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Unfortunately, this model is out of date.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The problem with using outdated models that “reduce” and subdivide the human body into increasingly smaller parts is that the big picture is frequently missed — spend some time on our “Blog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.

f

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.

f

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.

f

f

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.

d

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!

d

d

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%.

f

f

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”.

f

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.


f

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

153 responses to “FASCIAL ADHESIONS

  1. laura

    hello
    I live in Michigan and fear I am so afflicted with this I am dying a slow painful death. I have seen so many doctors Who claim to know whats best for me I could just scream. I have fired them…begged..cried…you cant imagine. Now i am reading your website and find what i feel is my only hope. Could you please tell me if there are other doctors out there in my area who can do this? If not I guess my goal will be to move to where you are. Please save me
    Laura

    • Hello Laura,

      There are any number of practitioners in every state doing similar things, although I don’t know anyone doing quite what I do. Sorry, but I don’t know anyone in your neck of the woods.

      Dr. Russ

  2. Linda

    Dr. Russ,
    At 57, I’ve been told I should no longer be riding horses, and up until 2 weeks ago, I would have vehemently disagreed. However, I was injured when my horse panicked under a bridge and I wound up with severe trauma to my right pelvis area. The pain is excruciating! My doctor has seen me twice for remolding, and the last time the pain had me just screaming. What would be appropriate management, as right now I am worsening. There is burning pain and severe swelling at the initial injury sight, and to be honest, I’m hesitant about going back after the last session. The procedure left me in tears and I don’t normally cry. Help!

    • Hello Linda,

      I’m a fan of horseback riding and have always said that it’s therapeutic until something goes wrong. As for the remodeling, I never remodel an area that is “severely” swollen. It’s difficult for me to give you any meaningful advice not really knowing what your doctor has done.

      Sncerely,
      Dr. Russ

  3. Clare Newman

    Hi there. I received a blow to the side of my knee a few weeks ago while playing sport. My GP said there was no major damage and it was probably a fascial injury. He just prescribed anti-inflammatories. When I apply light pressure at the medial side of my patella, I get a pain shooting right across the front of my knee to the distal side. This does tie in with your article and I wondered if remodelling is appropriate (also would need to find a practicitoner in Australia)

    • Hello Clare,

      The doctor could very well be correct in his assessment that the injury is on the outside of the knee (the Fascia) as opposed to the inside (Ligaments, Cartilage, Bone, etc). The thing to remember is this; most medical interventions (including NSAIDS and Corticosteroid Injections) are exceedingly harsh on multiple body systems. And while Tissue Remodeling might look harsh due to the bruising, it’s worth a try as you can’t really make things worse. In other words, there’s a tremendous upside, with no real downside.

      Sincerely,
      Dr. Russ

  4. Hello Dr. Russ.
    I have had heal pain for 10 months now and have tried physical therapy, cortisone shots, acupuncture, massage therapy, osteopathic manipulation, herbs, poultices etc. The most recent doctor told me I have a heel spur and significant tear in my facia with a thickness of #7+. He suggested a surgical procedure with AMNion injection. Can you please weigh in on this. I’m tired of the pain I can barely walk and need to do something.
    With gratitude,
    Julie

    • Hello Julie,

      Plantar Fasciitis is one thing, but when you start talking about tears in the Fascia, that’s something altogether different. I know they are using Stem Cells for joint problems. The thing is, the PF is not a joint. Simply go to PubMed and look up the studies; then start going around the internet message boards to find people with similar problems who have undergone that tx. With a few hours of research under your belt, you’ll have a better idea of whether or not it’s something you want to do.

      Sincerely,
      Dr. Russ

  5. Jonathan Salgado

    I believe I have damaged fascia on my lower legs because I feel dents when I rub my fingers down my leg. Then when I stretch a certain way, lumps form on those dents. I used to sprain my ankles all the time playing soccer, and some sprains were worse than others. Defects in the fascia? Muscle hernias. When I relax my leg there are no lumps, only the dents which can be felt.

    • Tough to say Jon, but could definitely be some sort of fascial hernia (muscles popping through torn fascia as they are contracted).

