ted Carrick.

      Sincerely,
      Dr. Russ

  8. Lyn

    Could you give me your opinion. My son was a very fast sprinter, football player, and could build muscle mass very quickly. He has very large bones and was easily the strongest kid in school entering high school (absolutely no steroid use!). He started experiencing extremely tight hamstrings when he ran and had to give up track. He went to several doctors that prescribed just stretching and physical therapy for muscle imbalance. It only got worse. Finally went to an orthopedic doctor and MRI showed extreme bone marrow edema in pelvis. He was on bed rest for 4 months it was so bad. He recovered but pain and tightness happened again as soon as he started athletic activities. Rest again, happened again. Rest again, happened again. We don’t know why this keeps happening. He watched a short video about myofascial release using a cue ball shoved and rolled into his hamstrings. He tried this therapy after he started experiencing a lot of pain again. Almost instant relief which makes me believe it is a problem with his fascia. Are there other treatments to keep this at bay or are there diseases that can cause this.

  9. Robert Mattull

    Hi there, I am a 37 year old male with a burning pain in my left lower side after an appendix removal. I was diagnosed with inner coastal nerve damage and have gone threw 3 shots of nerve block in my back. Back surgery to cut the nerve bundle. And things have only gotten worse! Dose this sound like fascia issue? Please help! Thank you!

  10. SUE GOODMAN

    I am sorry I forgot to ask can muscles, tendons , subcutaneous tissue damage be seen with ultrasound or mri when I said subcutaneous tissue I meant the skin layers including the fascia
    thank you
    Sincerely,

  11. SUE GOODMAN

    please can you tell me my Dr is wanting me to have a scan to look at the fascia and muscles and subcutaneous tissues of my back to look for serious damage , he said he thinks ultrasound ,its the thoracic area it feels like the tissues in side are splitting , can you also tell me where fibrous connective tissue is found what is it, is it fascia ?

  12. Zoya

    Hello Dr. Russ,
    My husband had a surgery “green light” 3 years ago. He is still in severe pain, as a result of the surgery. Could you give us consultation to help?
    Sincerely,
    Zoya.

  13. Rachael Simpson

    Hi Dr.Russ I believe I need the treatment you described badly. I had my gallbladder removed after my first pregnancy which left some sensitivity on the right side and back but I was fully functional. I then had a second pregnancy that ended in a very complicated c section and ended up eight months later with an appendix removal with witch I ended up with peritonitis, a collapsed right lung, severe hemorrhage and an access in my abdomen that had to be drained. Just to note this doctor also cut my psoas muscle right under my ribs to make sure there were no problems behind it. I ended up with severe pain in my SI Joint and from the front through the back and down my spine at about the T6 level. After just about every test and treatment and a surprise third pregnancy and c section they finally concluded that my SI joint was torn and they put a very long screw through my hip and spine to stabilize it. I am now in my fifth month of physical therapy and can walk very well now but I have been told that my lower ribs are actually immobile and the fascia wrapping around my right side is so
    tight it can’t even be pushed in. It is the
    muscle fascia now that is causing me so
    much pain and the therapist has been trying
    multiple manual methods to break it up but we
    have made little progress. I was just thinking
    about trying acupuncture because I don’t
    know what else to do. I am at the point now I
    would do anything to get this fixed and feel
    better. I have been almost immobile for three
    years am 37 years old and have three small children that need me desperately. In reading your article I finally felt like finally someone understands and has a realistic idea of how we might really fix it. If there is anyway I can be part of this therapy it would be worth it. Even if I had to travel. Can you give me more contact information on where to go and how I might go about getting this treatment?

    Thank you for anything you can do.

    Sincerely,

    Rachael Simpson

  14. Hey doc, I know this may be unorthodox, but I found you on the Internet, and believe you may be able to give some insight on my issue. I’m an athlete who suffered some type of bicep injury, but no one locally seems to be able to diagnose. There is in fact a deviation in my bicep, but there is zero pain, and no brushing or swelling. I have a pic that I sent to your personal Facebook, not the business Facebook, as I could not send a pic to that profile. I can email it as well. Could you please share your thoughts on this? Thank you sir.

