Fascial Adhesions: Deal With Them or They Will Deal With You!
Inflammation presents a conundrum to friction-free fascia. On one hand it’s critical for normal healing processes and should be harnessed. But on the other, if there is too much inflammation, rest assured there will be problems — lots of problems (HERE). Furthermore, it’s critical to realize that the end result of too much inflammation, no matter where said inflammation is (local or systemic), is always the same — fibrosis. And when fibrosis hits the fascia, you have fascial adhesions!
FIBROSIS is just what it sounds like; fibrotic tissue that is otherwise known as SCAR TISSUE (microscopically it tends to look and act more like a HAIRBALL than well-combed hair). Fibrosis leaves people in a quandary — a FULL-BLOWN CONUNDRUM that I have written about repeatedly. Considering that fibrosis is America’s leading cause of death, I sincerely hope folks are getting the message. Enter Dr. Lawrence Wilson.
Dr. Wilson is an MD (BS from MIT) who was a protege of the brilliant biochemist, Dr. Paul Eck. The focus of their clinical practice was mineral balancing, as well as pioneering the use of hair analysis to diagnose these imbalances. I was turned on to their work two decades ago when I attended a number of Dr. Janet Lang’s “Integrated Endocrinology” seminars. Read these cherry-picked statements from Dr. Wilson’s article titled Adhesions and think of this quote in relationship to facia (fascial adhesions).
“In the body, an adhesion is an abnormal attachment or stickiness between two or more body tissues. Adhesions are a type of scarring or scar tissue that causes two tissues to stick together in an abnormal way. Adhesions may also be viewed as a kind of substitute physical and chemical structure that can develop in the body.
In other words, adhesions can replace or substitute for other structures such as muscles, tendons, ligments and even bones that have become weakened or are out of place, or are not functioning for some other reason. In this case, the adhesions are compensations and adaptations to some kind of weakness or other problem in the body. Adhesions are always a toxic adaptation or condition.
Adhesions can interfere with the blood supply and the nerve supply to various parts of the body. They also restrict bodily movement and cause poor posture. For these reasons, adhesions often cause disease and shorten a person’s lifespan. In some cases, they become vicious cycles, in which case they are even worse. The most common site of adhesions is in the fascia layers, which are under the skin. However, they can occur at other sites, including the cell membranes, the intercellular substance and matrix, the muscles, tendons, ligaments, skin, organs and elsewhere.
In all cases, they involve a hardening, toughening or fibrosis of the body tissues. The main cause of adhesions appear to be inflammation that is not correctly resolved. Unresolved inflammation is often, or perhaps always due to nutritional imbalances, but may also be caused by a trauma such as a surgery, a fall, or something else. Inflammation may also be due to an infection. What is called scarring is nothing more than adhesions in the tissues that are visible, or can be felt or palpated with one’s hand. Unfortunately, most adhesions cannot be felt. They go undetected and are not dealt with by most medical and holistic doctors and practitioners.”
After discussing the “conundrum” I mentioned earlier (he refers to it as a vicious cycle), Wilson goes on to talk about many of the same things I deal with on my site, including the fact that both CHIROPRACTIC ADJUSTMENTS and THERAPY are a waste of time if these adhesions — the scar tissue that occurs mostly in the FASCIA LAYER (thus the name, fascial adhesions) — are not properly dealt with first. Dr. Wilson has his own nutritional protocol for dealing with inflammation that while certainly not the same, shares many of the same traits as PALEO.
And while nutrition is also an integral part of my OVERALL PROTOCOL for helping patients regain their lives as well as SOLVING THEIR OWN BACK OR NECK PAIN, there is another principle I agree with him on as well. “Medical drugs often subtly irritate, damage and congeal the tissues. These are among the “adverse effects” of these drugs. In fact, allopathic remedies cause so much adhesion damage that I predict that someday most of them will be outlawed.” Tough to argue that we don’t take WAY TOO MANY DRUGS!
I an article called Fascia and Inflammation, Kevin M. Cronin, a PT and owner of several Chicago area Physical Therapy clinics, said this of the connection.
“Nearly all painful conditions are accompanied by inflammation of the fascia. Fascia is the connective tissue that is abundant throughout the entire body and covers all nerves, arteries, veins, and internal organs of the body. Fascia is filled with millions of nerve endings and also contains smooth muscle cells, so it can contract if injured or traumatized, and also cause skeletal muscle to tighten. The inflammatory chemicals make those same nerve endings even more sensitive, so that now it takes only takes a very mild strain to cause more inflammation, muscle spasm, and pain.”
So, fascia is everywhere; and when it is attacked by inflammation, it tends to not only create scar tissue, but to become HYPER-SENSITIZED (see link for Dr. Chan Gunn’s amazing work). Although not as hard-line as Wilson, Cronin’s article also warned of the dangers posed by trying to deal with inflammation via drugs (HERE or HERE).
