What do your head and your feet have in common? They both contain fascia—and so does everything in between. Fascia, a thin connective tissue that surrounds everything from your bones and muscles to organs and nerves, plays a key role in keeping runners healthy, helping you avoid and treat injury, and sidestep pain.
So, to keep your miles ache-free and your body feeling strong, it’s important to understand your fascia. Here, your complete guide to this connective tissue, including how to take better care of it.
What is fascia?
Fascia is just two millimeters beneath your skin, encasing your entire body. Made up primarily of densely packed collagen fibers, fascia is a full-body system of sheets, chords, and bags that wrap and organize your muscles, bones, nerves, blood vessels, and organs. You’re protected by fascia and connected by fascia—it’s what gives humans shape.
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Fascia is strong, slippery and wet. It creates a sheath around each muscle; because it’s stiffer, it resists overstretching and acts like an anatomical emergency break. It connects your organs to your ribs to your muscles and all your bones to each other. It structures your insides in a feat of engineering, balancing stressors and counter-stressors to create a mobile, flexible, and resilient body unit. It generally keeps you from being a big, bone-filled blob.
Why is fascia important to understand?
For generations, most runners probably only thought about fascia when they were diagnosed with plantar fasciitis, when the connective tissue that spans the heel to the base of the toes is inflamed. That’s because, for the majority of medical history, it’s been assumed that bones were our frame, muscles the motor, and fascia just packaging. In fact, for a long time, the convention in medical school dissections was to remove as much fascia as possible to see the “important” stuff underneath. That illustration of the human body hanging in your doctor’s office is a body with its fascia cut away.
In 2007, the first international Fascia Research Congress, held at Harvard Medical School, brought about a new demand for attention to the fascial system. Since that first congress, fascia has been repeatedly referred to as the “Cinderella story” of the anatomy world, speaking both to its intrigue and the geekiness of those who study it.
“Fascia is the missing element in the movement/stability equation,” says Tom Myers, author of Anatomy Trains: Myofascial Meridians for Manual and Movement Therapists. Myers has practiced integrated medical therapy for over 40 years, and studied broadly across osteopathic and movement disciples. He wrote Anatomy Trains out of frustration with clinical practices that regard the body as a machine-like series of parts. He argues instead for a more holistic treatment of the body, with a focus on the fascia as an unappreciated overseer.
“While anatomy lists include around 600 separate muscles, it is more accurate to say that there is one muscle poured into 600 pockets of the fascial webbing,” Myers says. “The ‘illusion’ of separate muscles is created by the anatomist’s scalpel, dividing tissues along the planes of fascia. This reductive process should not blind us to the reality of the unifying whole.”
These days, people are at least a little more familiar with fascia (you might have heard about self-myofascial release or massage, which is all about attending to this connective tissue). The British Journal of Sports Medicine, published a 2018 consensus statement paper in which researchers noted that, “fascial tissues deserve more detailed attention in the field of sports medicine.”
A series of discoveries have also changed the medical world’s perspective on fascia. It’s not just packaging around “the important stuff.” Fascia can contract, feel, and impact the way you move. It’s our richest sense organ, possessing the ability to contract independently of the muscles it surrounds and responding to stress without your conscious command.
Why do runners need to pay attention to fascia?
Grab hold of the collar of your shirt and give it a little tug. Your whole shirt responds, right? Your collar pulls into the back of your neck. The tail of your shirt inches up the small of your back. Your sleeves move up your forearms. Then it falls back into place. That’s a bit like fascia. It fits like a giant, body-hugging T-shirt over your whole body, from the top of your head to the tips of your toes and crisscrossing back and forth and through and back again. You can’t move just one piece of it, and you can’t make a move without bringing it along.
Now, pull the collar of your shirt again, only this time, hold onto it for eight hours. That’s about the time you spend leaning forward over a desk or computer or steering wheel, right? Now, pull it 2,500 times. That’s about how many steps you’d take on a half-hour run. Your shirt probably isn’t looking too good at this point.
Fortunately, your fascia is tougher than your shirt is, and it has infinitely more self-healing properties. In its healthy state, it’s smooth and supple and slides easily, allowing you to move and stretch to your full length in any direction, always returning back to its normal state.
Daniel Lieberman, Ph.D., chair of the Department of Human Evolutionary Biology at Harvard University and avid runner, studies the evolution of long-distance running, researching the way bipedalism, stability, and economy effect the human form in walking and running. In his book, The Story of a Body, Lieberman details the human body’s evolution toward athleticism: “We enjoy rest and relaxation, but our bodies are still those of endurance athletes evolved to walk many miles a day, often run, as well as dig, climb, and carry."
According to Lieberman, our fascial network is an integral part of this evolution toward movement. At the 2018 Fascia Research Congress, he presented on fascia’s role in evolutionary biomechanics. According to his work, the iliotibial (IT) band, the densest concentration of fascia in the body, actually has the capacity to store and release elastic energy. While many runners think first of the IT band as a source of pain and tightness, it may be a major player in humans’ adaptions toward running.
The only downfall when it comes to fascia and what we do to it while running and/or sitting: It’s very unlikely that your fascia maintains its optimal flexibility, shape, or texture. Lack of activity will cement the once-supple fibers into place. Chronic stress causes the fibers to thicken in an attempt to protect the underlying muscle. Poor posture and lack of flexibility and repetitive movements (like running) pull the fascia into ingrained patterns. Adhesions form within the stuck and damaged fibers like snags in a sweater, and once they’ve formed they’re hard to get rid of.
However, every bit of the damage you’ve caused your fascia is reversible, and every one of the problems it’s caused you are avoidable. You just have to treat your fascia right.