  15. Rachel

    I am in physical therapy for fascia
    Restriction, I have several lumps, my OD.
    Has been treating me by using his thumb to push the lumps back through the fascia. My left hip and actually my whole left leg is affected. My left knee is extremely painful. I had an exray of my hip which showed only mild osteo arthritis. Even with pt I am in extreme pain, can barely walk orove my left leg. My bands of muscle through my left leg restrict
    My movement severely and cause extreme pain. Would your treatment be more productive
    For me?

  16. Julia

    Hi Doc Schierling!
    Thanks for your website! I have already heard a lot about the importance of fascial tissue but your article really puts it straight!
    I have a question:
    Do you think a tendinosis can be the reason for the swelling of a whole joint. In my case, it is the knee.
    I am a professional tennisplayer, suffering from pain in the back of my knee starting a year ago. It started with stiffness in the morning, but after a good warm up I was able to play without any pain but at some point i was feeling it on court, so i had to stop and rest.
    The pain showed up irregularly for the next time. MRI no diagnosis.
    I remember doing leg curls on a gym ball and ultimately my knee got swollen.
    Another MRI showed that there was nothing wrong regarding the knee.
    I was more or less treated for an IT Band Syndrome, whereas I do now think it has much more to do with the Hamstring tendons. Still i got a lot of bruises on my IT-Band..
    The swelling got away, it took a while though. I worked a lot on my core stability and my strenght got much better. It took me more a less 6 months to start to play again.
    The only time i still felt pain in the back of my knee was when i was accelerating, e.g. sprinting from the baseline to get a drop shot (i felt it not right from the beginning but after 2-3m, so I have to stop). I sometimes feel stiff the next day when i was training a lot. But foam rolling is a big help. Apart from that and the sprinting i felt okay!
    More suspect for me is now that after competing in a tournament, my knee got swollen again !
    Thats why I wanted to ask you: I was reading your other arcticle as well..
    What do you think of all this, are these signs for a tendinosis? And what about the swelling? Is there a connection or are there other things that should be considered?
    The last time it was swollen, the MRI did not show anything regarding the knee and also the doctors were running bloodtests, analysed the liquid in the knee, etc. so it should not be systemic.

    Thanks a lot!
    Julia
    Germany

  17. sue Goodman

    I have fibrous connective tissue , collagen ,and adipose cells coming out of an oral fluid all of the time , I have had acupuncture to my scalp and my scalp has a fluid movement over time the fluid has come into the oral cavity
    I don’t know what has happened the fluid is gel -like its awful can you help me this isn’t right is it who can I turn to

  18. Bianca

    Terrific article! I have Ehlers-Danlos Syndrome (Classical) and live in Australia. I had to self diagnose to get some answers, as I saw specialist after specialist who just didn’t look at the ‘big picture’ and therefore completely missed the underlying issue! My mother and sister too have EDS. Have you had much experience with any EDS patients and fascia issues?

  19. Anna D

    I believe that I have Duputren’s Disease. This is seems to fit your conception of adhesions on the fascia. I have the adhesions in more than the normal places discussed in most of the literature and websites. In addition to the adhesions, the fascia or tendons in the region are very stiff. I wake up in the morning with one hand in a fist and the other hand will not fully make a fist. Also having some problems on the back of my hand – stiffness and pain and wondering if it is also some problem with the fascia (do not feel adhesions on the back of the hand). BTW I have none of the pre-existing conditions for Duputren’s.

  20. Cynthia

    Wow! I have been suffering for several years with what I have described as muscle knotting. It is painful and will show up almost anywhere on my body anywherefrom pea size to softball size. I have been to many doctors my primary physician has labeled it chronic pain syndrome the rhuemotologist told me I have fibromalgia until I showed up the day after I had a knot on my shin which could still be felt (not as much as day before). She exclaimed “oh…you do not have fibromalgia…I m not sure what you have but its not fibromalgia” She the then sent me for a series of blood tests and never came up with any answers. Prednisone seems to help make it tolorable but my no means is it good. I have also had 2 surgeries where the have removed “fibrous banding” from collar bone area and my elbow I have severe atrophy and nerve damage to my hand. I say this is all related…which none of them will even give a second thought to. Your article is the most relatable thing I have ever read. Where are you located?

