A Scan Of The Layers Of Fascia

Throughout a Fascial Manipulation Treatment, I will talk often about your layers of fascia within the body and how, if densified, they may not slide and glide well. This can often result in changes in your biomechanics or movements which in turn result in a higher chance of injury and ultimately pain. So, what does this look like? Below is a great picture from a 2014 study called Painful Connections: Densification vs Fibrosis of Fascia by Pavan et al. 

It shows, with the use of an ultrasound machine (similar to what is used when scanning pregnant ladies), that we can see different layers of fascia and the muscles in your body. The picture below is of one of the neck muscles – your sternocleidomastoid. The red arrows in each box show the width of two fascial layers (the white lines) that surround this muscle. The black layer between is where the lubricant called hyaluronic acid. This lubricant promotes the sliding and gliding of the fascia layers. 

Box A is a normal scan of someone whose neck is painfree and moving well. The fascia layers are even, and the lubricant layer is easily visible. 

Box B shows that there is thickening of the lubricant layer (this is known as densification) as well as the thickening and subsequent stiffness of the layers of fascia.  

Box C is when this becomes thickened further resulting in fibrosis or stiffness of the area, a permanent thickening and lack of slide and glide of the fascial layers. 

What does this mean for us? 

When the layers of your fascia start to thicken, through injury, overuse or trauma (Box B), pain is felt, and decreased range of movement noticed. At this stage, with manual therapy such as Fascial Manipulation, the densification can be broken down and normal movement of your fascia layers and your body restored. 

If left for a long time, this lack of gliding can become permanent (Box C). 

Fascial manipulation is able to assist with breaking down the thickened hyaluronic acid, assisting to restore gliding, increasing movement and improving your pain.