The Fascia, Tensegrity, and Why Moving Well Is More Important - and Easier - Than Looking Perfect
You may have heard about the debate over whether or not cats can be described as liquid rather than solid, given that they seem to flow in and out of all manner of odd places and take every opportunity to pool into the place of least energy like water. On the other hand they can’t break apart and re-form, and fluid doesn’t tend to chase around balls of string of its own volition. Okay, so maybe not really liquid, but it seems inaccurate to call cats solid either. This ambiguity applies to us as well. Even though our bodies are composed of 50-60% water we don't sag or splosh about, unless we've drunk too much tea, and this is of course because the fluid is sequestered in our tissues; in our cells and muscle fibres, internal organs, and that mysterious, often overlooked part of us known as the ‘interstitium’ or more commonly called the fascia.
I say mysterious because historically the various layers and networks which compose this connective tissue have not been easy to see. When the human body was being dissected, and its various components classified by anatomists, muscle, organs and bone remained more or less well preserved, whereas the fascia would dry out, leaving only thin layers of opaque film or cobwebby strands, which made it difficult to appreciate the role it played in, for example, the flow of nutrients and metabolism through the body, or its role in structural support and movement. It is only until relatively recently that we have been able to estimate that fascia actually makes up around one-third of all protein in the human body and weighs around 20kg in the average adult. Much of this weight is liquid such as hyaluronic acid in which all manner of proteins, 'ground substance' and collagen are suspended. The structure of the fascia allows the flow of this fluid throughout the body, providing an extra transport system for nutrients, such as oxygen and metabolites. Strands of collagen have the ability to break when tissue is stretched and then reform, being neither truly fluid or solid, but something else. In this respect it is similar to other parts of us such as blood which can be fluid under certain conditions but solid under others, very much a living liquid.
To visualize this all-encompassing tissue we could imagine many hundreds of sheets of cling film wrapping and winding around the muscles and organs of the body, with all this fluid flowing between it. The 'cling film' is active, interlaced with networks of blood vessels and nerves, and therefore playing an important role in 'interoception' - our sense of internal experience. The sensitivity of this tissue is believed to be responsible for the difficulty we often encounter in localising pain. For instance we might experience pain in our lumbar area which convinces us that the source of the pain is there, perhaps from a herniated disc or inflamed nerve root, where in fact the origin of the pain is often in the muscles of the glutes, because the fascia covering the buttocks runs continuously up to the lower back. We might spend months stretching or massaging our lower back, or trying to release it with some chiropractic manoeuvre, but to no avail. However by widening our focus to the buttocks, by judiciously targeting the true source of the pain, with massage or sitting on a tennis ball etc, the low back pain higher up miraculously starts to abate. It is possible that acupuncture works to some degree by targeting the fascial networks, though this is just a hypothesis.
The lesson is that pain is often not where we think it is. Headaches for instance often seem to be 'in our brains'. Yet the brain itself has no pain receptors to feel pain, and the source is almost always in either the connective tissue around the brain, or often the scalp, which extends to the back of the neck. Only rarely are headaches caused by something going on in the brain itself. The same goes for our musculoskeletal system. Doctors - and I have also been guilty of this - will often tell patients that plantar fasciitis is due to inflammation in the thick layers of fascia in the sole of the foot. However, inflammation has not really been established as the cause and it is also likely that the base of the foot is merely one locus of an issue - tight, sticky fascia - that extends all the way up the calf muscle, to the the back and even up the neck in what is known as the posterior line. For this reason physiotherapists will often advise patients to stretch and mobilise this whole ‘line’ rather than focus on one area. By stretching your neck you can treat pain in your foot. One of the principle messages we ought to take away from our growing knowledge of fascia is that the best way to treat pain in one spot is to also focus on what's going on 'above and below' the pain, and ideally treat the whole body. If your knees hurt, look at what your pelvis doing, if your head hurts, what's happening with your shoulders and so on.
I've talked before about how our internal beliefs or images about what is going on with our bodies are, at best, reasonable guesses or analogies, and at worst ideas completely divorced from the organic reality. There is simply no way our mind - which usually understands things in terms of images, words, stories, metaphors and so on - can fully appreciate the dynamic complexity of the body. In general it doesn't really need to. However if we are not careful these erroneous images can get us into negative cycles of self-belief which in turn lead to unhelpful behaviour. Take the ideas we commonly attach to 'getting old'. I have often heard it said that our muscles stiffen with age, or our bones and joints gradually erode or seize up with advancing years, and that we have no choice but to accept that we will spend the last decades of our lives stiff and withered.
