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Philadelphia & Narberth – Fascia Restrictions and Myofascial Release Therapy

What is FASCIA?

fascia (plural fasciae, adjective fascial) is a band or sheet of connective tissue beneath the skin that attaches, stabilizes, encloses and separates muscle and internal organs. There are three layers of fascia: superficial fascia (skin), deep fascia (associated with muscle, bones, myofascial) and visceral fascia (encases the organs). Fascia is also classified by its function and anatomical location.

Fascia is made up of fibrous connective tissue that contain closely packed bundles of collagen fibers. The fibers are oriented in a wavy pattern parallel to the direction of pull of the fascia. Fascia is very flexible and able to resist great unidirectional tension forces until the wavy pattern of fibers has been straightened out by the pulling force. (Source: Wikipedia)

Fascia can be compared to an orange. if you cut an orange open, the stuff that separates the pulp is similar to the fascia. It’s a membrane that keeps the juicy pulp separate – it’s flexible but stabilizing.  that’s kind of what fascia is. It’s the membrane that keeps the juicy pulp separate.

How are the different levels of fascia connected?

At Rebalance, our physical therapists work on all three levels of fascia. Whatever level of fascia you’re targeting, the other levels of fascia will be influenced. Fascia is continuous. However, you can target a specific type of fascia with various techniques.

Depending on the severity of the symptoms, the superficial fascia might be worked on first. Once work on the superficial fascia is well tolerated, then treatment would move to the next level of fascia.

Superficial Fascia Restrictions

People with superficial fascia restrictions:

  • *Have hypersensitivity of the skin
  • *Are intolerable to clothing
  • *More sensitive to touch
  • *Feel like you have a wet suit around you
  • *Feel tight and constricted
  • *Feel like there is a vice around you

The superficial fascia would be focused on if someone could not tolerate work on their myofascial or visceral fascia due to extreme pain.

The targeted work on the superficial fascia might be used for:

  • *Pain management
  • *Scarring
  • *Prep for myofascial or visceral work in the future.


Any orthopedic or pelvic floor issue can benefit from myofascial work.

Myofascial restrictions can cause:

  • *Muscle tightness
  • *Reduced flexibility
  • *Muscle weakness
  • *Blood vessels and nerves that run through the muscle to become constricted
  • *Decreased circulation,
  • *Pain
  • *Numbness or tingling

Working on the myofascial helps improve the flexibility and circulation of that area, which usually involves the muscle and joint. That allows for:

  • *better healing
  • *less pain
  • *greater range of motion

All of this ultimately improves your muscle’s ability to contract and lengthen so it functions better.

Visceral Fascia 

Visceral fascia restrictions can affect all levels of fascia, including common myofascial restrictions. It can be anything:

You can have visceral restrictions around bladder, or any of the other internal organs.

Common conditions caused by tensioning in the visceral fascia include:

  • *Constipation
  • *Irritable bowel syndrome
  • *Slow transit disorders (e.g., gastrointestinal system isn’t pushing and stool is not moving through fast enough)
  • *Interstitial cystitis
  • *Bladder frequency
  • *Bladder urgency
  • *Low back pain
  • *Sacroiliac joint dysfunction
  • *Dyspareunia – pain with urination

How do trigger points affect fascia?

Trigger points are different than restrictions to the fascia.

Trigger points are hard knotted band of muscles within a muscle. It’s an area in a muscle where the fibers have tightened and banded together. This makes the muscle fibers tight and constricted which consequently restricts the fascia.

Alignment and Fascia Restrictions

It can be unclear about whether a fascial restriction is caused by misalignment or if the fascial restriction led to misalignment.

  1. 1. Tight fascia causing misalignment:

For example, if someone played sports repetitively and developed a pattern that made fascia tight, that would eventually pull on muscles which will affect alignment.

2. Misalignment causing tight fascia:

If someone had alignment issues, they might develop a certain form of walking. Because of this new form of walking, it would allow certain muscles to habitually work more than others and become tight.

Treating the Fascia: What is Myofascial Release?

When you’re doing myofascial release, you’re trying to separate the muscle from the fascia. Fascia is like a glue that binds and separates organs, muscle fibers, skin, etc. Click here for more on Myofascial Release at Rebalance

Treating the Fascia: What is Visceral Mobilization?

Visceral Mobilization is a hands on technique that works with the viscera (the internal organs) and the surrounding connective tissue that binds and anchors the organs to each other and to the bones of the body.

Click here for more on Visceral Mobilization at Rebalance.

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