Has Your Fascia Freaked Out?

The belief that painful lesions exist within the muscle and/or fascia of those with fibromyalgia remains a popular one, despite the absence of any supporting pathophysiological evidence. But, to be entirely fair, the very name of the condition suggests that such an association might indeed exist.

However, the upshot of this incorrect belief is that people with fibromyalgia are being confronted by a bewildering array of therapies, products and appliances targeted at their muscles and/or fascia.

One of the most remarkable therapeutic devices currently being advertised and marketed to them is a white plastic clawed implement known as the FasciaBlaster.

The sales pitch correctly points out that fibromyalgia is “the second most common symptom ailment that affects the muscular (sic) skeletal system next to osteoarthritis” and that people with the condition often either have to change their job or leave the workforce.

Then follows an astounding revelation: “fibromyalgia is NOT a biological abnormality in the nervous system or a physicological (sic) disorder– it’s something that is caused throughout life that triggers a TOTAL FASCIA FREAK OUT!”

But evidently there are 7 phases of this “fascia freak out” and those who are in phases 3 to 7 have real cause for concern and require treatment, which fortunately can be self-administered should they choose to purchase the said implement.

A chart has even been compiled showing the condition of the fascia at each phase, what’s happening in the body, and both the symptoms present and the respective diagnoses: https://ashleyblackguru.com/wp-content/uploads/2013/08/Fascia-Chart.pdf

So how can fascia “freak out” and cause mischief to its owner?

According to Ashley Black, inventor of the FasciaBlaster, “Nerves flow through the fascia, and tight fascia can cause pinched nerves, tingling sensations and numbness. In addition, the nerve is what fires the muscle, so if the nerve supply is limited, muscle output is lessened.” Evidently tight fascia can also restrict joints and “choke out muscles, causing a host of orthopedic problems.” And fascia can even trap fat, causing cellulite! Such entrapment suggests a potential cosmetic role for the FasciaBlaster.

It turns out that Ashley Black believes that many illnesses of unknown origin “such as Fibromyalgia, Migraines,“itis” (sic), Chronic Fatigue Syndrome, IBS, Restless Leg Syndrome, nerve pain, tender points, and many more are rooted in the fascia system”:

Total Body Pain Relief

She even suggests her own test: “A good way to check if fascia could be part of your total body pain is to pinch your forearm or the top of your leg and pull up and away from the bone. If the skin does not pull up easily, then fascia is at least part of the problem.”

Ashley Black’s implement is claimed to be the only self-treatment tool “designed to break up fascial adhesions and restore healthy fascia.” Moreover, “with consistent use, users can expect relief from pain, tightness, and restriction as well as improved muscle performance, mobility, circulation, nerve activity, and total body function.”

A comprehensive series of self-help tutorials is readily available on her website: https://ashleyblackguru.com/tutorials-home/

For those with fibromyalgia, a short video is used to explain the treatment: https://www.youtube.com/watch?v=JsNq9TLJWmc

So who is Ashley Black?

On her website Ashley describes herself as an “inventor, best-selling AUTHOR, fasciology expert and the owner of an exploding multi-million dollar business”: https://ashleyblackguru.com/about/

Apart from having attained “guru” status, Ashley Black does not claim to have any health professional qualifications or to have performed any research to support either her idiosyncratic views on fascia (quaintly termed “fasciology”) or her claims for therapeutic success that can be achieved by those with fibromyalgia who use her implement on a regular basis.

From the above on-line information, one can only conclude that that the aphorism of Johann Wolfgang von Goethe [1749-1832] still rings true: “Nothing is more terrible than to see ignorance in action.”

From: Maxims and Reflexions, I (translated by John Stuart Blackie in The Wisdom of Goethe).

14 Comments

  1. There is another product on the market for which quite remarkable claims are being made – the Fascia ReleaZer.

    According to the accompanying promotional material, if the fascial tissues are not exercised on a regular basis “they can stick together and thicken, losing elasticity and causing tears, inflammation and discomfort.”

    This sounds very similar to the “fascia freaking out” story.

    But do not despair!

    Use of the vibrating implement is said to rejuvenate and regenerate muscle fasciae (sic) tissue, boost blood supply, as well as increase suppleness and mobility significantly.

    But vibration by mechanical means is not a new fad.

    In “A Manual of Natural Therapy (1908)” by Dr Thomas Luke, two vibrators are pictured – the “Ruk” Vibrator and the “Barker” Vibrator. The claims being made of their efficacy are not quite as far-fetched as those for the more modern inventions:

    “Mechanical vibration is an admirable adjuvant to ordinary massage, and is one of the most passive movements used in medical gymnastics. There is no doubt that a machine-driven instrument can produce effects unattainable by means of the human hand. The effect may be stimulating or soothing as desired, while the circulation in any part can be improved, and the absorption of any morbid effusion can be hastened.” [p. 149]

    References:

    http://www.stressnomore.co.uk/beurer-mg800-fascia-releazer-11057.html#product-description

    Luke TD. A Manual of Natural Therapy. Bristol: John Wright and Sons, Ltd., 1908: 134-151.

