Fascia is of huge importance. It is one of only 3 networks that run throughout the entire body, the other two being the fluid and neural network. Anything that the body considers important enough to weave into every orifice of the body is simply vital, otherwise evolution would have thrown it in the trash long before we even made it out of the cave. So if this fascia stuff is so important how come we know so little about it and what the hell does it do anyway?
I believe it stems from the way anatomy is currently thought in school. We see pretty pictures of a muscle connecting to a tendon which in turn attaches to a bone; three perfect structures independent of each other. The truth is that it's far more like a continuum, everything flows gracefully from one structure to the next and the thing that ties it all together is fascia. Fascia is a matrix of fibrous connective tissue that runs throughout the entire human body, separating and binding together muscles and organs. Chaitow describes fascia a little more eloquently in this awesome blog as an "elastic-plastic, gluey, component that invests, supports and separates, connects and divides, wraps and gives cohesion, to the rest of the body". It's like a 3-D cobweb, but can also function as a sheath to wrap structures. It's simply fascinating stuff, and with research currently exploding in this area we're learning that fascia has more functions than we ever thought possible. Without going into a review of the current literature it's safe to say that it's far from a background material.
And here is a pic Robert Schleip, one of the leaders in the field of fascial research, sent me when I was in contact with him regarding my final year project. It's taken during the first few seconds of rat dissection really showing the fascia between the skin and muscle.
It's important, very important, but just like everything in life it can run into trouble every now and again. Although fascia raps muscles so that they can glide over each other in constant contact sometimes adhesions can occur and muscles that should glide over each other become stuck. Other reasons for adhesions stem from a simple lack of strength. If the muscle doesn't have enough strength to hold what it's supposed to hold in position the body simply doesn't give up, it ties down anchor points to support the muscle. A common site for this is the mid back which for most people is a mine field of trigger points and adhesions. The mid back is constantly put on a stretch when you sit in that seat, staring at this screen, with that crappy posture you're currently sporting. Shoulders elevated and protracted (rounded), T-spine (mid back) rounded, head about 4 inches too far forward; all of this is putting a hell of a strain on your mid back muscles that are trying hard to pull you back into place. But they don't have the strength so they lay down anchor points to stop your sipping even further forward. Yes, all those knots in your back are fascial support structures trying to hold you in place, so make sure you’re going to strengthen them if you are going to get them massaged out or you'll slip even further into the world of a hunchback.
Here is a pic of some adhesion's in our rat friend.
So where does this leave us in the world of strength and conditioning?
Three steps; we need to 1) Roll 2) Stretch and/or mobilize, and 3) Strengthen. You will never have an effective program unless all 3 are present. Figuring out exactly what do roll, stretch and strengthen is where a full assessment comes in. The combination of a postural, movement (FMS), and a table assessment is how I personally come to the conclusion of what each client needs to work on. Although I cannot stress the importance of a proper assessment to find you’re current weaknesses, the general pattern I see a lot is that people need to do roll and stretch the quads, hip flexors (especially TFL), ITB and pecs while strengthening the core, hamstrings, glutes (I cannot stress this one enough, seriously no one has an ass anymore WTF??), and every single muscle in the back except for the lumbar erectors and upper traps. It's important to roll before stretching, and in most cases people need to learn how to activate muscles before they can strengthen them. Once you've rolled and stretched a muscle you need to used it (ideally though a lengthened position) so that your brain will remember the extra movement you should have just given it. I use a foam roller for the thighs, hips and mid back and a tennis ball for the plantar fascia (video below), calves, pecs, lats and posterior side of the shoulder. PCV pipe, med balls, lacrosse balls and golf balls can all also be used if you want to get a little more aggressive - most people are not ready for this. I generally recommend 20 full passes over target areas and 5-10 passes over other areas. Once I've demonstrated how to target a specific tissue on the foam roll or tennis ball I don't give too many additional guidelines. As, I think, Mike Robertson said, "It should be an organic process". I really like this concept. Make it your own, if moving 2 inches one way gets you on "that spot" better then move 2 inches that way!! Don't think that if you're targeting a tissue, let's take the ITB as an example, you don't need to say exclusively on the outside of your thigh - move around! Hit the back side of the ITB (closer to the hamstrings), hit the front side (closer to the quads, you'll find some good stuff in there!), don't just stick to one line. Likewise, when you're on your quads make sure to get all of them, move more to the inside and then move more to the outside. Do a few passes with your feet pointing in, and then do a few with your feet pointing out. Bend your knee so your quad in on a stretch and then roll it. Play around on it once you have the general guidelines, you're looking for the sore spots.
In general, you want to move slow and deep, just like a proper massage. I find a lot of people want to tense up and move quickly to avoid any soreness. Suck it up and put in your time! You're just putting your body weight on a piece of foam, stop the whining already! Make sure that you keep breathing throughout. Holding your breath is a sign that you're tensing up, again, you're on a piece of foam, no need for you to turn red in the face; deep belly breaths please. If you find a really tight spot, which you will, get right on top of it, stop moving, focus on your breathing and try to get your muscle to melt over the foam roller or tennis ball. I also like small, micro rolls, over tighter areas, but always start and finish with full passes of the muscle. You should start at the middle of your body and work out, therefore, I get on the foam roller for my thighs and hips, then jump up onto my feet and work my calves, plantar fascia (bottom of your foot), pecs, lats and mid back with the tennis ball.
When to roll?
