Small Spaces

Small Spaces






The all encompassing word fascia holds some degrees of confusion and variation.  Fascia is a lot of things to a lot of people and depending on what you have read or what your field of thinking or science is, your view of fascia may vary accordingly.  As a connective tissue, it has a lot of properties and is described in many ways.  There are the sheet like structures that form aponeuroses around the body: the iliotibial tract or band (ITB) and the galea aponeurotica or scalp fascia to name but two.

Fascia however has lots of different presentations and formations and it’s worth remembering that as a connective tissue, its primary purpose is to connect.  Sounds obvious I know, but fascia gets imbued with lots of strange properties that in turn generate stories and fantasies around what it is and what it can do.

The main thing to remember about all connective tissues is that they are mostly non-cellular in their make up.  That doesn’t mean to say there are no cells in fascia, just that mostly the fascia is the product of the cell.  This is pretty important as if fascia were mostly composed of cells they would need to consume a lot of energy and would also need to be replaced.  As it is, fascia is mainly protein in the form of collagen and acts as both as a scaffolding and a separator.  The images reproduced here show this really clearly.

The muscle fibres are kept both separated and connected by the connective tissue that runs in between them and around them.  This gives the fibres both strength, integrity but also allows space for fluid and (probably) information to run between and around them.  The fluid is the important bit in all of this.  Fluids in the body not only allow for movement to take place on every level, but also allow for nutrients and waste to be carried around the entire system.

The idea of ‘releasing’ fascia is something that I struggle to get my head around, but is probably best explained as being a method of encouraging movement of fluids through and around connective tissues, where poor fluid movement has become an issue or results in presentation of pain.


Holism, or how the whole can get us out of the hole

Discussions!  The word holistic has long been used as a whipping tool for those who would suggest that a whole person approach is in some way flaky or flawed.  As patients visiting a doctor, we go with a problem to be solved and the doctor in his wisdom sets about finding the way to treat the condition we present with.

It would be naive to suggest that with our current medical model, the medic at the front line of disease fighting has the time, training or inclination to consider the subtleties of the individual.  Yet disease is rarely standardised in humans.  Common symptoms exist, but each person will have a learned response to each situation they find themselves in.

Similarly physical pains can have a myriad of reasons for their manifestation, even though at first glance the pain may be standard.  NSLBP as it is often referred to.  Non Specific Lower Back Pain.  The scourge of most nations, it is one of the biggest causes of lost work time and hence a costly affair for industry and health care alike.

Most nations are traditionally terrible at treating it, for the very reason that our anatomy fails us when looking at the back.  We see a collection of spinal muscles, some fatty stuff at the base, a joint that moves or doesn’t move, depending on who you believe and oh so many theories and stories.

The same pain in a hundred people could and probably does, have a hundred different causes and thereby approaches.  This man’s knees were injured and he compensated when recovering through poor use of his crutches.  This woman carried a toddler for two years on slim hips and used her neck to take most of the weight.

This lady leant over her husband every day for many years to help him get out of bed.  And so on and so forth.  We treat people as conditions, yet don’t often consider the person with the condition.

By considering who a person is, rather than what they are presenting with, our focus changes and our ability to see a different outcome as possible becomes an opportunity.