Adhesions & Fascia

Fascia up close... very close.

Fascia up close... very close.


Fascia (pronounced FASH-ya) is an all-encompassing network of strong connective tissue that wraps around almost every part of the body. Only the tubes of the respiratory, lymphatic, and digestive systems are free of this intricate web of tissue.

Fascia provides protection and support for nerves and blood vessels as they pass through body tissues. If the fascia around a nerve becomes adhered to something it should not, the nerve will be irritated and can cause tingling, burning, numbness, or weakness in the area.

Tendons and ligaments are made of fascia; fascia also surrounds and isolates individual muscles, letting them slide easily over each other. Restrictions in the fascia of the muscles and bones can affect posture and the ability to move freely.

Sometimes the body goes a little overboard in its attempt to heal. This is a natural response to any injury, whether it’s caused by infection, trauma, surgery, or radiation. Adhesions, which are fibrous bands of scar tissue, can extend beyond or behind the initial injury, sticking together parts of the body that would normally remain separate, which can lead to alterations in posture, movement, and function.

Imagine your scar is a boat in a harbor, floating around at the whim of choppy waves. You would want to secure your boat with ropes, ideally attached from different directions to give the best chance of keeping it steady. Your body does the same thing with a scar. It forms adhesions and secures them to other parts of the body to give stability to the scar or injury. The problem is when the “ropes” get too tight. Adhesions develop slowly and pull on surrounding body tissues, restricting the ability of the muscles and bones to work properly. They can also irritate delicate nerves and blood vessels.

To fully appreciate the interconnectedness of fascia and how a scar or trauma affects it, put on a tight-fitting shirt and stand in front of a mirror. Grab the fabric at the shoulder and note where the fabric bunches and creates cords on the shirt’s front, back, and sides. Now grab in the middle of the shirt where a Cesarean section scar or appendectomy scar would be. Notice the creases and pulls of the fabric. Finally, hold your shirt on one side of the chest, perhaps where a breast scar would be, and see how the fabric pulls in the back as well.

You can imagine that a scar on the knee could pull the fascia of the thigh, forcing the hip to drop. This in turn could shorten the torso, perhaps rounding the shoulder on that side, which might pull on the neck muscles and result in headaches. You can rub your temples all you like, but your headaches will not stop until you release your knee scar. Crazy, right?

Looser fascia, known as separating fascia, performs a different function. These fascia tissues sheathe all the organs and line the body cavities. Proper structural and functional relationships are maintained so that the organs can function properly. An example is the pericardium, which is a sack of fascia containing the heart. Another example is the fascia holding the pelvic organs in place. If these supportive tissues become weak or damaged, you can have something called a prolapse occur. You can see why we want to keep our different types of fascia healthy.

Besides massage, what can you do? For starters, drink more water.

Being sufficiently hydrated is essential to fascia health because fascia is made mostly of water molecules so that it will be slippery enough to function properly. When stretching, fluid is pushed out of fascia much like squeezing a sponge. When the stretch is released, the area refills with fresh fluid from the surrounding tissue, drawing from the lymph and vascular systems nearby.

Human bodies are roughly 60 percent water, and we need to drink a fair amount every day, about 3 liters (100 ounces) for men and 2.2 liters (75 ounces) for women per day. Water transports nutrients, acts as a shock absorber for the brain and spine, lubricates joints, and is the major component of most body parts. The brain and heart are composed of 73 percent water and the lungs are 83 percent water. Even so-called solid bone is 30 percent water. When you’re dehydrated, your health pretty much goes to hell in a handbasket, and nothing functions properly. This is especially true of your lymphatic system, which is intimately connected to your immune system, and ultimately to your scar.