  21. Nicola Andrews

    Hi I have pain in my glut region which is unexplainable and a have recently started breaking out in unexplained bruised to the right of my knees, and on the outerside of shin near my ankle. Could this be the result of fascia damage?

    I found your article extremely interesting.
    Nicola Australia

  22. Mary McCoy

    In March of this year I contracted necrotizing fasciitis internally, in the left side of my neck.
    I also got sepsis and bactaremia systemically. I now have pain throughout my body, especially smaller joints, wrists, elbows, knees, ankles, as well as pain in what I thought of, previous to reading here, as muscles…I believe the information in your article is more accurately explaining the situation. Can these types of illnesses, and/or the high levels of antibiotics administered, and/or the atrophy experienced, be an injury that would affect fascia?

  23. Danita Pate

    After a fall snow skiing 10 years ago…. Trying every therapy possible… 2 surgeries…I am still in chronic pain… Quit my teaching job 2 years ago due to pain. I have read lots about fascia and know and understand this is my problem. It is mainly in my neck…. Pulling and tugging all the time. What can you do to help me? Otherwise I am healthy and happy…. Just so tired of a pain only a few understand.

  24. Trina

    Awesome information. Are there other doctors privy to this meaningful and life-changing information? You should be conducting seminars around the world!

  25. Corey

    Thank you for the write-up! I work with chronic tension as well and there really is an astonishing dearth of formal medical study on the processes involved- I’ve had good luck with Canadian journals in particular, but not too much else. Would you mind terribly posting some of the sources for this post? It fits everything I’ve heard and learned through personal experience, but I’d still love to see who did the research and how.

    Thanks again!

  26. valerii

    I’ve long worked with this issue myself (4 car accidents, arrghghh!!) and am very interested in your approach as i have both found good bodyworkers and developed my own approaches as well. So thank you!! and i will keep reading. But! a quick question: friend just had a slip and fall injury, they thought cracked ribs (and KNOW bruised spleen) but after a week of not seeing rib fractures they went right to very strong physical therapy. His pain level skyrocketed, and my sense is that the original issue is actually fascial tearing. While i understand the micro-adhesions need to be broken and the fascia realigned, this seemed far too soon for me and i believe they are further disrupting needed initial fascial healing. Do you have a timeline as to how long the fascia and systems need to have, to engage their own healing processes, before moving on to the bruising and pain of re-aligning the fascia? I would have said to wait 3 weeks for basic healing (and work gently on range of motion etc) before vigorous massage/PT – what is your experience? Thanks so much!!

    • Honestly Valerii,

      Everyone is so different, it is almost impossible to try and quantify the answer to your question. I look at each person differently and determine their healing capabilities as well as their pain levels, and work from there.

      Sincerely,
      Dr. Russ

  27. Gerald Ardigliano

    I was Rolfed 25 years ago and these 10 sessions ruined my life! I feel like I am in a straight-jacket connected to a vise and have not had any positive changes at all in this time.

  28. Margie Ayers

    It really makes sense. Have had rib pain for months on right side. I’m cancelling the tests the doctor ordered and finding a chiropractor who understands the fascia connection.

  29. I am 29 and i just got diagnosed with having a form of Fascia today. Explains a lot actually. I was beginning to think I would never get any answers. I have been seen by numerous doctors since I was 24 for these issues and nobody had any answers. Thank you for the article it helped a lot.