      Sincerely,
      Dr. Russ

      • david

        hello Dr Russ- looking for an idea what is wrong with me – have had pain and stiifness on my left side of body from head neck shoulder hip down to underneath my left foot/heal also more sensitive on left side- have had this for 17 years- symptoms before were neck pain and lower back i have been told that my muscles particularly on shoulder are more developed- i also experienced tremors and panic attacks – doctors diagnosed general anxiety disorder- have had scans to eliminate any injuries- my muscles seem to be in a permanent state of being tight- even my left eyeball seems stiff when i move my eye? any ideas- thanks
        simon

      • Hello David / Simon,

        Although Tissue Remodeling might provide a great deal of relief, I would absolutely find a Functional Neurologist trained at the Carrick Institute. If I had a friend, relative, or even a child in your position, this is exactly what I would do.

        Sincerely,
        Dr. Russ

  6. Ann, ,

    Dr Russ,
    Does all fascia repair its self , if the deep fascia in the back tears under the trapezius muscle , could this repair itself if it splits both sides of the spine .
    If fascia tears in the back and an injury to the galea the fascia over the top of the head that didn’t have stitches in at the time could this tear away under the scar .causing it to split

  7. Lisa

    Hi, I had a partial hysterectomy three years ago and the doctor used a laparoscopic robotic devise through four different incisions encircling my belly button.

    In order to use the robot, they had to distend my belly with air. Long story short and about 10 different types of doctors and therapists later, it was recently determined that the bulge in my abdomen, which came after the surgery (probably due to them distending my belly too quickly resulting in a tear), which is contained within the circular set of scars, was no longer due to diastasis recti (becuase I did the proper exercise to heal that), but rather to torn abdominal fascia.

    I was told the only cure was to have it surgically repaired. What do you say and what do you know about John Barnes and myo fascias release therapy?

    I really need some solid advice. Everyone here in NY keeps telling me surgery is the only solution, but I don’t buy it anymore.

    THANKS SO MUCH.

    • Hello Lisa,

      Other than the fact that he is famous, I know nothing about him. Personally though, I would try Barnes before I tried surgery.

      Dr. Russ

      • Ann Shaw

        Dr.Russ, Thanks so much for being a seeker of knowledge, and understanding fascial function and adhesions. I went through one year, of trying to end my lower and upper ab pain, and right pelvis, thigh, groin to ankle pain after lifting and carrying an extremely heavy table.down a ver steep flight of stairs..history prior..but no problems until the table trauma…
        I have had 4 open ab surgeries..including complete hysterectomy, and two hernia repairs..story is .after 8 Drs, CT,a HIDA scan..X-rays. Blood work, 2 pelvic ultrasounds,, colonoscopy endoscopy…and then I self refered and went to a UroGyno..who did an interior exam.and voila. ..Pelvic floor dysfunction related to Myofascial .this disorder ..is treated by a pelvic floor pt…Readers Digest did a feature called the Pain Down There 10/2014. The pelvic floor is a melon sized web of muscles, ligaments, and exquisitely sensitive nerves at the bottom of the pelvis. It affects a wide range of organs and tissues, the treatment includes massage like work inside the vagina by a therapist to release tight spots affecting the piraformis, and obturator…Pelvic Floor Spasm:The Missing Link in chronic pelvic pain Oct1, 2012 by Patrice M Weiss MD…this is also an issue in men….Herman and Wallace Institute is a great resource..and Urogynecologist Colleen Fitzgerald MD Chronic Pelvic pain at Loyola… It may be hard to find a Pelvic Floor PT….but do research…
        It is life-changing and worth it.
        Ann

      • Thanks for sharing Ann,

        I have been planning on doing a post on Pelvic Floor Pain. However, because it’s not something I treat here, I have put it off. Thank you for putting this back on my radar.

        Sincerely,
        Dr. Russ

  8. nigel hotten

    I was in the gym doing squats one evening where I live human n the south of France. To do improve my performance I wore knee wraps but on this occasion I wore a pair of denim shorts that help restrict flexion at the hip joint thus allowing either more weight or more reps.
    The next day I had cross bruising line over the tops of my thighs and groin area where the denim had pressed very forcefully into me. After a few day I had pins and needles in my left groin and after a few more day pain would develop after walking or standing for an hour or less.
    My theory is that I have torn the fascia tissue in my left groin. I have no pain when attempting a sit up or bringing my thighs towards by body or addicted pain. I can feel no lump or tenderness in my lower abs to pelvis tendon area.
    It has been five weeks now and I take ketoprofen twice daily.
    I went to the local hospital in Béziers where I live and saw a specialist. He believe I may have strained or lightly torn the lower an tendon area. I think I have torn the fascia because when there is pain its between the skin and the muscle, not in the muscle.
    What do you think?