Because fascia is so important to your body’s ability to move and maintain NORMAL POSTURE (something spoken of by both Cronin, Wilson, and the guy we are going to talk about next), it obviously has important biomechanical properties attached to it (no pun intended). Closely related to both engineering and physics, biomechanics is simply the application of mechanical principles to biological systems (tissues, cells, organs, limbs, joints, etc, etc).
Three weeks ago, McGill University engineer, Dr. Mark Driscoll, published a paper called Fascia – The Unsung Hero of Spine Biomechanics, in which he discussed the various roles that fascia plays as a tissue whose unique properties allow it to be used to gain mechanical advantage in a variety of situations (FASCIA & BIOMECHANICS).
“Over the last decade fascia has gained acknowledgement as a player in biomechanics by way of conveying mechanical forces directly or indirectly. The spine is a biomechanical marvel in regards to its intricate control and performance. However, because of such complexities many things can go wrong, perhaps why the spine is responsible for plaguing so many with pain.
The role of fascia in spinal stability has yet to be fully understood but several novel and valuable discoveries have been made. Clinically, many researchers have shown and alluded to the role of the thoracolumbar fascia (TLF) in spine stability. The TLF is believed to play a role in transferring forces during coordinated activities and, consequently, such important function may be coupled with pathologies and clinical observations of TLF dysfunction. Mechanically, the tension in the TLF is regulated by many muscular attachments spanning the spino-pelvic region and by the intra-abdominal and muscular pressures.
From a rehabilitation or treatment approach, the aforementioned biomechanical role of fascia offers an option upon which to plan and treat musculoskeletal disorders. Once a dysfunction sets it, regardless of its etiology, compensatory patterns may worsen by way of the novel biomechanical notion of physiological stress shielding.”
I am a firm believer that ignoring fascial adhesions that routinely accumulate in the THORACOLUMBAR FASCIA of those struggling with CHRONIC BACK PAIN OR SPINAL DYSFUNCTION is a huge but commonly made error. We could easily take this concept a step further by saying the same thing about chronic neck pain as it relates to the CERVICAL FASCIA.
In other words, as I mentioned earlier, it’s not that I am against STRETCHING, therapy, chiropractic adjustments, RESISTANCE EXERCISES, or any number of other treatments so frequently used to address musculoskeletal issues (I suppose at times INVERSION might put on this list), but these have to be done after the facial adhesions are dealt with, which is especially true in severe cases. In fact, it’s why I have said for a very long time that in many cases, BREAKING SAID ADHESIONS must be intense (yes, there may actually need to be BRUISING involved).
For many reasons, lots of people are squeamish about bruising. The funny thing is that it’s not usually the patient, but the practitioner (or maybe the spouse or co-worker). My experience is that people who have hardcore chronic pain (EVEN THOSE WHOSE PAIN MAY HAVE CENTRALIZED), couldn’t give a rip if you bruise them or not — if you can show them quick results (I’ll show you just how quickly in a moment).
For instance, I had a female patient yesterday who 8 years ago decided to have a non-malignant tumor removed from her neck, just above her collar bone. The resultant fascial adhesions had disabled her, not allowing her to move her neck at all side-to-side. Her cervical ROM was about 90% better in 10 minutes (stupid me, I was too busy to take the time to do a before and after video). Like I said, GOOD RESULTS SPEAK FOR THEMSELVES.
I bring this up because a year ago, Elisha Celeste wrote an article called Fascia, Fat Shaming and Cellulite – Are You Saying Yes to Self Abuse, or Self Love? Although she was specifically picking on the people who use ASHLEY BLACK GURU’S FASCIA BLASTER DEVICE here, her point was that if a treatment meant to deal with Fascial Adhesions causes bruising, it’s too aggressive — a point that’s not uncommon among bodyworkers.
“Is there such a thing as “good” bruising? I’ve never heard that until now. A bruise is a soft tissue injury. Small capillaries have broken open, spilling blood into the surrounding tissue. Swelling and inflammation occur because the body isolates that area to STOP the bleeding and heal the damage by sending repair hormones to that spot. There is no one on this planet that can convince me that having bruises… is a good thing and a sign of healing my fascia. I proudly and happily make the claim, as a fascia release expert, that there is absolutely NO need to bruise yourself to get healthy fascia.”
I would never pick on Elisha here, because frankly, it sounds like she is doing some very cool things in her practice and helping a ton of people. However, because I personally hate seeing the same patients over and over and over for the exact same thing, I ‘proudly and happily‘ want to make a claim as well concerning what it takes to effectively deal with fascial adhesions.