  30. Rod B

    For 30+ years I have been dealing with chronic aching sensation on my left side that runs from my buttocks down through my knee and often times radiates into my abdomen and groin area, even making it difficult for me to catch a full breath at night. Over the years this sensation has worsened to the extent that my sons and wife stand, and even jump, on my buttocks and leg to provide my only relief (other than Ibuprofene which I prefer not to use on a regular basis). Recently, I visited my chiropractor who told me about the piriformis muscle and possible issues associated with the sciatic nerve. He said there is a possibility that my leg, stomach, abdomen, & groin issues may affected by the piriformis and recommended a few stretching exercises. After reading your web articles and applying pressure with my fist and now softball in the priformis area, I am convinced that this is what I have been dealing with all these years. After applying pressure to this area, amazingly, the sensation in my abdomen stopped, I could breath easily and the aching sensation down my leg disappeared. My mother in Pennsylvania also suffers from similar leg conditions for decades. I now plan to speak with my chiropractor about your treatments to see if he can provide a more permanent solution and I also plan to inform my mother about my findings at your website. I think you may have identified the potential culprits. Thank you so much! Hopeful in Phoenix.

  31. leonie

    I am an Australian, living in Australia, incapacitated by pain, I have learnt more about myself by reading this site, than I have learnt from any other medical practitioner or specialist.
    I now see a ray of light.
    Thankyou for taking the time, energy & compassion to put this site together. People in our situation NEED you.

  32. BEEN LOOKING FOR SOMEONE WHO KNEW JACK BOUT FASIA AND NOBODY LISTENS. i HAVE FIBRO AS MY DAUGHTER AND PRETTY SURE MY SON AND OTHER DAUGHTER DO TOO. bUT IT FEELS LIKE A RUBBER BODY GLOVE THATS WAY TOO TINY ON BACKWARDS AND WITH TIGHT RUBBERBANDS ALL OVER. i ALSO CALL IT A STATE OF PARTIAL RIGIMORTIS BECAUSE i ALSO HAVE HEMACHROMOTOSIS AND i THINK IT HAS EVERYTHING TO DO WITH THE FIBROMYALGIA. i CAN NO LONGER LIFT ANYTHING WITHOUT PAIN. HAVE BULGING AND HERNIATED NECK DISCS. AND ARMS AND HANDS SO STIFF THEY WON’T STRETCH TO THEIR PROPER EXTENT. mY HUBBY SQUEEZES IT SO HARD BUT IT DOESNT BUDGE AND YOU THINK i WOULD BRUISE BUT DO NOT. i DON’T GET IT. i KNOW IRON DEPOSITS ARE UNDER AND BETWEEN THE FASCIA SOMEHOW BUT NOBODY LISTENS AND IT IS OXYGEN STARVED SOMEHOW FROM THE HEMO CUZ THE RED BLOOD CELLS CARRY THE OXYGEN AND IT EITHER GIVES US TOO MUCH OR TOO LITTLE AND IT STRANGLES OR RATHER SUFFOCATES THE FASCIA AND TISSUES CAUSEING THEM TO GET GRAINY AND HARD AND SCARED LIKE YOU ARE SAYING. WOW THANKS

  33. J. Ashford

    Most informative!

  34. Kath Taylor

    This site was the most informative that I came across. It helped me immensely to understand more about Myofascial Pain Syndromes. Now I assist others in our massage class to have a better understanding. Cheers

  35. Reina

    What an informative site! Dr. Russell S. Schierling goes to great lengths to research chronic pain and has been helpful in assisting me find some relief in my hometown of San Jose, CA.
    Thank you!!
    Reina

  36. Brian Denton

    I suffered what I thought was a minor, innocent, hamstring injury in fall of 2007 that just would not get better. I tried several different treatment routines and plans, all with no noticeable improvement. After talking with Dr. Schierling, he told be about the fascia tissue and the problems injuries like mine caused with the fascia. Long story made short, he said he could fix it, so obviously I was game! After two treatments a week or so apart, I noticed SIGNIFICANT improvement in my range of motion and strength capacity. Now, a short two months after the treatments and the follow up recommendations for my “at home” part of the treatment, I am now back to 100% capacity with my leg strength and flexibility. Thank You!

    • Mark W.

      Thank you so much for your website! It really explains the Connective Tissue “Fascia”/Scar Tissue reasons for pain problems so often not known by most practitioners. After years of Doctor Visits, X-Rays, MRI’s (which showed nothing) and Failed Carpal Tunnel Surgery for “Repetitive Strain” pain problems in my Hands & Arms, your website is finally leading me in the right direction. God Bless you from Pittsburgh, PA.

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