Fascia

What is fascia?

Fascia is the band of thin, fibrous connective tissue that wraps around and supports every structure in your body.

Scientists initially thought fascia only provided support to your organs, muscles and bones. Recently, the definition has expanded to include the tissue that surrounds all of the cells, nerves, joints, tissues, tendons and ligaments throughout your body as well. As part of this discovery, they learned that fascia is a part of a system-wide network that provides form and function to every part of your body. It’s a continuous layer of tissue that’s flexible and able to resist tension.

Fascia is a stringy, white substance made mostly of collagen. Collagen is a type of protein that provides strength and flexibility. Fascia is soft, loose and made up of multiple layers. A liquid called hyaluronan is between each layer. The hyaluronan helps your fascia stretch as you move. Inflammation and trauma can dry up the hyaluronan and damage your fascia. When your fascia tightens, it can restrict the movement of your muscles and tissues, causing pain and other health conditions.

What does fascia do?

Fascia provides structure and support throughout your body. It holds your muscles together, which allows them to contract and stretch. It provides a smooth surface for your muscles, joints and organs to slide against each other without creating any friction or tears.

Fascia also stabilizes your body structures and gives your body strength. It separates your muscles and eases muscle tension. It also helps with joint stability and movement, and it improves your circulation. Fascia provides an environment that enables all of your body systems to work together.

Where is fascia located?

Fascia is located throughout the inside of your body. It attaches to and stabilizes every muscle, tendon, ligament, bone, organ and tissue in your body.

What’s the difference between fascia and tendons and ligaments?

Fascia is similar to your tendons and ligaments. They’re all made mostly of collagen, but their locations and functions are different. Tendons join your muscles to your bones, and ligaments join one bone to another bone. Fascia wraps around all your muscles and other body parts. Examples of fascia include thoracolumbar fascia, fascia lata and plantar fascia.

Thoracolumbar fascia surrounds your back muscles and divides them into compartments. Fascia lata is connected to a tiny muscular band located in your thigh called the tensor fascia lata or tensor fascia latae. The fascia lata helps this muscle provide balance to your pelvis while you’re walking, running or standing. Plantar fascia attaches to the fascia plantaris muscle behind your leg. You don’t use this muscle much, but it does help you flex your ankle and knee joints.

What are the different layers of fascia?

There are four different layers of fascia in your body: superficial, deep, visceral and parietal.

Superficial fascia

Superficial fascia is the outermost layer located directly under your skin. Layers of membranes, loosely packed interwoven collagen and elastic fibers make up this layer. Superficial fascia is thicker in your chest and back (torso) and gets thinner in your arms and legs. It also sometimes contains muscle fibers, which help create certain structures in your body.

Deep fascia

Deep fascia surrounds your musculoskeletal system. It covers your muscles, bones, tendons, cartilage, nerves and blood vessels. This layer is thicker than superficial fascia. There are two subtypes of this layer:

• Aponeurotic fascia: Aponeurotic is thick, pearly-white tissue that separates more easily from your muscles.
• Epimysial fascia: Epimysial is thinner than aponeurotic fascia and more tightly connected to your muscles.

Visceral fascia

Visceral fascia surrounds the organs in your abdomen, lungs and heart.

Parietal fascia

Parietal fascia lines the walls of certain body cavities, such as the area around your pelvis.

What common conditions and disorders affect fascia?

When your fascia is healthy, it’s relaxed and flexible. As you move, it stretches with you. When the hyaluronan dries up, the fascial layers can tighten around your muscles and other tissues. This can lead to pain and limited mobility. Many conditions and disorders can affect your fascia. These may include:

Plantar fasciitis

Plantar fasciitis causes inflammation and pain in your plantar fascia, which is a thick band of tissue that stretches from your heel to your toes. It supports the arch of your foot by absorbing pressure and bearing your weight. Plantar fasciitis is one of the most common causes of heel pain.