However these really are just word-images, no more real than butterflies in our stomach. The reasons we are more prone to aches and pains as we get older is not that our muscles or bones are getting worn out, slowly degenerating or drying out, but due to the fluid running between our fascia becoming sticker - if you imagine rubbing two layers of film over honey it will be far less mobile than if it were over water or thin oil. This stickiness is often accompanied by adhesions where the fascia sticks together, leading to tightness and catching. It is therefore important to stretch and mobilise our bodies as often as possible to break up the collagen cross links and adhesions and keep the layers gliding. Interestingly, stretching not only increases the range of movement by freeing the layers of fascia, but also by increasing our perception of how far we can stretch. Research suggests that stretching does not actually lengthen muscle fibres, but it does stretch our brain's idea of how far we can go. Yoga literally does stretch the mind.
It is worth mentioning in passing, because it is such a common nuisance, the phenomenon of ‘trigger points’: those tight knots of muscle which can often be felt, usually in inaccessible regions of the body such as between the shoulder blades or in the buttocks. These are another muscle-and-fascia problem; they are thought to be the result of a localised muscle spasm plus impeded flow of oxygen, leading to a build up of calcium, which in turn causes more muscle contraction, in a vicious cycle. Again, regular stretching and pumping of those areas can eventually release the knot, though it often takes quite a bit of exploring to find the way. Another important detail is that a stretch needs to be held for 90-120 seconds for it to actually 'release' tight myofascial regions, so I usually tell people to go to the limits of what is comfortable and hold for 2 minutes, and repeat the yoga maxim to 'go easy when you get there, but get there every day'.
Here we can see why painkillers, such as anti-inflammatories, paracetamol, opioids or those that modulate the nervous system, reach the limits of their effectiveness quite quickly, often to the dismay of the suffering person. While painkillers are valuable, they aren’t going to make the fluids between the fascia flow better, nor break up adhesions or unlock chronically tight muscle fibres. Even stretching and massage will provide only temporary relief if it is limited only to the problem areas, because as we have seen, the origin of the problem may not be where the pain is most felt. Once again we return to the necessity of treating pain or discomfort holistically. The term holistic seems to have acquired a slightly new-age flavour, but really it is nothing more than recognising that the body and mind is an interconnected whole, in which treating problems in isolation - 'atomistically' if you like - is of limited benefit unless one is also paying attention to the system, and in the problems listed above, this means the fascia which runs continuously through the entire body, integrated in the myofascial system.
The myofascial system consists of 'lines' of muscle, connected by fascia, which act a little like elastic bands transmitting tension and energy through disparate parts of the body, analogous to a ‘tensegrity’ structure. An example of a tensegrity structure is the bicycle wheel which supports surprisingly heavy loads travelling at speed with thin tensile spokes essentially suspending the weight from the centre and distributing it throughout the wheel, allowing for a light yet incredibly strong structure. In our bodies force is likewise distributed throughout the whole structure, from feet to fingertips. No part of it acts, or is meant to act, in isolation.
'Tensegrity' is a term borrowed from the architect and polymath Buckminster Fuller whose motto of 'doing more with less' resonates with the human body as much as with engineering. There are many examples of fun tensegrity structures and models on the internet, which seem to float magically in space, though are really clever arrangements of solid struts and wires or elastic. There has been a trend to apply the same principles of tensegrity to human anatomy. In this view the skeleton is not a 'continuous compression structure' with muscles as little more than levers, but more of a 'free-floating' structure much like a bicycle wheel, that distributes force across the entire system. If one part moves, the effects are felt in the farthest reaches. Another feature of tensegrity structures is that when one part is expanded, the whole expands with it. If two struts are pulled apart horizontally, the rest of the model rather than squishing down as we might expect, actually also expands vertically. By analogy the human body also has the capacity to expand and contract 'globally' and many martial arts, dance or movement practices emphasise the difference between moving in an open, expressive way, and in a closed, protective way. It is worth noting that when a tensegrity structure is more compressed, it is far stronger though also more prone to injury as it has less 'give' in the system. Similarly when we are physically at our strongest, at our most compressed, we are also often more likely to injure ourselves.
While applying the concept of tensegrity to the human body has an attractive ring to it, it is not without its problems. Certainly some parts of the musculoskeletal system could be regarded as free-floating. Our arms, for example, have minimal bony contact with the chest. The humerus connects with the scapula which does indeed 'float' over the back of the ribs on a bed of muscles and is only attached to the chest via the small knob of the acriomio-clavicular joint. Even if this joint is damaged in some way, the arm can still function thanks to the dynamic support from muscles, ligaments and fascia. This floating quality of the scapula-shoulder complex gives the arm remarkable mobility. However, most of the remaining skeleton is not nearly so free-floating. The ankles, knees, hips and sacro-iliac (SI) joint - where the pelvis fuses to the spine - are very much joints in close contact rather than free-floating struts. Tensegrity also potentially misrepresents the nature of bones, muscle and fascia. Bones are not completely solid, they bend slightly and remodel under force, and fascia is not especially elastic of itself.