A Pro Runner’s Advice on Taking Care of Fascia
The IT band—remember, that’s made of fascia—offers a prime example of how to treat this connective tissue.
“I have a great story of what not to do with IT bands,” says Lauren Fleshman, two-time national champion. In 2011, while training for her debut marathon, Fleshman felt a small pain in her knee during speedwork. She decided to finish the workout and take care of the knee later. “That was the first mistake,” she says.
For the next year, Fleshman raced and trained through pain. She took time off, but never enough, always feeling the pressure of the next season. In the end, she had to take a full year of rest, along with aggressive physical therapy and massage to chase the adhesions up the IT band and through the fascial junctions, to find and calm and loosen the web of tension.
“The tissues just felt unhealthy, lumpy or like overcooked steak, instead of having some spring,” Fleshman says. She made a regular practice of finding those areas, resting her fingers over them with slow and building pressure. “Like a cold stick of butter out of the freezer, if you put your warm thumb on it, it’s not going to melt instantly, but if you start soft and you’re not really pushing in very much, the butter will warm,” Fleshman says. “Then you’re going to get that melty glide.”
Fleshman offers herself up as cautionary tale to her athletes. “I have a very prescriptive approach: any pain in the IT band or the knee or TFL [tensor fascia latae, a muscle at the top of the IT band that helps to stabilize the knee and hip], we take a few days off right away,” she says. During that time, get a massage that concentrates on the lateral muscles and fascia of the leg. Afterwards, recommit to strengthening the supportive hip muscles, with an emphasis on the gluteus medius.
“Any time I’ve done that, I haven’t really had a problem,” Fleshman says.
Advice From a Novice on Taking Care of Fascia
Of course, not all runners have coaches giving them advice, not to mention a crew of trainers and massage therapists. When Lulu Dewey was a fledgling runner and undergrad at U.C. Berkley, she also experienced knee pain.
“Before running started to hurt, it was an escape,” Dewey says. “I didn’t know what I was doing, but getting out the door just made everything manageable.” It was so helpful in managing anxiety and had become such a joy in her life that when her left knee started to hurt, she didn’t want to stop.
The small pain got bigger, and eventually hurt so badly that she limped, even when walking. Eventually, Dewey tried physical therapy, massage therapy, rested, foam rolled, iced, and changed her running shoes. Still, the shortest run would send her right back to limping. The damage was done, it seemed.
As she struggled to make her peace with a life without running, a friend who practiced yoga suggested she start holding hip stretches. By then, Dewey was in grad school, so she’d lie on the floor in pigeon pose, reading for class and letting her body unwind beneath her. Dewey’s previous adherence to common therapeutic practice had ignored the tougher, slower, more expansive fascial chains. “I swear, I never thought I would run without pain again,” she says. “It was almost strange, when the tightness just left, when I started to realize walking around that something had changed, and I could tell it was gone.”
10 Other Ways to Care for Your Fascia
1. Move more, more often
Sticky adhesions form between fascial surfaces that aren’t regularly moved, and over time these adhesions get strong enough to inhibit range of motion. Take a few minutes first thing in the morning to roll around in bed and really stretch out, head to toe, just like a cat after a nap.
2. Stay hydrated
Just like every other tissue in your body, your fascia is made of water. It works better, moves better and feels better when it’s wet. So, drink!
3. Stretch it out
When your muscles are chronically tight the surrounding fascia tightens along with them. Over time the fascia becomes rigid, compressing the muscles and the nerves. Holding static stretches may help. To target areas of common fascial adhesion, try relaxing into a low lunge, a reclining figure four, or a gentle heart opener.
4. Practice Yin or restorative yoga
Some of the most popular forms of yoga, such as power and flow, incorporate fluid, fairly quick progressions from one posture to the next. While excellent for loosening muscle, it doesn’t give connective tissue, including fascia, enough time to release. Slower forms of yoga, such as a yin or restorative yoga class, that incorporate long holds and releases into postures, will help to target fascia.
5. Kick back and relax
If you spend all day tense and tight at a desk, ice baths may not be the best thing for you. Fifteen to 20 minutes in a warm Epsom salt bath can coax help you relax, potentially releasing tension in fascia and releasing your muscles from their stranglehold.
6. Use a Foam Roller
Be gentle and slow in your movements, and when you find an area of tension hold sustained pressure for three to five minutes.
7. Take time off when you need it
If you’re attempting to run through an injury, or returning from one with a limp, beware: Your fascia will respond to your new mechanics and, eventually, even after your injury is gone, you may maintain that same movement pattern. That’s a recipe for an injury cycle. It’s better to take some extra time than to set yourself up for long-term trouble.
8. See a Rolfer
If you have a nagging injury, or just don’t feel right lately, see if your area has a fascial or myofascial therapy specialist. While there are different philosophies and methods, the most widely practiced is Rolfing. Rolfers use manual therapy to “unwind” damaged fascia and release adhesions. The process can look like massage, but the method is specifically aimed toward the tougher surrounding material.
9. Find a specialist
As fascial studies continue to gain traction, more varied manual therapists are considering fascia in their treatments. Osteopaths, chiropractors, physical therapists, and massage therapists are embracing fascial therapies. If you have a hunch that fascia might be the key to unlocking your injury, ask around to see who has fascial certifications.
10. Reassess your movements
The Alexander Technique and the Feldenkrais Method are the two best known for movement education therapy, long embraced by dancers and gymnasts. They use verbal cues, light touch, and simple exercises to lessen unconscious destructive movement patterns that may be irritating or misshaping your fascia.
Julia Lucas is a retired professional runner with a personal 5,000 meter best of 15:08, and she’s writer and a coach in New York City, currently at work on her first book.
