Fascia is a fibrous connective tissue that integrates and holds together our whole body system – it allows muscles to glide over one another and transfers load from one part of the body to another. This is a normal function, but with dysfunctional movement patterns or injury the fascial structures can become overloaded and develop adhesions. For example; the common knee pain pattern “Runner’s Knee” is due to a weak gluteal muscle that transfers its load to the large fascial ITB on the outside of the leg, which becomes thickened and adhered with overload and then disrupts the tracking of the knee cap and causes pain.
Targeted fascial release enables clinicians to release adhesions, break up scar tissue and any fascial restrictions. This assists in restoring range of movement and reducing inflammation and pain. Tools like the Gua Sha board allow us to detect early fibrosis in the soft tissue structures as well as treat chronic inflammation and scar tissue.
But what about the hickey? This red patchy mark is called the petechiae response – a controlled microtrauma of the damaged tissue that helps initiates the healing cascade. It is this increase in blood flow and breakdown of the fibrotic tissue that allows the structure of the tissue to be re-arranged and replaced by new tissue. Ice is often used post treatment to reduce the localised inflammation and minimise the visual appearance of the petechiae response. There can definitely be too much of a good thing – fascial release should not leave long lasting marks and should be relatively painless during treatment.
Gua Sha is a Traditional East Asian Medicine modality that follows these principles (and has other purported benefits not discussed here), other physiotherapists use the Graston TechniqueⓇ and similar tools to achieve their fascial release. Self release like trigger point balls and foam rollers can help to release fascial tightness and we encourage their use, but often the adhered tissues will need a helping hand…
So, who’s up for a hickey?!