I tell my new patients that if I am going to be able to help them, they’ll know after one treatment (THAT WOULD BE ONE AS IN ONE). Not that one treatment is usually enough to totally solve many of the messes they bring in to me, but they’ll know). I honestly don’t know of anyone else making similar claims (it’s why a visit to see me is so BLASTED SIMPLE).
BTW, Elisha is absolutely right about much of what she said. When bruising occurs and inflammation is released from the areas of fascial adhesion that have been broken (remember that it’s SYSTEMIC INFLAMMATION that is so bad, and that a certain amount of LOCAL INFLAMMATION is critically necessary to ensure a proper and productive healing process — HERE), it sets in motion a cascade of chemical, neurological, and mechanical events.
The “hormones” that are released to the bruised / inflamed area (you can see these HERE or HERE) are actually the GH-like growth factors that turn the metabolic / anabolic crank in people with long-standing severe fascial adhesions. No, I don’t bruise everyone who darkens the doors of my clinic; not even the majority.
If, however, you have a chronic problem that is not responding to anything else, I’ll give you the option of seeing if a Tissue Remodeling treatment is something you’d like to try. We already know clearing out fascial adhesions is a big deal for pain relief, but let’s talk now about why this is important for problems other than pain.
A 2015 article by a group of very famous fascia researchers (Fascia Research IV: Basic Science and Implications for Conventional and Complementary Health Care) dealt with some of this. In this paper they discussed a new technology that is in many cases allowing practitioners to actually image fascia (DIAGNOSTIC ULTRASOUND) because the layers will start “sticking” or adhering together.
“The structural organization of fascia into sheet-like layers with multiple orientations, attachments and its intimacy with muscle groups provides fascia with a distinctly functional anisotropy (directional variability).”
When these sheets become “adhesed” to each other, the resultant fascial adhesions can cause a wide array of problems. What sorts of problems? Here is a small sampling of a common problem that has little — at least initially — to do with pain.
“AT Still, MD posited a connection between cancer and fascia more than 100 years ago. Epidemiological studies show that persons with diseases of increased systemic fibrosis such as scleroderma have a much higher rate of cancer. People, who exercise, particularly resistance or weight training, are less likely to die of their cancer (and other diseases). It has been noted that both cancer and the surrounding tissues become stiffer. Stiffening of the extracellular matrix is a hallmark of cancer.
The tumor associated ECM shows increased collagen deposition and crosslinking which stiffens the tissue, and increased tumor cell and fibroblast contractility which in turn increases the tension in the tissue, leading to further remodeling and stiffening. Mechanosignalling and cellular tension foster increased tumor aggressiveness. In response to mechanical cues from the ECM, cells modulate their shape and nuclear architecture which then remodels the ECM. Tumor cells show increased anaerobic glycolytic metabolism.
There is emerging evidence of a connection between the altered ECM stiffness and these metabolic changes. Nutrition plays a role in reducing inflammation. The anti-nflammatory diet is [not only helpful for treating] musculoskeletal conditions, but is also useful for cardiac conditions and for cancer.”
This is not so much different than some of what DR. INGBER & LANGEVIN have proposed — that fascial adhesions are a factor in all (or at least many) disease processes. Much of this has to do with the fact that intact and healthy fascia is a full-blown PROPROICEPTIVE POWERHOUSE. Furthermore, even though AT STILL recognized a century ago that CANCER was related to fascia, 90 years ago WARBURG DISCOVERED that cancer was fed by the “glycolytic metabolism” that these authors discussed (the body fermenting sugar).
The associated cancer made the ECM thick or ‘DENSIFIED‘, causing even more inflammation and subsequent mechanosignalling (MECHANOTRANSDUCTION — turning mechanical signals into electrical impulses). The authors went on to say that fascial adhesions and the mess they leave behind can be effectively treated (not always cured, but treated) by adding PROPER NUTRITION to whatever else you happen to be doing as treatment (remember that virtually all disease processes have similar starting points — HERE).
A huge problem, however, is that the medical community pays little more than lip service for using diet to treat much of anything — especially cancer (HERE, HERE, and HERE), let alone fascial adhesions. (MORE ON THE CANCER / FASCIA CONNECTION)
Beyond GIVING HELPFUL INFORMATION to both local and OUT OF STATE / INTERNATIONAL PATIENTS on a day-to-day basis, I created a completely free generic protocol that most of you can use to start taking your life back (HERE). This is important because regardless of how much my treatment helps you with your pain, a failure to deal with the underlying inflammation that is still on the loose will assure you that sooner or later your problem will return — probably with several nasty friends. If you liked this post on fascia, be sure to check out my 160 others on the topic as well (HERE). Oh; and don’t forget to like, share, or follow on FACEBOOK as well.