What’s it all about?
Functional Fascia aims to bring information on functional movement and the ‘missing anatomy.’ So much of what we see in anatomy books is not how the body really hangs together but is edited highlights. For those working in the field of hands on body work, this creates not just a problem of interpretation, but of understanding. Simply put, a new anatomical paradigm is needed. One of understanding the anatomy that gets thrown away and describing the tissues so often classed as ‘poorly described.’
Julian Baker has been a hands on therapist for over 25 years. The founder of the European College of Bowen Studies, ECBS he has taught thousands of students over the years the skill of The Bowen Technique, a non invasive system of fascial release. He is the author of two books on Bowen and Fascia and has contributed hundreds of articles about bodywork, fascia, dissection and the human form.
A popular and sought after speaker, he has presented widely at conferences around the world and as well as speaking, has been on the organising committee of the British Fascia Symposium since its inception in 2016. Since 2006 he has been leading human dissection courses throughout the UK focusing on the fascia and connective tissue structures, rather than standard anatomical approaches. From these studies we are able to see that the traditional way of teaching how and why the body works needs adjustment and a shift in understanding.
There is a lot of incredible science out there in relation to fascia and some very important research taking place that will change the way we understand functional movement. However much of the science is theoretical and complex in its terminology. The Functional Fascia model is to simplify and make the understanding of functional movement accessible and easy to understand.
The sole purpose of this dissection process is to deepen the understanding of human movement, how we get injured or stuck and what happens to our form when we do. The aim is to benefit others by exploring the tissues that someone carried around for many years.
What is Fascia?
There are several types of tissues that we can refer to as fascia around the body and not everybody agrees on the nomenclature or naming. I am going to follow the path that has always worked for me, mainly my own, in order to explain some of the layers that we include in our fascial family, what they do and why they might be considered important.
Fat or Friend?
Our first stop on this tour is probably the most argued about, least studied and yet most intriguing, the superficial fascia. This layer is often called the adipose, the pannicular layer or subcutaneous tissue and although contains the two types adipose tissue, white and brown, it is also much more than just a fatty layer and is the layer of tissue that we have the biggest direct relationship with in our daily life, in particular if we are therapists who put their hands on people.
The superficial fascia gives us the springy feel to our body and acts as a huge shock absorber as well as a very important infection fighting layer. It’s ability to easily store fat is one of the reasons that we experience obesity but it is also an endocrine organ, secreting hormones such as leptin,(Kershaw and Flier 2004) involved in the regulation of metabolism and appetite, and resistin, increased levels of which are suspected as playing a role in obesity and insulin resistance. In addition cytokines – cells secreted by the immune system- which regulate and control inflammation and emergency responses throughout the body are stored in the adipose. This means that superficial fascia as an adipose layer, has all the equipment it needs, not just to store energy, but to communicate with all the other organs of the body, including the central nervous system. And we thought it was just fat! This layer is a loose, aureolar layer of tissue, which when examined has the appearance of bubble wrap. One can push ones fingers in between the loose pockets of fatty, yellow material and gently tease it apart. Yet at the same time as being almost fluffy and flexible, it is incredibly strong and able to absorb large pressures placed upon it.
If for example you were to press hard and quickly onto it, then just like bubble wrap, the layers would close on themselves and protect the underling tissues from penetration or heavy pressure. It is adhered to the skin in an intimate arrangement that defies manual separation and the only way to examine this layer away from the skin is to use a very sharp blade and forcibly take them apart. Once apart the layer is still incredibly strong, dense and continuous and even prolonged and strenuous pulling will not rip the layer.
As well as the ability to contain fat, it is also a layer of connective tissue, which is three-dimensional and, like the skin sits in a continuous layer all over the body. The globular fatty deposits that are so prevalent here, are held in place by strong white, fibrous structures that give the whole layer a body wide continuity and integrity that is unique in the human form. No layer other than the skin, has this degree of continuity.
This image is taken from the remarkable Integral Anatomy Series by Gil Hedley. It shows the superficial layer removed from a cadaver in its entirety. It’s a beautiful layer and one that Gil movingly refers to as this lady’s “wedding dress.”
In dissection, the removal of the superficial fascia can be quite a laborious task, but the change once completed is remarkable. By taking away the entire covering, we can see clearly that what is left behind lacks identity and becomes androgynous and anatomical. The shape we see in the picture above is clearly female. What is left behind is not.
The superficial fascia varies in thickness from a couple of millimetres to several centimetres, but is always connected to skin at its outer surface. In much the same way that the skin is the interlocutor between the inside body and the outside world, the superficial layer is also acting on the internal organs. It is heavily supplied with blood and fluids from the rest of the body and is perforated throughout its surface with blood vessels and nerve endings that reach through it to end on the surface of the skin.
It is also a particularly poor conductor of heat, which means that it is very helpful in retaining the heat of the body and keeping us warm. So with all these useful qualities we have to wonder why we have such a poor relationship with it. The fatty layer that is our superficial fascia is often demonised. We are concerned about having less fat in and on our body, which is fine, but also go to great lengths to lose weight and burn fat and see it as something to be excised, even going to such extremes as liposuction and plastic surgery.
For the physical therapist, this is the layer that we have most in common with and through which we work when trying to reach into other structures of the body. This is the layer which is always present underneath our hands and however much we wish to think about muscle, bone, deep fascia and so forth, it is this layer which is the translator of our touch to the deeper tissues beneath. When working around the gluteal area for instance, the depth of tissue is such that we are feeling a distant resonance of gluteus maximus, and whilst we are able to define tension, tone and feeling of the underlying muscle, much of the quality of this palpatory sense will be subject to the sensitivity of how we approach the superficial fascia.
There are many deep tissue approaches in the world of bodywork, many of these applying great pressure to delve through the superficial tissues in order to work on ‘deep tissues’ such as psoas or even less likely QL. In theory you can access any areas of the body you wish to but generally the factor that will keep you out is the tension of the practitioner and the way in which the superficial fascia responds to this tension. If we work through the superficial layer with patience and a light touch, our ability to reach in, palpate and treat deeper tissues without creating pain or being invasive, is perfectly straightforward, although I doubt whether the psoas is really touched to any meaningful degree.
My ultimate concerns arise from those therapists who think that in order to go deep you have to go in hard. You don’t and you shouldn’t.
The sexy stuff! This is what everyone feels that they know about and is what is depicted or visualised when thinking about a white covering of muscle. This isn’t incorrect, but neither is it the full picture. The tendency of prosectors and those depicting anatomy, is to cut away the bits of the deep fascia that ‘gets in the way,’ and leave the bits behind that are more famous or more visually pleasing.
Then there are the rafts of therapies that have arisen over the past few years, that suggest that this or that ‘fascial release’ treatment is able to somehow change this deep layer of connective tissue. It’s not clear why fascia should be released and if it is, where it should be released to, but that’s not to say the treatments aren’t pleasant and effective, just that it’s highly improbable that much, if anything in relation to fascia, is going to change in the space of a one hour session.