Myofascial pain syndrome

Myofascial pain syndrome causes pain and tenderness in muscles in one or more “trigger points” in your body. To the touch, trigger points feel like small bumps or knots in your muscles. They are highly sensitive areas within your muscles that cause pain that you can feel in another area of your body.

Dupuytren’s contracture

Dupuytren’s contracture occurs when the fascia underneath the skin of your palm and fingers thickens and tightens. This causes your fingers to curl or contract. Contracted fingers affect your ability to perform daily tasks such as clapping your hands or putting gloves on.

Frozen shoulder

Frozen shoulder, also called adhesive capsulitis, is a painful condition in which your shoulder movement becomes limited. It occurs when the fascia surrounding your shoulder joint becomes thick, stiff and inflamed. Lack of use causes your shoulder to thicken and become tight, making the shoulder even more difficult to move.

Peyronie’s disease

Peyronie’s disease is a condition where scar tissue causes your penis to bend, curve or lose length or girth. In some cases, it can cause pain and prevent you from having sex. You may be able to feel the scar tissue through your skin or you may have pain in a specific part of your penis as the scar tissue forms.

Compartment syndrome

Compartment syndrome is a condition that causes painful pressure in and around your muscles due to swelling or bleeding. The condition can limit the flow of blood, oxygen and nutrients to a group (compartment) of muscles, nerves and blood vessels in your body. The fascia surrounding the compartment won’t expand to make room, so the swelling or bleeding puts pressure on your nerves and muscles.

Hernia

When your fascia lacks stiffness, internal structures can move too freely causing hernias to occur. Types of hernias caused by defects or disruptions in your fascia include inguinal hernias, femoral hernias and umbilical hernias.

Genetic conditions affecting collagen can lead to issues with your fascia. These conditions include:

Ehlers-Danlos syndrome

Ehlers-Danlos syndrome is a condition that causes loosened joints and fragile skin that tears easily. A genetic defect leads to weak collagen or not enough normal collagen in your tissues. This defect can harm your connective tissue’s ability to support your muscles, organs and other tissues.

Marfan syndrome

Marfan syndrome is a condition that affects many body systems, including your heart, blood vessels, bones, tendons, cartilage, eyes, nervous system, skin and lungs. Marfan syndrome is caused by a defect in the gene that encodes the structure of fibrillin and elastic fibers, major components of connective tissue.

How can I keep my fascia healthy?

Fascia plays an important role in the structure and function of your body, so it’s important to keep it healthy. Some ways you can make sure you’re keeping your fascia in shape include:

• Stay physically active: Move around as much as possible instead of sitting. Make sure to get regular exercise.
• Stretch frequently: Stretching makes your fascia more flexible. This can help lessen pain and inflammation.
• Sit up straight: Try to maintain good posture. Slumping over can cause your fascia to tighten.

What can I do for fascia pain?

If you’re experiencing painful trigger points caused by tightened fascia, there are several therapies and treatments you can try. These may include:

• Yoga: Many yoga poses can help relieve the pain caused by tightened fascia. Look online or find a certified yoga therapist.
• Heat therapy: Place a heating pad over a painful trigger point, or try taking a hot bath or shower to loosen any tight knots.
• Massage therapy: Look for a massage therapist with experience in stretching and working out trigger points through myofascial release therapy.
• Acupuncture: With acupuncture, a certified acupuncturist will place needles in your affected trigger points to help release tension.
• Foam roller: Roll a foam roller over areas of your body that are experiencing tension from trigger points.
• Fascia blaster: Fascia blasting is similar to using a foam roller. It loosens your fascia through physical manipulation and pressure.

A note from Cleveland Clinic

Your fascia is a sheath of stringy connective tissue that surrounds every structure in your body. It provides support to your organs, muscles, tendons, ligaments, tissues, nerves, joints and bones. Fascia is one continuous layer, so it’s flexible and moves with your body. When your fascia tightens, it can restrict the movement of your muscles and tissues, causing pain and other health conditions, so it’s important to keep fascia healthy by moving and stretching your body.