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There’s a common misconception circulating about manual tissue therapy: that they “break up” fascia. For instance, this is common for techniques like deep tissue massage, tooling and myofascial release

This notion is not entirely accurate, and it’s essential to clarify why.

Fascia is a dense, fibrous connective tissue that surrounds and supports muscles, organs, and other structures in the body.

LEARN MORE: What Is Fascia?

Additionally, its important to understand that fascia, connective tissue, and muscle tissue in the body are in a constant state of remodeling.  The amount of movement, tension, and biochemical environment affect the changes.


manual therapy
Professional manual tissue work has a lot of benefits, but they aren’t caused by breaking up fascia.

Manual Therapy Doesn’t Break Up Fascia

While manual tissue therapy can indeed have a profound impact on fascial health, it doesn’t actually “break up” fascia in the way this misconception suggests. Here’s why:

Fascia is a continuous structure

Fascia is an uninterrupted, three-dimensional network that envelops various parts of the body. It’s more like a seamless web than individual pieces. The idea of “breaking up” fascia into discrete parts is misleading because fascia is inherently interconnected.

Fascia is strong

Fascia is primarily composed of collagen, which is a strong and fibrous protein. Collagen provides tensile strength, meaning it can withstand stretching forces without breaking. In fascia, collagen fibers are densely packed and organized in a way that maximizes their strength.

Manipulation, not destruction

Manual tissue therapy techniques involve the skilled manipulation of fascial tissue. Therapists use their hands and specific methods to stretch, release tension, and encourage reorganization of fascial fibers. The goal is to improve the pliability and health of the fascia, not to shatter it.

Promoting fascial health

Manual therapy aims to enhance the function and condition of fascia by addressing issues such as adhesions, restrictions, and tightness. It encourages the fascia to become more supple, hydrated, and resilient.

No scientific evidence

There is no scientific evidence to support the idea that fascia can be permanently “broken up” or fragmented through manual therapy. Fascia is a crucial and resilient tissue that doesn’t easily disintegrate.


IASTM muscle recovery
Instrument assisted soft tissue mobilization (IASTM) has benefits for fascial health.

Better Reasons Why Manual Therapy Helps Fascial Health

Just because manual therapy doesn’t actually “break-up” fascia it still can help. 

A lot.

This is the reason it’s a mainstay in athletic training rooms and physical therapy clinics. Instead of breaking up fascia, manual tissue therapy helps to:

Improving Gliding Between Tissue Layers

Layers of tissue need to move over one another for healthy mobility.

One of the results of skilled manual therapists is that it can help you restore glide between layers of fascia and other tissues.

There’s a lot moving around under the skin with different layers of fascia, muscle tissue, and tendons.  Add in blood vessels, nerves, and lymphastic vessels, and there are a lot of things that need to slide and glide to allow you to move well.

Fascial Release

Manual therapy techniques like myofascial release and deep tissue massage target the fascial layers between muscles.

By applying pressure and stretching, therapists can help release new forming adhesions and restrictions in these layers, allowing them to glide more smoothly over each other.

Enhancing Interstitial Fluid Movement

Manual therapy promotes the movement of interstitial fluid, which lubricates the spaces between tissue layers.

This increased fluid flow can reduce friction and improve the sliding of tissues, contributing to greater flexibility and reduced stiffness.

Influencing the Nervous System to Change Fascial and Muscle Tone

Fascial tissue is innervated, meaning it is supplied with a network of sensory nerves. These nerves are embedded within the fascial matrix and play a vital role in proprioception – the body’s ability to sense its position and movement in space.

Sensory signals from fascial tissue help the brain understand muscle tension, joint position, and movement, contributing to our overall sense of body awareness.

Additionally, these sensory nerves can transmit pain signals when the fascia is irritated, injured, or under excessive tension, helping to alert the body to potential issues that may require attention or treatment.

This also gives a few more ways that manual therapy can provide results;

Reduce Tension

Manual therapy techniques can stimulate proprioceptors within muscles and fascia. This sensory input communicates with the nervous system, promoting neuromuscular re-education. As a result, fascial and muscle tone can be adjusted, leading to relaxation and reducing tension that limits mobility.

Pain Modulation

Manual therapy can trigger the release of endorphins and other neurochemicals that help reduce pain perception.

When the nervous system perceives less pain, it may allow muscles and fascia to relax, contributing to a more balanced tone. In turn, this means better mobility and less pain.

Reorganizing Collagen Fibers

Collagen is a structural protein that forms the framework of connective tissues in the body, including fascia.

Within fascia, collagen fibers provide strength, support, and elasticity.

Manual therapy techniques have the remarkable ability to influence the organization and health of these collagen fibers, which can have a profound impact on tissue function.

Type of Collagen

Collagen is not a single entity but exists in various types throughout the body. Type I collagen is particularly abundant in fascia and tendons, providing tensile strength. Manual therapy can affect the alignment and quality of Type I collagen within the fascial matrix.

Reorientation

Skilled therapists use manual techniques to encourage the reorientation of collagen fibers. Fascia with disorganized or irregular collagen patterns can lead to stiffness and restricted movement. Manual therapy uses tension, glide, and stretching to encourage realignment in these fibers. In turn, this promotes greater flexibility and tissue resilience.

Preventing Adhesions

“Adhesions” are excessive and dysfunctional in loose connective tissue between fascial layers.

Adhesions within fascia can result from injury, surgery, or inflammation. These adhesions can limit the sliding and gliding between fascial layers.

This process is also called densification.

LEARN MORE: Densification and How To Stop It

Manual therapy, through controlled pressure and manipulation, can help break down these adhesions, allowing for smoother tissue movement.

Tissue Remodeling

Over time, consistent manual therapy can contribute to the remodeling of fascial tissue. Fascia is in a continual state of remodeling over weeks or months. Subsequently,  fascia adapts to new patterns of tension and alignment, promoting healthier and more functional tissue.

Improved Circulation

Manual therapy techniques can stimulate blood flow to the fascia. Improved circulation ensures that collagen-producing cells receive essential nutrients, supporting the maintenance and repair of fascial tissue.

In summary, manual therapy is a valuable tool for reorganizing collagen fibers within the fascia.

By influencing the type, alignment, and quality of collagen, manual therapists can contribute to enhanced fascial health, leading to improved mobility, reduced discomfort, and better overall tissue function.

Understanding these mechanisms underscores the importance of manual therapy in maintaining and optimizing fascial well-being.

Fix Your Fascia, But Don’t Break It Up

In summary, fascia is a strong, interconnected tissue in the body that doesn’t “break up” with manual therapy; instead, it’s stretched and reorganized.

Understanding these facts dispels myths and highlights the importance of evidence-based manual therapy.

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