  9. Rodica Nikitin

    I am 24 weeks pregnant. 6 weeks ago i experienced a sharp pain/pulling on the side of my lower right thigh, just above the knee area. The pain dissolved with walking, but little by little it increased. I went to the chiropractor , as I thought it was sciatica, but the pain came back and worsened. Now it is spread though my side and front thigh, very deep. The skin is super sensitive, walking is accompanied by constant pain/pulling/ tingling. At nights there is burning added to all that. I only get around 3 hours of sleep… My doctor … Is of no use , he told me ta take Tylenol …which does not help enough so I can at least sleep. I am desperate…I still have 16 weeks to go with my pregnancy, but things are getting worse every day. Please help!!!

    • Hard to say what’s causing it, but definitely nerve involvement (tingling). Could be a baby-pressing-on-a-nerve thing. Just too hard to say.

      Dr. Russ

    • Lisa Weigand

      If you were my client, I would try a soft roller. Its excellent. I would start with your back and sides, and then the legs. Most likely the baby needs to move position for you to get lasting relief, but this should help more than anything else to reduce the pain. This type of massage will serve to rehydrate your tissues and allow fluids to move more freely. Nerves get irritated when tissues can’t move. It’s gentle enough to use all over your body barring any positions that are uncomfortable or contraindicated while your pregnant. I wish you the best!

      • Thanks for the reply Lisa,

        I thought about including a link to THIS ARTICLE about “Foam Rolling” I recently published, but was too busy at the time. By the way, Lisa runs 3D Fitness in the Houston, TX area. It’s a personal training and fitness studio that specializes in Pilates and various sorts of Functional Training. Hope that is helpful Rodica. Thanks Lisa.

        Sincerely,
        Dr. Russ

  10. tifanie

    I am a LMT in AL and have been dealing with forarm and hand /wrist pain presumably from work related overuse for a while (I was diagnosed with carpal tunnel 3 years ago) but it has in the recent past few months gotten close to debilitating. I try to avoid conventional Western medicine as much as possible and use herbs & nutrition as my main/first choice of action but I need to find something else to allow me to continue my daily activities. I am only 30, raising a almost 2 year-old and cannot continue along this degenerative path of hardly using my hands for daily activities at home. I have successfully been battling TN (trigeminal neuralgia) for the past 8 years with magnetic therapy and nerve relaxing herbs etc. I’m so grateful to find your site! I’m unsure if I’m both acute & chronic or where to go for further help healing what I believe is forearm/wrist tendenosis.

  11. Margo

    Con’t …
    can’t get my orthopedic surgery to admit that there’s a problem. As your blog says he says nothing is wrong yet says go to PT and the pain doctor. My PT thinks surgically repairing the fascia would help the rope and pulley muscle system work. any suggestions? thank you

    • Hello Margo,

      Tough for me to comment on the surgical repair as it’s not my field. It is not something that is commonly done. There is, however, a second issue in play here. You have got to go to my Doctor Schierling dot com site and start reading my numerous posts on Inflammation and Scar Tissue.

      Sincerely,
      Dr. Russ

  12. monika

    Hi
    I am suffering from pain in abdomen area since last seven years. All tests ,scans etc done but no diogonisis. It all started when I tied my stomach area too hard for few days .I kep telling docs that there is something wrong with my abdominal wall and not internal organs. But since no scan shows anything ,I am left suffering with this pain. While researching I found that I have developed a diastis of rectus muscle. But the severe problem is in upper abdomen. I cannot stand beyond 10 minutes and it starts hurting in upper area. I think I have damaged some connective tissue ans fascial with my tight tieing of abdomen. What can be a solution for me. I am too frustrated

  13. julie

    I am 34, (barely maintaining 97pounds) importantant !! As i have only 5’3″ and weighed close to 140 and very active only 2yrs ago. My diagnosis is interstitial cystitis and chronic pain but i also have muscle loss on the right side of about 75percent( 55on left) frequent mri and ct scans do not explain pain not related to ic , until i happened to run across. An er doc who practices orthohealing !!! And told me my fascia was so tightly woven it was the cause of the pain !!! Eurika. I found a logical answer finally :) !!!!! I don’t. Believe in masking pain with drugs unless there is a surgery (broken bone protruding lol, organ removed hahaha. , etc) so he showed me some resetting techniques for home that are helping tremendously! Glad i found a site to reinforce what i was told yesterday at the emergency room , thank you for the information

  14. Elizabeth Jeser

    I’ve developed L’Hermitte’s sign and just underwent a whole MS work-up. I started with plantar fasciitis years ago…then had a frozen shoulder, now all sorts of pain related to what I describe as tightening of all my joints….especially my back and neck. Thoughts????

