Myofascia (My-o-FASH-ah) is a type of connective tissue that envelops our muscles and every individual muscle fiber in a most meticulous and entirely thorough manner. It connects our muscles to bones and in turn, other muscles. Myofascia is specific to muscles, “myo” is the root word for muscle. However, we have fascia, also known as connective tissue, which connects much more than muscles and bones. Thomas Myers, author of Anatomy Trains, summarizes it well: "Connective tissue is very aptly named....It binds every cell in the body to its neighbors.” ²
So what's the big deal about fascia and myofascia? Because connective tissue (fascia) is so good at connecting, the touch of massage therapy at the surface of the skin can have profound effects much deeper than the surface of the skin. These effects rely on a few key characteristics of connective tissue.
If you want to take a deeper dive into what makes connective tissue so unique and so impactful in massage, read on! If you simply want to take a look at what this connective tissue business looks like under our skin, scroll down to the DISCLAIMERS and video at the bottom of the blog.
Connective tissue is made of a mix of cells, fibers and ground substance.
There are three types of cells:
1) Fibroblasts, which produce the various fibers that are such a key part of connective tissue.
2) Mast cells, which secrete substances that affect blood and blood vessels.
3) Macrophages, which literally means “big eater.” These cells help get rid of unwanted material.
There are also three types of fibers:
1) Collagen fibers, made from collagen, which is very tough and resistant to stretching.
2) Reticular fibers, made from reticulin, which is slightly extensible and tolerates moderate tension without tearing.
3) Elastic fibers, made from elastin, which is much smaller and more flexible than the other two fibers.
Ground Substance is the fluid / gooey component between the cells and the fibers. It is mostly water but also has crazy-sounding things called glycoaminoglycans (aka GAGs). The GAGs are unique molecules that serve as water magnets and help keep the ground substance fluid, allowing it to fulfill its function as a spacer and lubricant. ¹
The ground substance within connective tissue is what gives it a unique characteristic called thixotropy. Thixotropy refers to the ability of the ground substance to shift between a more solid state or a more liquid state. When connective tissue is cold, it is stiffer and less pliable because the ground substance is in a more solid state. For example, think of how stiff you might feel first thing in the morning, getting out of bed. However, when heat, movement or compression is applied, the ground substance in connective tissue shifts to a more liquid state. This is why kneading, compressing, rolling or other techniques that stir the ground substance are used in massage therapy - to achieve softer, looser and more pliable tissues. ¹
Finally, the concept of piezoelectricity. Basically, our cells can communicate with one another without using the classic neuron pathways. It’s more long-term and slower-paced and occurs when our cells are compressed or stretched. If part of our body is under stress (from tight muscles, poor posture, an injury, repetitive use, etc.) then our connective tissue will respond accordingly, by adding or removing cells and fibers as needed. “Stress passing through a material deforms the material, even if only slightly, thereby ‘stretching’ the bonds between the molecules. In biological materials, among others, this creates a slight electric flow through the material known as a piezo- (pressure) electric charge. This charge, representative of strain through the tissue, can be ‘read’ by the cells in the vicinity of the charge, and the connective tissue cells are capable of responding by augmenting, reducing or changing the intercellular elements in the area.” ²
This is relevant in massage because we can create this piezoelectric current in our cells and connective tissue (through compression, kneading, rolling, etc.) and though short-lived, this calls our body’s attention to those areas. In massage therapy, we’re really here to facilitate the body’s innate healing ability, allow release of muscles that have been locked in either a lengthened or shortened position and help bring a little more circulation to areas that have been deficient in blood, impacting the oxygen and nutrients those cells are getting and their capacity to clear metabolic waste.
All told, connective tissue is an incredibly important, versatile and pervasive part of our human body and due to its unique nature, helps us, as massage therapists, affect positive change in muscles and other soft tissue.
If you like anatomy and biomechanical concepts and want to take an even deeper dive into connective tissue and myofascia, Thomas Myers has written a fascinating book called Anatomy Trains. He gives a very thorough explanation of connective tissue then maps out 12 lines of interconnected muscles throughout our body that he’s named “Myofascial Meridians.” In his book, he explains in depth how tightness or stuckness in one part of our body can impact a seemingly distant part of the body. This book has been very instrumental in the way I approach and assess each massage therapy session.
VIDEO:
If you’d like to see an example of how adaptable and amazing our connective tissue can be, and what it actually looks like under our skin, click on the link below.
DISCLAIMERS:
1) The beginning of the video is quite graphic, I recommend starting around minute 14.
2) This is a 28 minute film recording an arthroscopic surgery by French surgeon, Jean-Claude Guimberteau. It literally allows us to see what our bodies look like under the skin of a live human being. If you start the video in the 14 minute range, you will be transported directly under the skin, witness to how our fascia behaves and adapts, in vivo!
3) The narrator definitely uses some very advanced jargon. You don’t have to follow what she’s saying to appreciate the phenomenon that is the human body. :)
Sources:
Archer, Pat & Nelson, Lisa A. Applied Anatomy & Physiology for Manual Therapists. Philadelphia, PA. Lippincott Williams & Wilkins. 2013.
Myers, Thomas. Anatomy Trains, Myofascial Meridians for Manual & Movement Therapists. 3rd Ed. New York, NY. Churchill Livingstone Elsevier. 2014.
"Strolling Under the Skin." YouTube, uploaded by UKyOrtho, 28 August 2014. https://www.youtube.com/watch?v=eW0lvOVKDxE&t=896s