Fascia: Why (And How) You Should Take Care Of Yours

Fascia is the web-like layer of connective tissue that divides your muscles and organs from each other. It simultaneously holds some stuff in place, and allows other parts to glide over each other with minimal friction.

At least, that’s what it’s supposed to do.

Like any body part, it can go wrong. More on this later. But first…

A quick note on terms

It may seem like sometimes people say “myofascial” because it sounds fancier, but it does actually have a specific meaning too:

• “Fascia” is what we just described above
• “Myofascial” means “of or relating to muscles and fascia”

For example, “myofascial release” means “stopping the fascia from sticking to the muscle where it shouldn’t” and “myofascial pain” means “pain that has to do with the muscles and fascia”. See also:

Myofascial vs Fascia: When To Use Each One? What To Consider

Why fascia is so ignored

For millennia, it was mostly disregarded as a “neither this nor that” tissue that just happens to be in the body. We didn’t pay attention to it, just like we mostly don’t pay attention to the air around us.

But, much like the air around us, we sure pay attention when something goes wrong with it!

However, even in more recent years, we’ve been held back until quite new developments like musculoskeletal ultrasound that could show us problems with the fascia.

What can go wrong

It’s supposed to be strong, thin, supple, and slippery. It holds on in the necessary places like a spiderweb, but for the most part, it is evolved for minimum friction.

Some things can cause it to thicken and become sticky in the wrong places. Things such as:

• Physical trauma, e.g. an injury or surgery—but we repeat ourselves, because a surgery is an injury! It’s a (usually) necessary injury, but an injury nonetheless.
• Compensation for pain. If a body part hurts for some reason, and your posture changes to accommodate that, doing so can mess up your fascia, and cause you different problems somewhere else entirely.
  • This is not witchcraft; think of how, when using a corded vacuum cleaner, sometimes the cord can get snagged on something in the next room and we nearly break something because we expected it to just come with us and it didn’t? It’s like that.
• Repetitive movements (repetitive strain injury is partly a myofascial issue)
• Not enough movement: when it comes to range of motion, it’s “use it or lose it”.
  • The human body tries its best to be as efficient as possible for us! So eventually it will go “Hey, I notice you never move more than 30º in this direction, so I’m going to stop making fascia that allows you to go past that point, and I’ll just dump the materials here instead”

“I’ll just dump the materials here instead” is also part of the problem—it creates what we colloquially call “knots”, which are not so much part of the muscle as the fascia that covers it. That’s an actual physical sticky lumpy bit.

What to do about it

Firstly, avoid the above things! But, if for whatever reason something has gone wrong and you now have sticky lumpy fascia that doesn’t let you move the way you’d like (if you have any mobility/flexibility issues that aren’t for another known reason, then this is usually it), there are things can be done:

• Heat—is definitely not a cure-all, but it’s a good first step before doing the other things. A heating pad or a warm bath are great.
  • Here’s an example of a neck+back+shoulders heating pad; you can get them for different body parts, or just use an electric blanket!
• Massage—ideally, by someone else who knows what they are doing. Self-massage is possible, as is teaching oneself (there are plenty of video tutorials available), but skilled professional therapeutic myofascial release massage is the gold standard.
  • Foam rollers are a great no-skill way to get going with self-massage, whether because that’s what’s available to you, or because you just want something you can do between sessions. Here’s an example of the kind we mean.
• Acupuncture—triggering localized muscular relaxation, an important part of myofascial release, is something acupuncture is good at.
  • See also: Pinpointing The Usefulness Of Acupuncture ← noteworthily, the strongest criticism of acupuncture for pain relief is that it performs only slightly better than sham acupuncture, but taken in practical terms, all that really means is “sticking little needles in does work, even if not necessarily by the mechanism acupuncturists believe”
• Calisthenics—Pilates, yoga, and other forms of body movement training can help gradually get one’s fascia to where and how it’s supposed to be.
• This is that “use it or lose it” bodily efficiency we talked about!

Remember, the body is always rebuilding itself. It never stops, until you die. So on any given day, you get to choose whether it rebuilds itself a little bit worse or a little bit better.

Take care!