  15. Derek

    Very good blog today, thank you. So these tender points on my spine could be caused by fascial adhesions?

    • Thank you Derek,

      I would be shocked if they were anything other than some sort of myofascial problem — either Fascial Adhesions or Trigger Points (my money is on the former as you get below the upper traps).

      Sincerely,
      Dr. Russ

  16. chris

    Just wondering how u would treat a fascial tear. I have a 5.1cm tear of the fascial around my gastroc. Thanks

    • Hello Chris,

      I’m not really sure. The Fascial Adhesions I speak at length about are the microscopic “tears” that produce Scar Tissue that can’t be seen with diagnostic imaging such as MRI. You are talking about a two inch tear in some of the denser Fascia in the body. Not something I could likely help.

      Sincerely,
      Dr. Russ

  17. Derek

    I’ve been dealing with shoulder, neck, scapular/thoracic pain for almost 10 yrs which has progressively gotten worse, it’s debilitating. I’ve exhausted all my options, X-rays, MRIs etc… No Dr can ever figure out what’s wrong. I believe in my heart that it’s fascia related. I’m only 34 yrs old and I’m in severe discomfort. I wish somebody could help me, living life is a daily struggle.

  18. donna

    Have you ever heard of kenalog being injected into an abdominal muscle and damaging the fascia causing a huge herniated muscle?

  19. Jonathan Germino

    Hello Dr. I think with your help I may have identified the problem I have. For the past twelve years I have suffered very bad stabbing pains in my lower back, neck, shoulders, collar bones and sternum. The locations keep changing weekly or monthly. The specialists have yet to figure out what’s wrong with me. They keep giving me steroid injections. M sternum hurts so bad right now I have to hold my breath while I write this. I live in east stroudsburg PA. I tried exercise, physical therapy, aqua therapy. Is there anything I can do to reduce the pain? Or even dare I say it, Cure myself? I am on ssd, 35 years old and stuck in constant pain. I can’t do anything. Thank you for all this information anyways. You sound like a doctor who really cares.

  20. Mr Jody Arrowsmith

    Hi- I’ve just been diagnosed with a facia tear on my hamstring (a 7cm long x 5cm wide lump that appears on my right leg under tension- then virtually vanishes when I relax) it doesn’t actually cause pain where this occurs but the rest of my hamstring really aches or often throbs. I had knee surgery last October (2013)

    • Mr Jody Arrowsmith

      Hi- I’ve just been diagnosed with a facia tear on my hamstring (a 7cm long x 5cm wide lump that appears on my right leg under tension- then virtually vanishes when I relax) it doesn’t actually cause pain where this occurs but the rest of my hamstring really aches or often throbs. I had knee surgery last October (2013)

  21. cj

    Is there any way of fixing a torn fascia without having surgery?

  22. mmsr1967

    Since you have seen these at the injection site are they typically removed?

  23. Patty Gore

    Just found your site and piriformis syndrome may be what I’ve been dealing with for 30+ years. About 5 years ago I had some marble-sized lumps appear in the ‘triangle of pain’ area. An MD said they were ganglion cysts (I have one on my right wrist) and a chiropractor said they were fatty tumors. They are harder than the ganglion cyst on my wrist, but not extremely hard. All my life I’ve had small gravel-like bumps in the tissue around the outer sides of my ankles. Sometimes there is aching and mild pain in these “lumpy” areas. If I massage them there is a mild burning sensation. The lumps are not visible, they can only be felt and they do move around some when massaged. Could these lumps be fascial adhesions?

    • Hello Patty,

      Highly doubtful they were Bible Cysts on your buttocks (they are common on the wrist). And usually Lipomas (fatty tumors) are fairly soft. Not sure what it is, and it may not be related to the pain you are having. They do not sound like Fascial Adhesions or Trigger Points, although the latter would be more likely than the former.

