Over the years I've written here several times about my efforts to explain and overcome mysterious chronic health impairments including fatigue/lethargy and tension/pain.
In recent times, my research and experimentation has led me to explanations and treatments that focus on the fascia, and whilst I've not yet achieved full recovery (a recovery time of several years is par for the course with these kinds of issues), this approach does seem to be helping to improve my conditions.
The approaches I've been undertaking include yoga/pilates-type stretching exercises and specific types of massage that seek to break up fascia "adhesions" [1].
I'm being careful not to make any specific claims of diagnoses or remedies, as I'm fully aware from my own experience (and background as a scientifically-minded person) that this this whole topic is nascent in terms of solid scientific evidence, and rife with pseudoscience.
But it does seem clear to me that there is "something there", and that more research into this topic could likely lead to explanations and remedies for conditions like "chronic pain" and "chronic fatigue", which many people currently endure for years or for life without understanding or relief.
[1] It's not the only work I've been doing; as I've written about here before, diet, cardio exercise and emotional work have all been part of my regimen for some years, but since introducing the practices that focus on fascia, my condition has improved faster and in different ways.
Note: tight fascia with trigger points inside _cannot_ be released by stretching alone. Source: personal focus of finding why the hell my posture was crooked after falling off bike; after 3 years of weekly massages my therapist and me finally found a huge trigger point in a thigh. It took one-two weeks to release fully, and then my posture magically straightened.
People swear by trigger points , and as it is a relatively recent discovery, not every massage therapist knows about them.
Also make sure to get a good therapist. I had somebody do trigger point therapy with me for a few months and had zero improvements while the sessions were very painful every time.
I’m in the same boat as you. My PT has helped a lot. I discovered many of the treatments were in the book The Perrin Technique. The symptoms in the book described me exactly.
I gave her a copy to read and it has helped greatly. My PT told another one of her patients with similar symptoms who has gone from mostly bed/housebound to regular outings.
Even as much as a disalignment of a degree forward or backward rotation in the pelvis, caused by sitting for a long time and thereby shortening the back muscle, or hunching forward, can cause stress on other systems in the body.
Here is a little fun exercise to show the effect of fascia : bend over, straight legs and see how far your hands go, just measuring how close you get to your feet (they don’t have to touch, don’t push yourself, just see where you end up) Now take a tennisbal or small round object and stand or move with one foot on it for a while, and roll a bit especially on the arch of the foot, like a massage.
Now do the exercise again, bending over with your hands towards your feet and see what happens.
For that experiment to be valid you'd probably want to do a control where you try the stretch, then wait doing nothing for the same amount of time that you would roll your feet and try again and another where you just rotate your ankle in the same way you would if you had a tennis ball under it. Taking your baseline reading one day and trying the tennis ball plus stretch the next day or week would be good too.
This wouldn't really convince me because I find any additional stretching helps with my reach and I'm more likely to chalk it up to a warm up effect or maybe some other effect on the the tendons or muscles. I don't see any particular reason to attribute it to fascia release.
It is 4 and a half minutes of an incredibly ripped guy explaining that standing toe touches usually isn't stretching what you think it does and is often achieved by putting other body parts in positions that are not beneficial -- eg, rounding your back. Instead he gives a different exercise. Watch from about the 2:30 mark to see the recommended stretch.
> Even as much as a disalignment of a degree forward or backward rotation in the pelvis, caused by sitting for a long time and thereby shortening the back muscle...
This doesn’t pass the sniff test. Your pelvis tilts by more than a degree just from slightly tightening your glutes.
Also, how does sitting shorten the back muscles? Sitting puts the back in a mild state of flexion.
The condition is called anterior or posterior pelvic tilt. However you are right that the back muscles are not the responsible muscles and it comes from somewhere else. Thing is while looking up the issue I see many different causes stated. So the cause might be different in different people.
1 degree doesn’t make for anterior or posterior pelvic tilt. Also a number of doctors who specialize in fitness (e.g. Austin Baraki) do not recognize this as a legitimate disordered condition anyway.
This is how they sell those magnet bracelets that "align your chakras" or whatever. The reason you can reach farther the second time is that you stretched.
I notice how carefully you had to tread here to not actually talk about or discuss, brainstorm or theorize, what's going on - not sharing any specifics of your experience except that there is "something there."