From Blue To Green…

We sometimes write about supercentenarians, which word is usually used in academia to refer to people who are not merely over 100 years of age, but over 110 years. These people can be found in many countries, but places where they have been found to be most populous (as a percentage of the local population) have earned the moniker “Blue Zones”—of which Okinawa and Sardinia are probably the most famous, but there are others too.

This is in contrast to, for example “Red Zones”, a term often used for areas where a particular disease is endemic, or areas where a disease is “merely” epidemic, but particularly rife at present.

In any case, back to the Blue Zones, where people live the longest and healthiest—because the latter part is important too! See also:

• Lifespan: how long we live
• Healthspan: how long we stay healthy (portmanteau of “healthy lifespan”)

Most of our readers don’t live in a Blue Zone (in fact, many live in a COVID Red Zone, a diabetes Red Zone, and a heart disease Red Zone), but that doesn’t mean we can’t all take tips from the Blue Zones and apply them, for example:

• The basics: The Blue Zones’ Five Pillars Of Longevity
• Going beyond: The Five Key Traits Of Healthy Aging

You may be wondering… How much good will this do me? And, we do have an answer for that:

When All’s Said And Done, How Likely Are You To Live To 100?

Now that we’re all caught-up…

The news from the Blues

A team of researchers did a big review of observational studies of centenarians and near-centenarians (aged 95+). Why include the near-centenarians, you ask? Well, most of the studies are also longitudinal, and if we’re doing an observational study of the impact of lifestyle factors on a 100-year-old, it’s helpful to know what they’ve been doing recently. Hence nudging the younger-end cutoff a little lower, so as to not begin each study with fresh-faced 100-year-olds whom we know nothing about.

Looking at thousands of centenarians (and near-centenarians, but also including some supercentenarians, up the age of 118), the researchers got a lot of very valuable data, far more than we have room to go into here (do check out the paper at the bottom of this article, if you have time; it’s a treasure trove of data), but one of the key summary findings was a short list of four factors they found contributed the most to extreme longevity:

1. A diverse diet with low salt intake: in particular, a wide variety of plant diversity, including protein-rich legumes, though fish featured prominently also. On average they got 57% and 65% of their energy intake from carbohydrates, 12% to 32% from protein, and 27% to 31% from fat. As for salt, they averaged 1.6g of sodium per day, which is well within the WHO’s recommendation of averaging under 2g of sodium per day. As a matter of interest, centenarians in Okinawa itself averaged 1.1g of sodium per day.
2. Low medication use: obviously there may be a degree of non-causal association here, i.e. the same people who just happened to be healthier and therefore lived longer, correspondingly took fewer medications—they took fewer medications because they were healthier; they weren’t necessarily healthier because they took fewer medications. That said, overmedication can be a big problem, especially in places with a profit motive like the US, and can increase the risk of harmful drug interactions, and side effects that then need more medications to treat the side effects, as well as direct iatrogenic damage (i.e. this drug treats your condition, but as the cost of harming you in some other way). Naturally, sometimes we really do need meds, but it’s a good reminder to do a meds review with one’s doctor once in a while, and see if everything’s still of benefit.
3. Getting good sleep: not shocking, and this one’s not exactly news. But what may be shocking is that 68% of centenarians reported consistently getting enough good-quality sleep. To put that into perspective, only 35% of 10almonds readers reported regularly getting sleep in the 7–9 hours range.
4. Rural living environment: more than 75% of the centenarians and near-centenarians lived in rural areas. This is not usually something touted as a Blue Zones thing on lists of Blue zones things, but this review strongly highlighted it as very relevant. In the category of things that are more obvious once it’s pointed out, though, this isn’t necessarily such a difference between “country folk” and “city folk”, so much as the ability to regularly be in green spaces has well-established health benefits physically, mentally, and both combined (such as: neurologically).

See: The health benefits of the great outdoors: A systematic review and meta-analysis of greenspace exposure and health outcomes

And showing that yes, even parks in cities make a significant difference:

The association of green space, tree canopy and parks with life expectancy in neighborhoods of Los Angeles

Want to know more?

You can read the study in full here:

A systematic review of diet and medication use among centenarians and near-centenarians worldwide

Take care!