      Dr. Russ

  24. Michele

    I have had chronic pain in my left heel following plantar fasciitis well over a year ago. I had a few cortisone injections during my healing period. The plantar fasciitis pain was gone but I soon realized I now have a marble size hard knot inside my heel were the fascia connects.

    First the doctor said it was liquid filled and injected it more saying it was just inflammation then he followed with oral steroids for 14 days. I finally went to a new podiatrist an he looked at it with ultrasound and said it is solid and he would do a surgical injection that may help it shrink. Still no luck and a lot of money spent. Now my doctor wants to cut it out and that really worries me because if it’s scar tissue won’t it just possibly come back after a surgical procedure??? I’m at my breaking point and just don’t know what else to do.
    I can’t even find anything to read online about this particular situation and really do not want surgery.

  25. Shawn P.

    I am a guitar player and developed pain in my palms after extended practice sessions. I feel small, painful lumps in the muscle of the palm. This has persisted for six months despite rest,ice, and NSAIDS. What are my treatment options?

  26. Tyrone Frye

    Hello Doctor. I just want to thank you for the article on understanding fascia. I was in Boot camp in 2013 and couldn’t make it through because of how much pain running/speed walking brought me. The physical therapist there actually was the first doctor I had went too who had figured out what it was that was causing me the pain. The tears in the fascia of my shins. Its gotten worse over the year as well. Do you have any suggestions? Its getting to the point that regular walking on hard surfaces is making my left shin throb where a majority of the pain occurs.

  27. nick t

    Hello doctor,
    A few years ago I pulled a muscle in my right lower back pretty bad. I heard that “pop” sound. After 2 months of increasing pain I finally saw a doctor who gave me muscle relaxers and nsaids. The pain definitely died down but over the years I was in a cycle of healing and re-injuring that muscle. About 2 years ago, I did something to it and I can now feel the ruptured muscle in my back as there is a ball/lump where the muscle rolled up and I can feel a frayed muscle underneath when I compare it to my left side of my back. There is noticeably less muscle tissue in that area as compared to the left side of my back and all those muscles feel like hard ropes compared to the left side of my back which is soft and smooth. Ive ben doing physical therapy for a while now but this injury is still in a slow decline. Im afraid I could be very disables by the time im 40. Im 32 now.

  28. Karen C

    Very informative. I’ve been having problems managing the pain from costochondritis off and on now for 18 months. The chiropractor I see explained the fascia connection with the cause of the pain. The massages and ice/heat packs do help, but for just a few days. I was diagnosed with fibromyalgia about 10 years ago. I did fall on my chest 2-1/2 years ago. But, just a bit of pain from the fall that required ibuprofen for a couple of days.
    Are there any exercises to help heal the fascial adhesions?
    Thank you,
    Karen C.

  29. Holly

    Dr. Schierling,
    I am a 39 yr old female who has been “shrinking”. I feel as though my whole fasciae is pulling me into the fetal position. I no longer eat wheat, dairy, refined sugar or food additives. After battling chronic yeast, 2 c-sections and losing mobility in all joints, the deep tissie massage was the only thing that has offered relief although I am unable to miss more than a day of massage or I
    go back to “shrinking”. What is the prognosis for fascial healing? Do you believe there is a conection between yeast and fascial deterioation and adhesions?

    Holly

  30. vicki jean

    Dear Dr. Schierling,
    I have been suffering from what I was told was bursitis in my hips, bilaterally, for over two years. I was doing mini-triathlons and possibly not training or stretching properly. I am in physical therapy now and have been off and on for a year. I cant seem to get rid of this pain. My physical therapist tells me my IT bands are a mess and they are terribly sore to the touch and very ‘lumpy’. If I keep foam rolling them and have them do manual work to the IT band to break up the scarring and adhesions do you think this will help thee hip pain?
    Vicki