And I understand why, it's because enough of a majority of people on HN aren't very open minded nor supportive of open discussing theory or anything unproven, so like where I briefly shared my thoughts here - https://news.ycombinator.com/item?id=21961032 - it quickly got -3 points, and deemed unacceptable for anyone else to chime in if they have similar thoughts or theories or experiences to share to add to a body of knowledge, even if mostly anecdotal.
Edit: Downvoted for sharing my observations of people's behaviour on HN? Brilliant.
I've been discussing these topics on HN for a long time. I've learned it's better to meet people where they're at than to demand people immediately leap to my place of understanding.
Interesting perspective that them simply reading something you wrote is demanding something of them - I suppose it could be taken that way if they take everything they read as wanting it to be their gospel. HN's downvote mechanism certainly reenforces you having to adjust vs. creating a better system for tolerance in discussion if you don't want your voice to be suppressed - which we all naturally do, perhaps unless we're depressed or don't believe our voice is worth being heard.
I think things like the work with fascia suffer from people feeling the need to explain something with scientific terms. For a few years I was involved in the yoga community and noticed a lot of practices where something that was clearly beneficial to a lot of people got explained with clearly very questionable science terms.
I am not sure why that is. Will you get ignored when you demonstrate something that works but say “I have no idea why or how it works” ?
This is a good observation. I think that “it works but we don’t know why” is appealing to a small slice of well-educated people who are comfortable with complexity and the limits of knowledge, but otherwise off-putting.
For most people I think that “it works but we don’t know why,” translates to “it doesn’t really work.” Thus a fake explanation adds credibility and believability. And if it does work, then people feel reassured and confident in the fake explanation.
> I think that “it works but we don’t know why” is appealing to a small slice of well-educated people who are comfortable with complexity and the limits of knowledge, but otherwise off-putting.
Really? So a limited number of intellectual elite are the only people capable of accepting faith-based arguments?
Seems like the opposite of a faith-based argument to say “It works but we don’t know why.” Wouldn’t a faith-based argument typically specify the “why” without evidence. To me what GP is describing sounds more like science in that it wouldn’t be making unjustified claims.
Is this specific
to medicine? In physics it’s perfectly ok to say “ here is an observation which can’t be explained with our current knowledge “. See dark matter and dark energy.
The story of Ignaz Semmelweis seems to indicate that medicine is different from physics in that aspect.
Laypeople don't believe in dark matter yet. They're skeptical and expecting something with a clearer expectation. Physicists and yourself can accept dark energy because you are in the "small slice of well-educated people who are comfortable with complexity and the limits of knowledge".
That’s another thing I wonder about. What’s so wrong about the placebo effect? If it makes people feel better we should embrace it. I think a lot of things like yoga work because they are done in positive environments by positive people. Whereas a lot of regular medicine is performed in pretty negative circumstances. So the same treatment may not work in a doctors office but it may work in a yoga studio.
The problem isn't the placebo effect per se. Nor with it's application as a treatment. It's with misleading people as to what is actually helping them. For example selling magical crystals to adjust your aura. I don't know about studies and evidence specific to yoga, but would suspect it's benefits are a combination of real and placebo. Thus it isn't all placebo effect as there is a foundation of actual therapeutic benefit.
Perhaps there's a relationship between the perceived need for a scientific sounding explanation and compatibility with traditional medicine for a particular idea.
It's ironic that virtually all drugs are discovered via effects and not designed via a known mechanism.
Once a novel compound is discovered, and the mechanism characterized, tweaking it to get better binding affinity for the affected binding site, or reduced affinity to a side-effect-producing site, is tractable and is practiced in industry and research.
Without waxing too poetic about it, its like .. are you deliberately not hitting the nail on the head? ;)
> Perhaps there's a relationship between the perceived need for a scientific sounding explanation and compatibility with traditional medicine for a particular idea.
I think there is a chemical reward system in play in order to even want to seek information, of any quality. Even in its most utterly click-baity, priori, emotionally contrived or pseudo-scientific form...(needing something "science.")
It isn't as deep of a reward system as the one engaged where you are totally in awe of natures order and discover the capacity to produce information and thus direct some control over it through planning...(demonstrable compatibility.)(its too bad the click-bait people aren't selling better dope.)
