Preventing injury and general maintenance is a consideration for a lot of athletes, in particular athletes that have dealt with injury and don't want to have to go there again. Frequently these prevention strategies focus on keeping the range of motion in muscles and ensuring good blood return throughout the body's system. These are done through stretching, compression garments, foam rollers, yoga classes, etc. What about the fascia, though? Wait, what is fascia? What is its function, and how do I fix it if its "broken"?
Fascia is literally the structure that holds us all together. Fascia is a thin layer of tissue that lines the outside of all muscles and serves to transmit mechanical tension generated by muscular activation. It helps to reduce the friction of muscular forces. There is also a thin layer of fascia that creates the bottom later of the dermis (skin) called the superficial fascia. For multiple reasons, tension can build up in some areas of fascia, leading to restrictions and tissues adhering to each other rather than smoothly gliding over them. When this happens, muscles don't function correctly and may create motions that were not intended.
For example, if the fascia that covers the quad muscles begins to adhere to the IT band, then every time the quad muscle contracts, the leg will have a tendency to not stay within the sagittal (front to back) plane. Instead, your upper leg will move forward and laterally.
These types of examples can occur all over the human body. The resultant effects of fascial tension are greatest for muscles that cross multiple joints. When a muscle crosses multiple joints, it contributes to movement at both joints. Any impact that fascial tension has at one joint will lead forces to be transmitted differently down the chain to other joints.
I know this seems like an anatomy lesson. The take-away is that we need to focus on preventative and recovery techniques that restore the fascia to its correct tension and function. Over the last few years, I have had multiple injuries, most of which have been related to the hip and abdominal area. I've tried a variety of treatments, and those that focus directly on returning the fascia to its correct function have had the best impact. In order of effectiveness, my top three treatments for fascia are Ultrasound-guided dry needling, cupping with movement, and Kinesiotaping.
All of these treatments help to stimulate and release tension in the fascia. The dry needling is obviously the most invasive and the most uncomfortable but probably the most effective in the end.
Dry Needling: Dry needling uses acupuncture needles placed down to the fascia layer. They then move the needles around to stimulate changes in fascia tension. Dry needling typically leads to increased soreness for about 1-2 days but significantly improves after that.
Cupping: Cupping can be used in multiple ways. I have found the method with the greatest impact is placing the cups on the skin, gently pulling away from the skin, and then moving the cups up and down the area you want to release. You can also place multiple cups along a muscle and then gently stretch the muscle, and this will help release the tension as well.
A quick disclaimer: I would have a medical provider assess and determine if cupping is safe for you. Make sure you know how to use the proper technique before doing it on yourself.
Kinesiotape: Kinesiotape (sometimes called KT Tape) can be used for a variety of reasons. Its application depends on the tension placed on the tape. When applying the tape with about 25% stretch, it functions to pull on the underlying fascia and release areas of adhesion. Again, I would probably recommend a physical therapist place the tape the first time, but there are tons of online videos that walk you through the process.
There are many ways to address restrictions in the fascia. I wanted to first remind everyone to not forget this critical structure and to give some techniques that I have had firsthand experience with that have been very useful.
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