  31. Dwayne Lindstrom

    Dr. Schierling,
    Thank you for the site, Its the best starting point for me regarding rethinking therapy for the Plantar fasciitis adhesions I have in my right heel. I go through chronic pain everyday, and I need help. In June I re traumatized the area with blunt force from a small sharp rock. Two years previously I also struck a rock on the same spot it seems. From the first injury I suspect the adhesions didn’t fix themselves (don’t know how else to say it ..sounds dumb right!) but I’ve been able to mask that pain with quality footwear and swap 2 pairs of Paris brand orthotics which as you’ve said Orthotics replace the arch. In hindsight I guess it improved but after this June bout however the two separate Sports Medical Dr.’s I’ve seen in my area of Winnipeg Manitoba, recommendations differed. The first Dr. said swap out the orthotics for “soft ” support so I’ve been wearing Tuli Heal cups in all my different shoes and doing all the stretching, including plie’s actually because the calf dips over the edge of stairs just seem to aggravate the tissue. Scrunches work, writing out the alphabet with my big toes over the edge of the bed before I get up are OK but not a day goes by wherein if I’m on my feet for more than two hours I’m in Chronic Pain again and again. I received 6 LLL therapy sessions (passive low light laser therapy, not normally covered or recognized by health plans and it was more psychological than anything else). The second Dr.’s opinion was to stretch out the fascia and thumb message the arch the instep, but stay away from the heel and keep the foot taped everyday in such a manner to gather the fat pad as well but it just doesn’t work well enough to relieve that pain that comes back. I thought maybe I had Bursitis because I’ll be driving and out of nowhere BOOM the pain will emanate from the fascia through the ankle and deaden in the shin area. I have a short term medical form which protects me at work , otherwise I could be required to be on my feet all day. Do you know anyone that can perform this procedure of remodelling my tissue here? I’ve checked your picture page and I can’t fathom how this could be done to a heel without having me tied down? I’m willing to try it because it makes sense now that I’m just re aggravating. In the meantime I’ll try the stretches for this area as described on your stretch page and research the anti inflammatory collagen enriching foods page.

    • Hello Dwayne,

      Yes, a rock could easily cause an adhesion. I am not a fan of “soft” orthotics for most people because they do not provide enough support. The heel never bruises like shoulders or other body parts do. Not sure who to send you to in your area.

      Sincerely,
      Dr. Russ

  32. Valerie Cirillo

    2 years ago my son was in a very bad car accident. At the time he was in excellent physical health. He hit the steering wheel with his face (he did have a seat belt on) broke his nose and suffer some brain trauma. His back hurt but that was ignored. Well it has progressively gotten worse. He is in the military and not able to work due to pain and swelling. He has been doing physical therapy including water therapy, trigger massage weekly and now chiropractic has been added. His shoulder, especially lower back, (most of his back actually) is very painful. He has experienced numbness tingling in his arms, hands, legs, and feet off and on. If he misses a week of the very painful trigger massage it is far worse. Everyone treating him has said the muscles in his back are constantly extremely tight and won’t let go and relax. His core strength was fabulous now horrible. The massage therapist feels he is dealing with adhesions. Because he is considered injured the military will not allow him leave. He has had MRI’s, xrays, and back/head scans all come up clear. He is in El Paso, TX. Is there anything you can suggest? Much of what has been done that works we have had to pay for out of pocket. He just wants the pain to go away. Thank you!

    • Hello Valerie,

      MVA’s are devastating, and in my estimation, account for more CHRONIC WHIPLASH PAIN than everything else combined. Unfortunately, the military has always lagged behind when it comes to taking care of chronic problems like this. HERE is an example. I wish I could convey to you how bad the person in this link was. He wanted to do a video, but is unfortunately tangled up in litigation pertaining to his injuries.

      Sincerely,
      Dr. Russ

      • Valerie Cirillo

        I am so well aware of the military lagging behind in care. The military chiropractor they sent him to put his hip back and then did 2 or 3 treatments of electrode therapy which was just a duplication of the physical therapy appts he was also having. No other adjustments were even made. It is why I am paying out of pocket for both a real chiropractor and a weekly trigger massage. I would love to bring him to you but the military will not give him a leave due to his injury. He isn’t even allowed to come home. I must therefore seek outside of the military care for him in the El Paso area. Any ideas in El Paso or self treatment things he can do?

      • Hello Valerie,

        Other than making a concerted effort to deal with SYSTEMIC INFLAMMATION, I am not sure as I know no one in your area.

        Dr. Russ

  33. podaddy12

    I was a sprinter in high school & was running in college before a massive achillis tendon injury occurred. Since that time I have experienced tightness in my hamstrings. How can I break up the fascia correctly & regain elasticity again?