Yet I don't think these criticisms are especially damaging to the tensegrity analogy. Even if most of our joints are directly connected, they still behave as a whole as if the system were a tensegrity structure. True, you can't walk on a broken leg, but many people function perfectly normally with vertebral fractures or herniated discs because the spine is so well supported by the surrounding muscle and fascia. In other words, under certain conditions the body acts more like tensegrity structure - say running for a bus - and under others it acts more like a continuous compression structure - standing while waiting for the next bus. When not taken too literally, tensegrity is a valuable metaphor for how the body moves and distributes force as a system.
So, the myofascial system is a complex network of connective tissue that spans the entire body and provides structural support, communication and nutrition. It acts as if it were a tensegrity structure: if one part moves, a distant part will also move, often in an opposite direction, and this makes our movements more stable, fluid and efficient. The spiral dynamic muscle chain for instance does this in movement. In walking, the movement of one leg forward activates this chain through our rotational core and the opposite shoulder will also pop forward. It is the difference between the confident stride of a catwalk model and the stiff shuffle of the commuter. At rest the vertical static muscle chain allows us to stand for long periods without fatiguing ourselves. Without the myofascial system we would be continually having to work and think to maintain even the simplest posture and our movements would be cumbersome and unstable. The question is, to what extent are we taking advantage of this system to enable us to move fluidly and efficiently? How much am I restricting myself when hunched over my smartphone while walking? When I turn my head, do I just twist at the neck, or do I let my whole chest twist and shoulders expand, as they are meant to? Am I open or closed when I move?
As with so many other aspects of the body, the modern world has given with one hand and taken with the other. The relative comfort and stability of our modern environment has come at the cost of adaptability. I wouldn't like to get through the day without the aid of the humble chair, and yet there is no doubt that this has negatively impacted on my myofascial system in particular. In technical terms, I now spend hours a day with my lumbar spine abnormally curved forward, my hip flexors drastically shortened, my neck also craned forward, as if I were looking up all day. When I switched from being on my feet all day to being sat at a desk, almost overnight I started to develop back pain. Rather than spending our days squatting close to the ground as our ancestors did, walking around, stooping and bending, clambering and so on all day, our repertoire of movement has been whittled down to a handful of patterns - sat at a desk or in a car, or on the sofa, walking down flat streets, the odd dash for the bus, moving things around on a counter surface etc. This is the real reason that we accumulate stiffness and pain as the years progress, why we 'age'. Not, as is widely believed, a 'wearing out' of our bodies, but actually a dynamic de-conditioning, which can be remedied at any time.
The restrictions in our movement that the modern world imposes on us results in a lot of pent up energy which we either suppress in some way or feel the need to release in exercise, but even this is often confined to fairly stereotypical routines, such lifting weights as if our muscles really were simple levers, or running steadily on flat ground. There is nothing wrong with this and it's still good for us in all kinds of ways, and is undeniably satisfying, but it is questionable how much it is putting us through our full range of movements. It is a curious feature of fitness culture that the emphasis is often on making movements less efficient in order to stress the muscles and body more, and this is very much in keeping with the pain-and-gain, the-more-effort-the-better mentality that characterises our culture; in a system where the individual is continually encouraged to maximise their 'value'. It has also led to an emphasis on external gains, on how exercise makes us look, rather than how it makes us move. Yet a great-looking physique does not necessarily translate into a body that moves well, and the effort involved in acquiring a ripped body may not be worth it given we spend most of our days with our clothes on anyway.
As an alternative we could try switching our focus from effort and results, which will always be fleeting, to paying attention to the process of movement itself, something that movement practices like yoga, tai chi or Feldenkrais are about. If I run or walk with somewhere I need to get to, faster, I will move very differently to how I would if I am focusing on my posture, how my shoulder and knees relate, how my back stretches from heel to the top of my head as I push off. In the first case, I am usually 'falling forward', in the second case my stride is less hurried, less effortful. In this respect exploring how our bodies move and experimenting with how we can make our movements more graceful and efficient we might actually find ourselves enjoying movement more, rather than seeing it as something to get out of the way. In this frame of mind, we can also see that every movement is a form of training - including walking down the street or sitting on a chair, no less than dancing or swimming - and an opportunity for self-awareness and growth. Rather than waiting for some transformative experience or gruelling challenge to 'prove' ourselves, or seeing fitness as a regular chore we have to make time for, the simple act of picking up a pen or opening a door becomes the work of a lifetime, and exercise becomes something to be enjoyed, an endless exploration of life's dance.
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