Fascia is a layer of connective tissue that surrounds and protects the muscles and organs of our bodies. It is composed of fibrous bands that can stretch and compress to absorb shock and tension. In fact, it is so extensive and continuous that it essentially holds our body together while also compartmentalizing it.
It surrounds muscles, wraps around tendons, encases blood vessels and nerves, and supports our vital organs. Fascia can be thought of as the glue that holds the entire body together.
Damage to Fascia
Because fascia is such a significant component of the body, damage to it can cause pain, discomfort, and a loss of mobility. For the remainder of today’s article, let’s dive into three instances where fascia may cause us discomfort…
Another common fascial injury occurs due to trauma from a wound or from surgery.
Finally, a variety of degenerative diseases can also affect fasciae throughout the body. Another common cause of plantar fasciitis is the degeneration of the fascia.
Literally meaning “inflammation of the fascia,” plantar fasciitis is the most common source of foot and heel pain as well as one of the most common fascial injuries.
It involves inflammation of the fascia supporting the arch, making walking and standing painful and difficult.
A variety of methods exist to treat plantar fasciitis. Physical therapy and non-invasive treatment options are beneficial to many patients. Some externally applied devices such as insoles, night splints, rocker shoes, and even tape can help (1).
Night splints help to stabilize the foot while you sleep, allowing the fascia to rest and heal. The combination of insoles with rocker shoes or night splints may improve pain relief and increase mobility more than the use of any of these treatments alone.
A more invasive treatment option is a surgical procedure known as a plantar fasciotomy. This operation involves cutting into the fascia in the foot and is an effective option for patients who have tried non-invasive treatments with no symptom relief (2).
Iliotibial Band Syndrome
Iliotibial (IT) band syndrome is common among runners, cyclists, and weightlifters. This type of injury occurs due to overuse and chronically poor technique during exercise.
Because the IT band is used to stabilize the knee joint, one sign of this injury is pain on the outer aspect of the knee. It is also common for people to experience pain up and down the entire length of the IT band, which runs along the outer thigh.
Fortunately, IT band syndrome is often treated successfully with physical therapy. Following a diagnosis of IT band syndrome, it is typically recommended to cease activities that aggravate the area and make the pain worse.
If the pain is severe, however, a doctor may recommend steroid injections. When the pain has started to subside, and the IT band has begun to recover, exercising of the hip and thigh is often the next step in treatment (3).
It may be possible to prevent iliotibial band syndrome by stretching before any form of exercise, especially running. Also, strengthening the hip muscles can reduce the likelihood of this injury (4).
Scarring naturally occurs as wounds and injuries heal; however, large scars can reshape the deeper fascial structures. After surgical procedures, for example, the fasciae may not heal properly, leading to excessive connective tissue beneath the incision.
This excess tissue causes reduced mobility and discomfort. Adhesions occurring after abdominal surgery can have even more serious consequences, including obstruction of the bowel, chronic pain, and infertility in women (5).
Surgeons are becoming more aware of the process by which adhesions form and taking precautions to avoid serious problems. However, if a severe adhesion occurs after a surgical procedure, treatment typically requires an additional operation.
Looking to address your fascia?
We have many physicians and health practitioners at Pacific Coast Sports Medicine that can address injuries and joint pain, especially as they relate to fascia.
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1. Schuitema D, Greve C, Postema K, Dekker R, Hijmans JM. Effectiveness of Mechanical Treatment for Plantar Fasciitis: A Systematic Review. [Published online ahead of print October 18 2019]. J Sport Rehabil. 2019. DOI: 10.1123/jsr.2019-0036.
2. Mao DW, Chandrakumara D, Zheng Q, Kam C, Kon Kam King C. Endoscopic plantar fasciotomy for plantar fasciitis: A systematic review and network meta-analysis of the English literature. [Published online ahead of print August 20 2019]. Foot (Edinb). 2019. DOI: 10.1016/j.foot.2019.08.001.
3. Fredericson M, Weir A. Practical management of iliotibial band friction syndrome in runners. Clin J Sport Med. 2006; 16(3):261-8.
4. Kollock RO, Andrews C, Johnston A, et al. A Meta-Analysis to Determine if Lower Extremity Muscle Strengthening Should Be Included in Military Knee Overuse Injury-Prevention Programs. J Athl Train. 2016;51(11):919-926. DOI: 10.4085/1062-6050-51.4.09.
5. Liakakos T., Thomakos N., Fine P.M., Dervenis C., Young R.L. Peritoneal Adhesions: Etiology, Pathophysiology, and Clinical Significance. Dig Surg. 2001;18(4):260-273. DOI: 10.1159/000050149.