    • Looks like change of body sense of position and movement is a major contributor to increased mobility after self massage with a vibrating roller caused by stimulation of muscle spindles: “When vibration of 100 hertz was applied to the tendon of the biceps or the triceps muscle, the subject made a systematic misjudgment of the angle at the elbow. During contraction the error could be as much as 40 degrees. The subject thought that the elbow was in the position that it would have assumed if the vibrated muscle had been stretched.”
      http://science.sciencemag.org/content/175/4028/1382

      • Yosefa, this phenomenon you describe is interesting but it seems a huge leap of faith to attribute increased mobility after self massage with a vibrator to such a mechanism. Has it been studied?

        • Not directly. It is my intake based on:

          1. Foam rolling for delayed-onset muscle soreness and recovery of dynamic performance measures. (Pearcey GE1, Bradbury-Squires DJ, Kawamoto JE, Drinkwater EJ, Behm DG, Button DC, 2015)
          “Other DOMS-induced impairments that may reduce athletic performance include decreased joint proprioception.”
          https://www.ncbi.nlm.nih.gov/pubmed/25415413

          2. Training principles for fascial connective tissues: scientific foundation and suggested practical applications. (Schleip R1, Müller DG., 2013)
          “When including intramuscular connective tissues, periosteum and superficial fascia as part of the body wide fascial net as outlined above, fascia can then be seen as one of our richest sensory organs. It is certainly our most important organ for proprioception (Schleip, 2003).”
          https://www.ncbi.nlm.nih.gov/pubmed/23294691

          3. Proprioception: The Sense Within, By Uwe Proske and Simon Gandevia, 2016
          “The authors argued that vibration had stimulated muscle spindles, stretch-sensitive capsules found in most of our skeletal muscles. The response to vibration mimicked spindle activity generated by muscle stretch, leading to the illusion of a stretching biceps, that is, extension of the arm.”
          https://www.the-scientist.com/?articles.view/articleNo/46796/title/Proprioception–The-Sense-Within/

          4. AN ACUTE SESSION OF ROLLER MASSAGE PROLONGS VOLUNTARY TORQUE DEVELOPMENT AND DIMINISHES EVOKED PAIN
          Conclusion: Data suggest that RM-induced neural inhibition decreased MVIC F200 and nullified the testing-induced increase in evoked pain associated with 70% tetanic stimulation.
          and..”With the gate control theory of pain, direct activation of percutaneous mechanoreceptor and proprioceptor nerve fibers can alter the transmission of ascending nociceptors via small diameter Aδ fibers to the periaqueductal grey (PAG) nucleus (Moayedi and Davis 2013).”
          https://www.ncbi.nlm.nih.gov/pubmed/27853885

          • Importantly, in addition, since application of a vibrating roller interacts with a heterogeneous tissue to include skin, I am convinced that skin mechanoreceptors are key players in the acute change of the sense of movement, possibly even to overcome what is known as “fear avoidance”.

  2. INSTRUMENT ASSISTED SOFT TISSUE MOBILISATION

    There seems to be no limit to the number of tools available for the purpose of administering massage: https://au.pinterest.com/pin/292804413257849150/

    Despite the variations in treatment approaches and instrument design, the general premise of what is known as Instrument Assisted Soft Tissue Mobilisation (IASTM) is to enhance “myofascial mobility” with limited adverse effects such as discomfort during treatment or bruising after treatment.

    Claims for success of IASTM in various conditions, such as lateral epicondylitis, carpal tunnel syndrome, chronic ankle instability, and patellofemoral pain syndrome are not supported by the relevant studies that have to date been undertaken.

    The use of these appliances over “myofascial trigger points” is of course bedevilled by the fact that their existence as pathophysiological entities has never been demonstrated.

    A recent systematic review of IASTM by Cheatham et al. [2016] concluded: “overall results among studies were insignificant with the IASTM group displaying equal improvement as the control or comparison groups … The current evidence seems to lack the methodological rigours necessary to validate the efficacy of IASTM itself or any of the IAST protocols.”

    The authors suggest: “clinicians may also benefit from further reading related research in order to further understand the postulated physiological mechanisms that occur with the different myofascial therapies.”

    Should clinicians choose to take this advice, it seems that they will succeed in rediscovering the entity that was once termed “fibrositis”: http://www.fmperplex.com/2015/07/14/could-fibrositis-be-making-a-comeback/

    But in so doing, they might recall the words of Ogden Nash [1902-1971]: “I haven’t the slightest idea where fashions in pathology are born …” [From Saturday Evening Post, October 14, 1933, “How’s your sacro-iliac?”]

