“Fascia,” pronounced “fash-ee-uh,” has recently become a buzzword among the general active public, and it’s about time! Fascia is the reason the neck bone really is connected to the foot bone, and its importance in our lives, how we feel and how we move is becoming increasingly apparent. Some use the term, “myofascia,” to mean the same thing, but this technically includes the muscle fibers along with the fascia itself. So what is fascia?

According to Serge Paoletti’s “The Fasciae: Anatomy, Dysfunction & Treatment,” fascia is “the soft tissue component of the connective tissue system that permeates the human body. It interpenetrates and surrounds muscles, bones, organs, nerves, blood vessels and other structures. Fascia is an uninterrupted, three-dimensional web of tissue that extends from head to toe, from front to back, from interior to exterior … After injury, it is the fascia that creates an environment for tissue repair.”

It is theorized that when fascia is distorted from its normal arrangement, it can restrict or change the movements of the aforementioned structures, potentially causing pain and/or predisposing you to injury. These changes in fascia can have a wide variety of causes, including everything from a one-time trauma to poor posture and repetitive overuse. Luckily, in most cases, fascia can be manipulated back to a normal or at least more normal arrangement quite quickly.

Abnormal fascial changes can lead not only to pain in the areas they exist, but elsewhere in the body, as well. Here is an example I recently saw in the clinic. One year ago, “Mr. Smith,” an avid runner, strained his right lower back lifting a heavy box. The discomfort from that injury faded over the next few months, and since the symptoms were getting progressively better, he decided not to get checked out by a health care practitioner.

Once his back pain was resolved, he resumed his daily run and progressed back to five miles per day. Within two to three months, he began to notice a mild pain in his right knee after his morning jogs. It wasn’t long before this pain was present during his runs as well, and within a few weeks, he could no longer run. His orthopedic specialist referred him to physical therapy with a diagnosis of patellar tendonitis.

After a few treatments, Mr. Smith’s symptoms began to improve, and he started some light jogging. Two months, many physical therapy treatments and a cortisone injection later, Mr. Smith was still not able to progress beyond a two-mile jog without pain. The ultrasound, leg/hip stretching and strengthening and massage of the painful area all helped, but did not solve the problem.

When I saw Mr. Smith the first time and watched the way he stood, walked and ran, I noticed a very slight shift of his upper body to the right. This prompted me to ask about his back and any injuries/pain he may have had in the past. By the end of the evaluation, it was clear that his tendon irritation was due to repeatedly overloading his right leg. The injured myofascia in his lower back had remained tight and shortened even though the pain faded over time, and it caused him to shift his weight slightly to the right. The overuse injury was an irritation of a tendon in his knee, though it actually could have manifested as a problem in a variety of other areas.

The orthopedist was correct. Mr. Smith did have inflammation and irritation of his patellar tendon. Treatment of this area was effective to a point, but was not addressing the underlying cause of the problem. After a few treatments to loosen and lengthen the fascia, muscles and joints in his lower back, Mr. Smith was back to running five miles pain-free.

The moral of the story is that even if the pain of an injury fades quickly, it does not mean it didn’t leave behind a problematic change in the fascia. Though the source of pain/injury may be in the same place that symptoms are experienced, it is also quite common for it to exist in a different part of the body.

So to answer the title question, yes, you do! Fascia connects our body from head to toe and has more to do with how we move and feel than you might expect.

Jarod Carter is a doctor of physical therapy, a certified manual therapist and a certified strength and conditioning specialist. For more information, contact him at 512-947-3705 or DrJarodCarter@gmail.com, or visit www.CarterPT.com.