That biology produces complex molecules which are even 'compatible between organisms in plant and animal is pretty awe inspiring. And, that the control of human intention has any control over nature, electrochemically or otherwise, likewise so.
Whenever anything "smells" like pop pseudoscience, I think we should apply scientific resources to build an evidence base. As opposed to getting scared.
I've been doing empirical research on "the vibe" for that reason. It is commonly enough discussed in popular culture and is clearly valuable. Yet, there is almost nothing scholarly written about it. To me, as a scientist, that says "low hanging fruit." Any association with the esoteric will create a kind of forcefield around it, so many fewer scientists will have studied it. But, in my opinion, the topics are avoided for the wrong reasons.
If you're in the SF Bay Area and want to "do science" to Reiki "energy" I'm available. I don't know what the phenomenon is but it engenders pretty dramatic physiological changes in a way that should be easy to measure somehow.
Objectively, heart rate, breathing volume and rate, posture, muscle tonus (relaxation), and I would expect but haven't observed directly changes in blood pressure, brain waves, etc.
Subjectively, people report a variety of sensations, warmth or coolness, tingling, a fullness or emptiness or both, etc.
edit: I forgot to mention accelerated healing (the whole point of Reiki, der! lol)
Well, there are lots of different types of meditation so it's hard to give a brief, comprehensive breakdown. FWIW, the "destinations" of both meditation and Reiki are congruent, if not identical.
Metaphorically, you might say that meditation is like a lamp while Reiki is like a laser. (It's not a very good metaphor.)
The main specific difference is that Reiki is for healing. It engenders and accelerates healing physically, emotionally, and mentally.
As far as the subjective sensations of chi flow they tend to be more dramatic with Reiki than meditation, but again, so many variables that it's hard to give solid generalizations.
I’d argue that the properties of most / all tissues undergo changes when subject to stress.
Stress ramps up blood pressure, causes changes in the properties of blood directly, increases inflammation, down regulates the immune system and healing in general, increases muscle tension generally, constricts blood vessels, causes changes in hormones and cell signalling molecules in general.
"He suggests that stiff fascia decreases lymphatic fluid flow and can contribute to swelling in the limbs."
The first thing I thought that sounded like was ancient Chinese medicine and the Meridian system. [1]
Next I thought of the reflexology diagrams of areas of the bottom of the foot being connected to different parts of the body. The foot is a body part particularly rich in fascia.
You know what else can contribute to swelling in the limbs? Heart failure. Massages might help with circulation a little, but no amount of massaging is going to correct a serious cardiovascular problem.
I believe that connective tissues do have real function and massages could have some mild health benefits. But I don't like this article because it doesn't sound like science. And there are quite a few people promoting pseudo-scientific ideas that can influence patients to put off effective treatments.
> I don't like this article because it doesn't sound like science
The article is specifically about the fact that the scientific community has little knowledge or consensus about this topic, but that hypotheses are being formulated and research undertaken.
This is the epitome of how science progresses in as-yet unexplored fields.
> there are quite a few people promoting pseudo-scientific ideas that can influence patients to put off effective treatments
Perhaps you should provide evidence that measures up to your own standards: what data is there to demonstrate that significant numbers of people have died of cardiovascular illness because they tried to treat serious limb swelling with just massage?
On the flipside, here's some relevant data:
– "Drug overdose deaths involving prescription opioids rose from 3,442 in 1999 to 17,029 in 2017" [1]
– "Orthopedic pain (34.8%) was the primary reason for an opioid prescription, followed by [...], back pain (14.0%), and headache (12.9%)" [2]
If it turns out that fascia-related issues are frequently a factor in these kinds of chronic pain conditions, which currently seems at least somewhat plausible, it may well turn out to be a scandal that this topic has not yet been more heavily researched, given that many people outside the pharmaceutical sector of the health industry have been talking about it for years or even decades.
If there's little knowledge or consensus then we should be cautiously optimistic about any perceived progress, we shouldn't run headlong into X fixes everything territory. It's important to keep in mind that we may not know why something works because that is also how science progresses, it's the motivation to continue refining a process or experiment until we have fully explained the method of action. Doing this often leads to important improvements in the method of application.
