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Fascia, Your Body’s Fashionable “New” Organ

Image: Andreas Vesalius (1514-1564), via Wikimedia Commons.

It’s not often that a new functional organ is found in the human body, considering that everything has been dissected and drawn for centuries and photographed in detail for decades. This organ is big and obvious! Ignoring it is like throwing away the wrapping paper and then finding out that the wrapping paper was a major part of the gift.

It’s called fascia — a word from Latin meaning bandage. In anatomy, fascia is defined as “a band or sheath of connective tissue investing, supporting, or binding together internal organs or parts of the body.” Laypersons who have heard the word were probably afflicted with plantar fasciitis, an ailment that inflames the fascia along the bottom of the foot. I’ve had it and know that PF is painful. It can sometimes be relieved by weeks of physical therapy or a shot of cortisone. I reflected on a long hike recently how wonderful it feels to walk again without PF pain. I learned from my podiatrist and his foot model that the plantar fascia holds the heel and toes together.

Types of Fascia

Fascia comes in different types. There is “superficial fascia” found under the skin, and “deep fascia” found around internal organs. An intriguing article in New Scientist by Caroline Williams explains the new interest scientists are taking in fascia since Italian anatomist Carla Stecco began studying it around year 2000. There’s a big story for ID advocates in what Williams relates about this multi-functional “overlooked” connective tissue. Fascia is composed primarily of the proteins collagen (for strength) and elastin (for flexibility). It is now becoming understood to play numerous roles, even to the point of earning the title of a new “organ” in the body.

The 19th-century anatomist Erasmus Wilson called this tissue — now known as fascia — a natural bandage. In dissection, that is exactly what it looks like: sheets of white, fibrous connective tissue that are strong yet flexible and perfect for keeping muscles and organs in place. They are also sticky, gloopy and get in the way of looking at the muscles, bones and organs they cover. Which explains why, for years, anatomists cut this tissue off, chucked it away and thought little more about it.

Recently, though, researchers have begun to take a fresh look at fascia and are finding that it is anything but an inert wrapping. Instead, it is the site of biological activity that explains some of the links between lifestyle and health. It may even be a new type of sensory organ. “There appears to be more going on in the fascia than is commonly appreciated,” says Karl Lewis at Cornell University in Ithaca, New York. [Emphasis added.]

What kind of biological activity goes on in fascia? What does this network of tissue do for us? 

Here’s a Summary

Cushioning: The main ingredients in “loose” fascia (the “gloopy” kind) are “hyaluronic acid, for lubrication, and proteoglycans, molecules that provide cushioning.” These are secreted by cells in the tissue such as fibroblasts and the “recently discovered fasciacytes.”

Packaging: Fascia surrounds internal organs to offer protection and hold them in place. Think of a simple duffle bag for camera gear; items can shuffle around and become separated or damaged. Newer packs have compartments for lenses, the camera body, memory cards, and other parts that keep them separated and safe. Fascia acts like that. What would happen to a runner or gymnast without it? The thought of organs jostling about in the body cavity is not pretty.

Sensation: Stecco’s father Luigi Stecco, a physiotherapist, “invented a form of physical therapy called fascial manipulation, which he claimed could treat everything from headaches to muscle and joint pain.” He based his now-popular therapy on the belief that fascia could become stiff, and that this painful stiffness could be alleviated by massage. But, as Williams relates, it wasn’t known in 2000 what fascia actually is, or if it contains nerves. 

Since then, she and others have shown that fascia is indeed rich in nerves, and that the information that these relay varies throughout the body. Superficial fascia contains nerves that specialise in sensing pressure, temperature and movement. Deep fascia is involved in proprioception, the body’s sense of its position in space, and nociception, the sensing of pain.

Because of this sensory role, some researchers say that fascia should be considered a new organ, one that is specialised for communication about the body’s internal state. Robert Schleip at the Technical University of Munich in Germany recently estimated that an adult’s fascia contains approximately 250 million nerve endings, similar to, or slightly more than the skin. “It is beyond any doubt our richest sensory organ,” he says.

Immune Response: If one takes the broad definition of fascia to include the interstitium (“the fluid-filled connective tissue that lines every organ, muscle fibre and blood vessel,” then fascia can be thought of as “a whole-body network of fluid that could function both as a shock absorber and an immune network relevant to inflammatory disorders, scar formation and the spread of cancer,” Williams says.

Time for a Fresh Look

It’s about time scientists take a fresh look at this “wrapping” that anatomists, since the days of staged public dissections by Andreas Vesalius and others, cut away to get to the interesting stuff. And without question, an organ with so many roles is likely to hold secrets that could lead to major insights about the causes and cures of a variety of ailments. Williams describes some of the new thinking about how fascia relate to joint stiffness, inflammation, cancer, depression, and lower back pain. For instance, Helene Langevin at the NIH says “people with chronic lower back pain had thoracolumbar fascia that was 20 per cent stiffer than those without this pain.”

Other studies by Langevin with pigs showed that stretching the lower back for 5 minutes, twice a day, not only reduced the size of an area of inflammation, but also seemed to induce a series of anti-inflammatory chemical events from the fascia. This is a promising finding because chronic inflammation has been linked to pretty much every modern ailment going, from heart disease and diabetes to cancer and depression.

One thing we can all learn from the new interest in fascia is that it’s a good investment to keep our fascia network functioning at its best. Williams ends with a story about new imaging techniques by Neil Thiese and colleagues at the Icahn School of Medicine at Mount Sinai, New York, that allowed them to observe fascia’s 3-D structure in living tissue. They found it to have “a sponge-like structure filled with fluid that drained into the lymphatic system, part of the body’s immune set-up.”

The team suggested that physical movement may help keep this fluid healthy, whether due to the pumping of the heart, the movement of the digestive tract or physical movement of the body. “It seems that no such spaces are static,” says Thiese. This discovery opens up the possibility that the body is connected in ways that we are only beginning to understand and that movement is required to keep this tissue healthy.

The body is connected in ways that we are only beginning to understand. Isn’t that true of so many past cases of simplistic material explanations in science that failed? Spontaneous generation, featureless protoplasm, vestigial organs, junk DNA — they all have in common the assumption that the stuff of life is simple to imagine having come into being by unguided natural processes. Fascia reminds us that the closer one looks at life, the more wondrous and well-designed it appears. Never count anything as useless. The wrapping is part of the gift.