    Reference:

    Cheatham SW, et al. The efficacy of instrument assisted soft tissue mobilization: a systematic review. J Can Chiropr Assoc 2016; 60(3): 200- 211.

  3. Since I read those fascia stories they made non sense to me. As a patient, I feel as all my systems are involved. In fact, the last year, when I was diagnosed, my whole body hurt so badly and I was anxious and having digestive problems for almost four months; while I had some breathless, weakness, shakes and nauseas, etc…those were not the most remarkable symptoms and I thought I was feeling distressed for the pain.
    This year my symptoms are different, I can control pain, so definitely is not the worst symptom. Instead, I often feel very tired, with migraines, some times even lethargic and with shakes, besides I feel as I can’t control my temperature easily. The nauseas and shortness of breath are daily things now…and sometimes I feel tension and butterflies in my stomach…so how fascia could explain all these? It is sad that there are so many people playing to do science with serious issues like this.

    • Thanks for your response. Yes, it seems that “fascia” is again in fashion and all pain sufferers do need to be made aware of the enormous amount of nonsensical advice and the various products that are being targeted at them.

      This may be of interest to you and others who are interested in Chronic Widespread Pain (aka Fibromyalgia). According to Professor Alexander (Sandy) McFarlane (Professor of Psychiatry and Head of the University of Adelaide Centre for Traumatic Stress Studies and an acknowledged world expert in this subject), “Pain shares many of the underlying neural substrates with posttraumatic stress disorder (PTSD). Regions such as the amygdala, insular and thalamus, which are critical to nociception, somatic registration and sensory filtering, are disrupted in PTSD in a way that is similar to chronic pain patients. Prospective studies of military personnel highlight how activation of the inflammatory cascades is a significant risk factor for emerging PTSD symptoms on deployment. Equally, in longitudinal studies of accident victims, PTSD predicts chronic pain and disability. Interventions need to recognise the centrality of the shared neurobiological underpinnings of these disorders and develop interventions that modulate and re-regulate the systems that drive the hyper-reactivity to environmental stimuli that underpin both pain and PTSD.”

      Reference: Abstract presented by Professor McFarlane at Plenary Session 1 of the Annual Scientific Meeting of the Australian Pain Society in Adelaide on Monday 10 April 2017.

  4. Thanks Dr. Quintner. It is really important for us to understand what is happening into our bodies, so the newest academy conclusions about chronic pain are totally about us and our hope. I will never tire of thanking you all for accepting the challenge of researching this complex disorder bypassed for so long time.

  5. Hi John, take a look at these papers with regard to pain alleviation by vibration, again with a strong neural basis. It is from the work of Lundeberg et al, back in 1984.

    Pain alleviation by vibratory stimulation

    “The effect of vibratory stimulation was assessed during and after stimulation using a graphic rating scale. Sixty-nine per cent of the patients reported a reduction of pain during vibratory stimulation.”
    and here is the theorized explanation:
    “It has been proposed that activity in large diameter sensory fibers interacts with impulse transmission in pain pathways, thereby alleviating pain. A relevant question is then what kind of receptive units are excited by the vibratory stimulus. Several studies have shown that superficial and deep cutaneous mechanoreceptors are sensitive to vibratory stimulation. Among the receptors with high sensitivity to vibrations are the Pacinian corpuscles and the primary endings of the muscle spindle. The observation that more effective pain reduction was obtained when the stimulus was applied with moderate pressure and cushion, so that a large area and underlying tissues were stimulated, might indicate that the pain alleviation could be attributed to activation of Pacinian corpuscles in connective tissue, ligaments or joints and primary endings of muscle spindles. However, activation of other types of receptors in skin, subcutaneous tissues and bone may also contribute to the effect.
    One effect exerted by vibratory stimulation is a depression of the excitability of motoneurons innervating the antagonistic muscle via reciprocal inhibition. This may explain the obtained reduction of pain in some patients when vibratory stimulation was applied at a muscle antagonistic to the painful area. An interesting observation was that vibratory stimulation for 45 min regularly caused a redness of the skin and a feeling of warmness in the stimulated area. It can therefore not be excluded that part of the pain reducing effect may be attributed to autonomic effects.”
    https://www.ncbi.nlm.nih.gov/pubmed/6333660

    then, they carried on to check the long term effect of the treatment.

    Long-term results of vibratory stimulation as a pain relieving measure for chronic pain.

    “In the present study 267 patients with chronic neurogenic or musculoskeletal pain were given vibratory stimulation for the pain. The patients were observed for 18 months or until they terminated the treatment. About half of the successfully relieved patients (59% of the total number of patients) reported more than 50% pain relief, as scored on a visual analogue and an adjectival scale. Seventy-two per cent of these patients reported an increased social activity and greater than 50% reduced intake of analgesic drugs after 12 months of home treatment. It is suggested that vibration may be a valuable measure for symptomatic treatment of chronic pain.”
    https://www.ncbi.nlm.nih.gov/pubmed/6436774

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