The epitome of how science progresses is diligently applying the scientific method (repeatedly) and not fucking with the results to generate hype or feed a pet theory.
The biggest news out of this is that stretching and exercise are still good for your health and you should do them more often. Massage probably won't hurt but if you have serious health problems you should probably still see a doctor.
While I have no experience with, or would endorse it, the practice of ‘rolfing’ should be mentioned in this context. It specifically targets fascias with manipulations.
> My reader will not wonder, that, after having ascertained the superior goodness of dephlogisticated air by mice living in it, and the other tests above mentioned, I should have the curiosity to taste it myself.
Nope.
It’s important to remember that unbelievable beliefs associated with observations do not implicitly negate the observations, especially when it comes to understudied areas of the human body.
What we know about the vagus nerve today seemed insane and nonsensical fifty years ago, but historical writings for hundreds of years are filled with tales of drinking magic elixirs that change people’s mind and body. Magic? Probably not. Valid? Possibly so.
Further study is required, if only to separate the magic from the biology.
From my own experience with "energy" I seem to be able to have a higher resolution experience with than most, along with my experience as a client for acupuncture, physiotherapy, osteopathy, and other - I think it will be an uphill battle to come to a scientific consensus as I don't believe we currently have tools to adequately measure what is happening on the subtle level of how energy flows or for what information flows (or becomes stuck/blocked). And what purpose is it flowing? It is just some form of static that we've evolved to ground literally into the ground - whether as a form of waste or perhaps more - and perhaps our rubber soled shoes most of society now wears for the majority of our days, at least when we're most active, plays a role in tension building and fascia-related dis-ease occurring and progressing?
Edit: Thanks for the downvotes and supporting philosophy and an open discussion for what hasn't been proven! You'd almost certainly also downvote theoretical physicists and people historically who brainstormed as to possible reasons the planets moved the way they did or other physics properties - examples of which exist where they wrote about where they had part of the idea right but not fully. How about adding to the conversation instead of being lazy and downvoting to suppress topics you don't seemingly have experience with? You know you could say "I don't have the same experience" or "I experience things this way". Or perhaps if you don't have any understanding or experience of related to things then maybe stay out of the conversation?
I wholeheartedly disagree with downvote mechanism - it's a terrible mechanism for guiding toward civil conversation, and the fact that even talking about that is artificially frowned upon is absurd. If people have an issue with something - if it's well thought out enough reason by a person who would otherwise downvote, then if they're not willing to even spend the effort to articulate it into words - which would 1) help them think through their logic, develop their own critical thinking, perhaps catch incongruence, and 2) offer an opportunity of a different perspective to the person they're responding to. The ease of someone downvoting, the laziness of it, doesn't match real world conversations.
eg : "If you talk to most surgeons, they would think of it as ‘what you cut through'"
Surgeons actively use fascia to ease peeling off one structure of the other. They actively use fascia as conduit from an incision to deeper parts of the body; literally, to stick a hand in.
Eg: most of the article uses the term "fascia" in away akin to an "organ", i.e.: "fascia is everywhere".
That means the author did not fully grasp the concept (if at all).
Think of "fascia" (plural) as "sheets". You have many such "sheets" in your body.
(I know that term and this concept were mentioned in the article; but not in away that conveyed a useful or fully correct understanding).
The existence of fascia has long since been known. Testut and Latarjet extensively described fascial anatomy... in the end of the 18th century!
Fascia are known pathways for spread of disease.
Fascia cause compartment-syndrome in limbs.
etc.
It's fascianating :-) how this is now described as something new and almost magical...
Kind of a tangent but does anyone know the name of the recently discovered sub-dermal tissue? It a network of fine capillaries (that have something other than blood in them) IIRC.
It wasn't discovered previously because it shrivels or thins out after death, something like that.
I remember reading about it a few years ago. It was like we had found a new organ.
This article and discussion is just packed with pseudoscience. Not what I was expecting at hackernews. What does "releasing the fascia" even mean?
I'm an MD, I have performed a lot of dissections of and through fascias. It's absolutely interesting, there's A LOT we don't now. Let's not reduce the complexity to "releasing the fascia".
> It's absolutely interesting, there's A LOT we don't [k]now
Thanks for conceding that, as a mainstream medical professional.