I get every single client to foam roll first thing. When most people start they need to spend more time on the foam roller so I'll allow 20 mins at the start of the session for just foam rolling for the first week or two. After that 5-10 mins tops. Once clients have the technique down I ask them to keep a foam roller in their living room and get on it as often as possible. If it's during the ads break pick a muscle and just roll that, next ad break pick a different muscle. Generally people need to spend a lot of time on the foam roller for the first month or two, after that 10 mins at the start of all workouts is normally enough. Having said that, it can also be useful during the workout, between sets, if an area is very tight. A perfect example of this is the 90/90 Split Squat - most new clients can't even hold the proper position due to tightness in the quads/hip flexors, not to mind move up and down. Rolling the quads/hip flexors during the rest period, along with some glute activation work, generally helps out a lot.
Areas you shouldn't foam roll.
Don't roll your knee cap, or directly behind the knee cap. Only roll parts of your spine that have the support of your rib cage. That means that your lower back and neck are a no no. When working around your shoulder with a tennis ball don't roll into your arm pit. Apart from that everywhere else is a go.
So how does all of this affect fascia?
Well, generally sticking points or adhesions occur because the fascial matrix in that area dries up and layers end up sticking to each other. Rolling over them can help to break up these adhesions but it also stimulates the fascia to become more fluid. Drinking your 2 liters of water a day, every single day, is only going to help this process. Supplementing with Fish Oil is great too. If you really find a tight spot that just won't break up (give it a week or two, not just one session) you should probably consider getting a massage from a registered massage therapist (RMT). Hands on tissue work wins hands down every single time (no pun intended). If I could get my clients 15-20 mins of hands on tissue work at the start of their warm up the foam roller would start to gather some dust pretty quickly. But the problem is that good RMT's are generally over $100 per hour. A quality foam roller and tennis ball are at most $50 and they last for months. It's an awesome way to get a regular cheap massage and it will drastically improve your tissue quality, with will in turn improve you movement quality. Here is a very random pic of the foam roller I personally use.
In general, you want to move slow and deep, just like a proper massage. I find a lot of people want to tense up and move quickly to avoid any soreness. Suck it up and put in your time! You're just putting your body weight on a piece of foam, stop the whining already! Make sure that you keep breathing throughout. Holding your breath is a sign that you're tensing up, again, you're on a piece of foam, no need for you to turn red in the face; deep belly breaths please. If you find a really tight spot, which you will, get right on top of it, stop moving, focus on your breathing and try to get your muscle to melt over the foam roller or tennis ball. I also like small, micro rolls, over tighter areas, but always start and finish with full passes of the muscle. You should start at the middle of your body and work out, therefore, I get on the foam roller for my thighs and hips, then jump up onto my feet and work my calves, plantar fascia (bottom of your foot), pecs, lats and mid back with the tennis ball.
When to roll?
I get every single client to foam roll first thing. When most people start they need to spend more time on the foam roller so I'll allow 20 mins at the start of the session for just foam rolling for the first week or two. After that 5-10 mins tops. Once clients have the technique down I ask them to keep a foam roller in their living room and get on it as often as possible. If it's during the ads break pick a muscle and just roll that, next ad break pick a different muscle. Generally people need to spend a lot of time on the foam roller for the first month or two, after that 10 mins at the start of all workouts is normally enough. Having said that, it can also be useful during the workout, between sets, if an area is very tight. A perfect example of this is the 90/90 Split Squat - most new clients can't even hold the proper position due to tightness in the quads/hip flexors, not to mind move up and down. Rolling the quads/hip flexors during the rest period, along with some glute activation work, generally helps out a lot.
Areas you shouldn't foam roll.
Don't roll your knee cap, or directly behind the knee cap. Only roll parts of your spine that have the support of your rib cage. That means that your lower back and neck are a no no. When working around your shoulder with a tennis ball don't roll into your arm pit. Apart from that everywhere else is a go.
So how does all of this affect fascia?
Well, generally sticking points or adhesions occur because the fascial matrix in that area dries up and layers end up sticking to each other. Rolling over them can help to break up these adhesions but it also stimulates the fascia to become more fluid. Drinking your 2 liters of water a day, every single day, is only going to help this process. Supplementing with Fish Oil is great too. If you really find a tight spot that just won't break up (give it a week or two, not just one session) you should probably consider getting a massage from a registered massage therapist (RMT). Hands on tissue work wins hands down every single time (no pun intended). If I could get my clients 15-20 mins of hands on tissue work at the start of their warm up the foam roller would start to gather some dust pretty quickly. But the problem is that good RMT's are generally over $100 per hour. A quality foam roller and tennis ball are at most $50 and they last for months. It's an awesome way to get a regular cheap massage and it will drastically improve your tissue quality, with will in turn improve you movement quality. Here is a very random pic of the foam roller I personally use.
By no means is this all you should do as your warm-up, but it defiantly should be an integrated part of the 20 mins you spend getting ready to strength the movement patterns you should have just improved.
If you want to learn more, check out this Foam Rolling Clinic I'm putting on this Wednesday the 23rd!
Cian Lanigan
If you want to learn more, check out this Foam Rolling Clinic I'm putting on this Wednesday the 23rd!
Cian Lanigan
Congratulations on an excellent summary of current fascia news.
ReplyDeleteWOW!! Thank you so much for taking the time to comment! Although I've focused on becoming a strength coach your work on manual therapy, and just generally how you view the body has really influenced me. Thank you for your work in the field and hopefully I'll get the chance to thank you in person at the Fascia Research Conference in Vancouver.
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