The tissue that connects the muscles may be a key to better health

NEW YORK – In recent years, the concept of caring for one’s fascia – the tough, flexible tissue that surrounds and connects muscles, bones and organs like cling wrap – has permeated fitness and wellness culture.

Pilates instructors and massage therapists offer to make fascia more supple, and products such as foam rollers, massage guns and “fascia blasters” claim to help people improve their fascia health at home.

“Fascia as a buzzword has really exponentially taken off,” said Dr Christopher DaPrato, a physical therapist at the University of California, San Francisco, who studies the connection between fascia and athletic performance.

Until the early 2000s, doctors believed fascia was just packaging for more important body parts. Since then, researchers have discovered that the connective tissue plays a vital role in how people function and is key to flexibility and range of motion.

Emerging research suggests that caring for your fascia might help treat chronic pain and improve exercise performance and overall well-being.

“We’re still at the very, very beginning” of understanding fascia, said Dr Helene Langevin, director of the National Center for Complementary and Integrative Health at the National Institutes of Health. “This is a part of the body which we have neglected for so long.”

What is fascia?

Your body has two forms of fascia: dense and loose. Each is key to facilitating movement.

Dense fascia, made of sturdy collagen fibres, helps give your body its shape. It holds muscles, organs, blood vessels and nerve fibres in place. It helps your muscles contract and stretch, and stabilises your joints.

The more slippery loose fascia allows your muscles, joints and organs to slide and glide against one another like a well-oiled machine.

How does fascia get damaged?

In 2007, Professor Carla Stecco at the University of Padova in Italy, who researches on anatomy, found that fascia is alive with nerve endings. This means it can be a source of pain. The longer it is damaged or inflamed, the more sensitive it becomes.

When you are sedentary for a long time, fascia can shorten, become overly rigid and congeal into place, forming adhesions that limit mobility, said Dr David Krause, a physical therapist at the Mayo Clinic.

Over time, inactivity can also lead fascia to reshape itself. If you spend most days hunched over a computer, the fascia surrounding your neck and shoulder muscles may change so that your posture becomes curved.

Fascia can also become damaged from repetitive movements, chronic stress, injury or surgery – becoming inflamed, overly rigid or stuck together. And it stiffens with age.

Finally, because it consists of a matrix of fibres, fascia that is too short, stiff or sticky in one part of the body can lead to pain and dysfunction elsewhere, by pinching or pulling in the wrong direction, Prof Stecco said. The body can also compensate by changing the way it moves, causing other issues.

It can be tricky to determine whether pain is coming from your fascia or your muscles and joints. Generally, muscle and joint problems tend to feel worse the more you move, while fascia pain lessens with movement.

How can you care for your fascia?

The most effective way to keep your fascia sturdy and elastic is to stay active. Experts also recommend a few things in particular.

Resistance training keeps fascia strong, Dr Langevin said. “A weak muscle is not going to do a great job at moving and mobilising the fascia,” she added, nor will stiff and congealed fascia help the muscle do its job.

“They need each other,” she said. “Once one starts improving, it helps the other.”

Exercises that involve a range of movements – such as dancing, jumping jacks, tennis and swimming – also help keep the fascia lubricated, Dr DaPrato said. Movements that involve bouncing are particularly effective at keeping fascia healthy.

“Skipping, for example, is such a wonderful movement,” said Dr Robert Schleip, director of the Fascia Research Group at Ulm University in Germany.

For those who have not been active recently, it is important to “be gentle with our fascia and to go slowly and try to re-establish the movement that has been lost”, Dr Langevin said.

Dynamic stretching, which contracts the muscle while elongating it, will benefit healthy and damaged fascia alike. Try trunk twists, squats or forward lunges.

Consider seeing a physical therapist who can offer hands-on treatment and guide you towards the best programme.

Along with moving, experts recommend sipping water throughout the day, which can help fascia glide with ease.

Despite the popularity of tools and treatments that involve applying pressure to fascia, research has not yet proved their long-term effectiveness. Foam rollers and percussion guns can temporarily alleviate fascial soreness and improve flexibility by “changing some of the fluid dynamics in that local area”, Dr DaPrato said.

If you choose to use a self-massaging device, do not overdo it. No evidence supports the recent trend of “fascia blasting”, or aggressively manipulating fascia through the skin, which can lead to bruising.

The same may be true for treatments such as myofascial massage and cupping. If these treatments make you feel and move better, that is great, experts said – but simply staying active is the best medicine. NYTIMES