But maybe give people a break.
Given that there's a lot we don't know, it's fair enough for laypeople to talk about it in fuzzy terms and use metaphors that make sense to them, until your profession has more detailed knowledge to share.
As one of the many people who has suffered severe pain and debilitating illness for many years, which has not responded to conventional medical treatment but has responded in interesting ways to various practices that purport to address problems with the fascia, I appeal to you to dial down the know-all attitude and be part of a good-faith discussion from which we can all learn and benefit.
EDIT: In response to your question “What does "releasing the fascia" even mean?”, this quote from a recent medical journal paper [1] may suggest an answer:
There are some researchers who suggest strongly that any change in the viscoelasticity of the fascial system activates the nociceptors.3,12 The hyaluronic acid becomes adhesive and less lubricated, altering the lines of forces within the various fascial layers.3 This mechanism could be one of the causes of articular stiffness and pain in the morning.11 In fact, the stiffness experienced by some patients when they wake up in the morning could be related not with the joint but with the fascial system: if there is a minor quantity of hyaluronic acid or when it is not equally distributed, the tissue is dehydrated and has less possibility of sliding.3,11,12
So as I understand it, what people refer to as "releasing the fascia" describes a mechanism to detach adhesions that form between the fascia layers due to this reduced viscoelasticity.
I claim no expertise on this topic and cannot vouch for the medical validity of this paper; I just learn what I can from the material available, and apply it to my own healing efforts where it may be applicable.
No doubt! Given this, it'd be much better if my parent commenter had brought that kind of humility and a spirit of acceptance and constructiveness to the discussion.
Sorry if I sounded unnecessarily hard, that wasn't my intention. Another commenter mentioned that 50% of what we learn in med school is wrong, I'd say it's probably much higher than 50%.
I haven't read the article yet so unsure of the context where "releasing the fascia" is used, however at least in fitness related practices, it means relaxing the tension in it - whether by applying tension to it say with yin yoga postures where you support the muscles with bolsters, blocks, or are in positions that aren't engaging them - and where you maintain a somewhat uncomfortable stretch into fascial layers. So releasing a muscle that's tight would be a similar idea.
Any surgeon or occupational therapist can talk about fascia for hours. There is nothing new in this article that has not been known for decades if not centuries. (search Scholar pre-1700 and there are plenty talking about fascia.)
To draw a parallel, it is like writing an article about using bank debit cards, instead of writing checks. Or, dealing with an automated teller machine instead walking into a bank to get cash.
A significant portion of the article is literally about painstaking work that is being done to start building a body of evidence.
Anecdote and informal observation has always been, and must necessarily be, a prior stage to formal evidence-gathering.
That the evidence-gathering is only starting to happen now indicates nothing about what the outcomes may be.
But the fact that there continue to be vast numbers of people suffering "mystery" and "incurable" illnesses means there really needs to be far more of this kind of observation and early-stage evidence gathering.
I'd invite you to do some reflecting on what motivates you to be so dismissive of research that could turn out to have huge benefits for huge numbers of people.
Exercises/interventions based around the fascia have a long history in sports, martial arts, and exercise. Although not conclusive, the success of the athletes and martial artists who follow those approaches constitute evidence.
In recent times, my research and experimentation has led me to explanations and treatments that focus on the fascia, and whilst I've not yet achieved full recovery (a recovery time of several years is par for the course with these kinds of issues), this approach does seem to be helping to improve my conditions.
The approaches I've been undertaking include yoga/pilates-type stretching exercises and specific types of massage that seek to break up fascia "adhesions" [1].
I'm being careful not to make any specific claims of diagnoses or remedies, as I'm fully aware from my own experience (and background as a scientifically-minded person) that this this whole topic is nascent in terms of solid scientific evidence, and rife with pseudoscience.
But it does seem clear to me that there is "something there", and that more research into this topic could likely lead to explanations and remedies for conditions like "chronic pain" and "chronic fatigue", which many people currently endure for years or for life without understanding or relief.
[1] It's not the only work I've been doing; as I've written about here before, diet, cardio exercise and emotional work have all been part of my regimen for some years, but since introducing the practices that focus on fascia, my condition has improved faster and in different ways.