Myofascial pain is probably the most common cause of musculoskeletal pain in medical practice (Imamura, Fischer, Imamura et al.1997). Pain from myofascial dysfunction is probably at the source of many of your symptoms. A small change in the myofascia can cause great stress to other parts of your body.

Superficial fascia is attached to the underside of your skin. Capillary channels and lymph vessels run through this layer, and so do many nerves. The subcutaneous fat is attached to it. If your superficial fascia is healthy, your skin can move fluidly over the surface of your muscles. In FMS and CMP, it is often stuck. In the superficial fascia, there is a great potential to store excess fluid and metabolites, which are the breakdown products of informational substances and other chemicals in your body. This is the area of fascia that often is the easiest to palpate. Palpation is the art and skill of being able to touch meaningfully, interpreting what the skin and fascia are willing to tell about your state of health.

Deep fascia is much tougher and denser material. Your body uses deep fascia to separate large sections, such as the abdominal cavity. Deep fascia covers some areas like huge sheets, protecting them and giving them shape. Deep fascia also separates your muscles and organs. The bag-like covering around your heart (the pericardium), the lining of your chest cavity the pleura), and the area between your external genital and your anus (the perineum) are all made up of specialized deep fascia.

There is a third layer of fascia, called sub serous fascia. This is loose tissue that covers your internal organs and holds the rich network of blood and lymph vessels that keep them moist. Even your cells have a type of cytoskeleton connected to fascia network, which is what gives your cells shape and allows them to function. Myofascia is fascia that is related to muscle tissue. Healthy myofascia allows for compression and tension, as well as relaxation.

The dural tube is another fascial connection. This is the tube surrounding and protects your spinal cord, and it contains the cerebrospinal fluid. This tube is connected to the membranes surrounding your brain. Together, they hold and protect your craniosacral system.

Fascia is also the material that forms adhesions and scar tissue. When you are healthy, your ground substance has a gelatinous consistency so that it can absorb the forces that are created when you move, or if you are involved in trauma. When the ground substance hardens, it’s as if glue or cement has been poured into our fascial spaces (Barnes, 1990). When this happens, it isn’t enough for a therapist to break up cross-links. They need to return your ground substance to its healthy, more fluid state.

In the myofascia there is a material called ground substance. The ground substance part of the fascia can be like a loose gelatin, or like gel-foam medical packing, or like sprayed on Styrofoam insulation. It can harden and lose its elasticity. When ground substance changes from a liquid to a gel, and then into its more solid form, the myofascia tightens. It won’t reverse to its previous more liquid state without outside intervention. One of the main jobs of the ground substance is transferring nutrients from where they are broken down into usable materials to their place where they will be used, and to remove the waste products from these areas of use. This exchange and transport through diffusion takes part in the ground substance.

Another important job for your ground substance is to maintain the distance between connective tissue fibers. This prevents microadhesions from forming, and keeps your tissues supple and elastic. When the critical distance is not maintained, the fibers become cross-linked by newly synthesized collagen, which are also part of the fascia. Collagen crosslinks are arranged haphazardly, unlike healthy linkages, and are hard to break up.

Sheets of fibrous myofascial adhesion can form anywhere along nerves and block normal healthy function. Too often, fascia has been considered by the medical world as merely packing material, simply a connective tissue between areas of function. The mobility, elasticity, and slipperiness of living fascia can never be appreciated by dissecting embalmed cadavers in medical school (Leahy and Mock 1992).

Where muscles and tendons, bones and ligaments come together, there are areas of attachment. The cellular membranes in these attachment areas can become extremely convoluted, which increases the surface area and changes the angle of force. This increases the potential for things to get stuck together , and causes the tissue there to become more easily torn (Simons, Travell and Simons, 1999).