  34. F Walker

    I have been in a lot of pain and discomfort for a long time. My back and shoulders are full of knots and lumps. I went for a massage and was told that my fascia is really tight all over. I have been diagnosed with scleroderma which effects the collagen in the body. I have no skin thickening but I have muscle pain and a feeling of weekness. Would scleroderma effect the whole fascia and be a cause of this tightness and pain? Any advise would be most welcome.

    • Absolutely Scleroderma could cause pain and tightness / restriction! Scar Tissue Remodeling is not the solution. Because this is an AUTOIMMUNE DISEASE, you need to do things to help ‘fix’ your Immune System. Click on the link and spend a few hours reading. You may be overwhelmed at first, but the information is invaluable for people with problems like yours.

      Sincerely,
      Dr. Russ

    • ENF

      I recently went to a chiropractor that left me in more pain! Before even looking or feeling the area I was concerned about he told me I needed to have the Fascial Adhesion to be broken in my back and shoulder where I was having shooting pain. He used hard plastic scarpers across the muscle areas and said it would make a big difference in that area within a couple hour. the next day I was in tears from the pain and for several days later. Now a week later I have muscle weakness and struggle to reach up my arm above my head. Do you think he damaged the Muscle Fascial and if so will it heal over time???

      • Hello ENF,

        It always amazes me when a physician of any sort prescribes or treats without really understanding what is going on first. I realize that many cases can be extremely complex, but how can you help someone without at least having some sort of idea of what the underlying problem is? As to your particular case, it is tough to know exactly what happened here or what is going on right now.

        Dr. Russ

  35. gbsk

    I have done yoga for years. a few years ago, I overstretched where the hamstrings attach to the sit bones. I start stiff every morning barely touching my toes. At the end, I can put my hand flat on the floor with my chest on my leg. Then the next morning the same thing and then after a half hour of hamstring stretching I can do it again. It hurts at the attachment. Why so stiff? I also have a Baker’s cyst behind my right knee sp the more exercise, the more it swells. I never gain on the stretching. Why?

    Thanks

  36. Pam Leaman

    I think I have finally found the root of my pain problem after over 20 back doctors. My massage therapist thought I had a rib out of alignment so sent me to chiro and sure enough. But pain is still on my right side, so she is thinking the rib fascia has adhesions or scar tissue because I have had the pain for over 7 years, so she and the chiro will work together to see if they can correct this situation. That would be WONDERFUL> I’m so ready to be off ibuprofen and tramadol. Thank you —so glad I found your info.
    Pam

  37. Lee Kestler

    This is a very informative piece. My question for you is this: would working out in water be advantageous to maintaining better mobility and strength in the muscle tissue if chronic pain likely associated from the Fascia is the likely cause? Is this an option to manage the symptoms of chronic pain versus just taking a drug? Thanks much and really appreciate the simple to read explanation.

  38. Paula

    I have recently learned I have severly torn my plantar facitits and on a MRI scan the Dr. Told me it just looks like a bunch of strings hanging there. I did not have a tramtic fall or do anything to my foot. Was having pain for months then he put me in a boot which made me much worse then now to a cast once he read my results. This Dr seems very uncertin in what or how to treat me. He has only said it should heal eventually and I should have no more pain in my foot from the plantar facititus. On the other hand when he took cast off once it feels like I have a towel rooled up to one side inside my foot as well as under my pinkie toe the bones are so sore it almost feels like they are going to break through my skin. Another Dr said she had heard of fixing this with a band to stabilize my foot. Any suggestions I am really at a loss here since this Dr seems very uneducated as how to deal with my injury. All I have read states I am in danger of other problems down the line coming into play once the arch is gone for good.

  39. 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?

  40. 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?

  41. 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.

  42. 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

  43. 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.

  44. 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

  45. 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

  46. 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.

  47. 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!

  48. 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,

  49. 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 ?

  50. 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.

  51. 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

  52. 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.

  53. 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?

  54. 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

  55. 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

  56. 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?

  57. 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.

  58. 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?

  59. 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

  60. 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?

  61. 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.

  62. Trina

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

  63. 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!

  64. 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

  65. 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.

  66. 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.

  67. 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.

  68. 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.

  69. 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.

  70. 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

  71. J. Ashford

    Most informative!

  72. 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

  73. 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

  74. 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.

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s