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This article provides a brief overview of the importance of connective tissue health as well as the benefits of myofascial release in the group & clinical setting with promising outcomes in enhancing mobility, increasing proprioception, supporting injury prevention, promoting tissue healing, regulating inflammation and immune function and optimizing tissue resilience.
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Well Being Journal
Grounding • Emotions & Health • Prolotherapy • Singing & Happiness
Heralding tHe integration of Medicine witH PHysical, Mental, eMotional, sPiritual & social asPects of HealtH
VOL. 27 NO. 2 March/April 2018 U.S. $6.95/Canada $8.95
The Gut & Nutrient-
Dense Foods
Power of Intention
& Vital Force
Connective Tissue
The Grace of
16 March/April 2018 Well Being Journal
Vol. 27 No. 2
C  has a long history of
being overlooked in favor of what seem to
be more important features in the body. In
medical school cadaver dissections, the connective
tissue is carefully extracted and thrown away to reveal
the more precious structures and organs, but our low
prioritization of it is nally being reconsidered in light
of recent research putting fascia and other connective
tissue in the spotlight. With so many new studies
opening our eyes to the crucial functions of this tissue,
the need to reexamine our understanding
of it and its potential contributions to our
health and quality of life is undeniable.
Fascia, a type of connective tissue, has a
broad array of functions, including linking
nearby tissues, supporting organs, reducing
friction that comes with muscular force,
forming compartments that enclose groups
of muscles and other structures, separating
tissues, investing the tendons (thereby
adding to their strength and resilience),
creating functional chains of muscles that
allow us to move more smoothly and
eciently, and much more. is tissue also contains
important immune cells, protective adipose cells,
myobroblasts that assist tissue healing, and a complex
communication system to help oversee it all. Another
important feature of fascia is that it is a continuous
intermeshed system of brous tissue that weaves
through the body, from head to toe. is interconnected
system can be the reason your pain in one area may be
inuenced by changes in another part of your body,
and it is also a big part of how we adapt and respond
to stress via a body-wide tension-distributing system.
Every year, half the fascial bers (collagen) are replaced
in a healthy body, providing us a powerful intervention
point to steer these changes in the tissues at any time.
Myofascial Release
e term myofascial release refers to any technique that
works on the muscles and the fascia. ere are many
dierent modalities; however, the most common self-
myofascial release (SMFR) techniques
usually involve the use of balls or foam
rollers. e beauty of SMFR is that it can
be done with simple tools and training,
making it accessible to the general public.
ere are numerous articles and studies
showing positive outcomes for these
modalities. e main limiting factors of
these studies are that many of them are small
and their methods can vary considerably.
Nevertheless, most of them show signicant
positive outcomes with only minor side
eects, which usually involve temporary
soreness and/or bruising.
Fibroblasts, cells within the fascia that are responsible
for producing the fascial matrix, play a large role in
how the tissues remodel over time in response to the
demands placed on them. ese demands can have
relatively positive (as in yoga, stretching, exercise, or
myofascial release) or negative (in the case of poor
posture, repetitive motions, or injuries) eects on the
way the broblasts remodel the components of our
Connective Tissue Health
& Myofascial Release
By Tiffany Cruikshank, LAc, MAOM, E-RYT
“e term
release refers to
any technique
that works on
the muscles
and the fascia
© microgen
well Being Journal Vol. 27 No. 2 March/April 2018 17
connective tissue. Myofascial release is thought to
both stimulate and regulate broblasts; it helps break
down excessive connective tissue deposition as well
as stimulates them to produce new, more resilient
connective tissue. It also enhances hydration of this
Probably the most well-known uses of SMFR are
to increase mobility and relieve pain and injuries. e
eects of SMFR on mobility are probably the most
commonly studied, with positive but often temporary
eects seen. Immobility, repetitive movements, poor
posture, and injuries can all cause excessive collagen
deposition that leads to brosis or adhesions between
the tissues, resulting in diminished range of motion and
mobility. SMFR helps to reduce and
prevent excessive collagen deposition
by increasing collagen turnover to
keep the tissues strong, elastic, and
resilient. is feature is critical both
for working with injuries and helping
to prevent them. Also, one of the great
advantages to using SMFR is that the
increases in mobility do not initiate the
temporary decrease in muscle power and
performance seen with stretching.
A key feature of connective tissue
that we are still learning about is its function as a
communication system. With six times as many
sensory neurons than are found in any other tissue
(besides the skin), the fascia is a huge sensory organ
important both for proprioception (spatial awareness)
and interoception (internal body awareness). One of the
often-overlooked benets of myofascial release is this
increase in proprioception, which you feel right away.
Try, for instance, rolling out your feet before attempting
a challenging balance position, and you can experience
this rsthand. Research suggests that increasing
proprioception can also decrease pain. What’s even
more interesting is the new research pointing to
the fascia having its own internal communication
system, which functions independently from the
nervous system via vibration, crystallinity, and
electricity. is suggests an inherent body-wide
intelligence within this system.
Within the fascial layers, we also nd important
immune cells that help to modulate inammation and
tissue healing. Many people think of the fascia as just
surrounding the muscles, but this tissue also interweaves
through the muscles and surrounds organs, bones,
nerves, and blood vessels throughout every part of the
body. Since it envelops just about every structure of
the body, you can imagine how important the immune
function in this protective internal fascial layer is. ere
is increasing evidence that the physical and mechanical
environment of the tissues can inuence cell behavior
and tumor progression. In fact, some of the newest
research on fascia focuses on its eects on cancer and
suggests that healthy fascia could be an important
component in treatment and prevention.
e hydration of the connective
tissue is a key component in its health,
inuencing communication, adhesions,
and immune function. Imagine dry
tissues rubbing over each other with
every movement. Impaired hydration
of the fascia causes increased friction,
stimulating the broblasts to lay down
more collagen cross-links between
layers of tissue, eventually leading to
adhesions between the layers. You might
think drinking more water would solve
the problem, and though that may
be part of the answer, it doesnt necessarily equate to
connective tissue hydration. Gentle SMFR techniques
help to increase the hydration of the connective tissue
to decrease adhesions, enhance communication, and
facilitate healthy immune function. ink of the
connective tissue as being like a sh bowl; not only do
you need to add more water, you also need to clean it
out from time to time.
ere are also other body functions that SMFR
inuences—the parasympathetic response, the blood
and lymph circulation, and possibly many more
that may be revealed as the studies
continue. In
“Within the fascial
layers, we also
nd important
immune cells that
help to modulate
inammation and
tissue healing”
© Stakhnyk
18 March/April 2018 well Being Journal
Vol. 27 No. 2
addition, there are mental and emotional implications of the connective
tissue system that we don’t fully understand yet. Practitioners may
observe this in their clients as an unexpected emotional release that may
spontaneously arise with SMFR. e beauty of SMFR is that you don’t need
to understand the emotional history of a trauma or injury to let it go; you
need only provide the space to allow it to pass.
Studies suggest that receiving SMFR just once or twice a week will
yield a more resilient fascial system in six to twenty-four months, so slow
and steady wins the race for connective tissue health. As with any healing
modalities, it’s important that you consult your doctor before using SMFR
and seek the help of someone trained to use it.
ough there is still a lot of research needed to show the extent to which
the fascial layer may be involved in many pathologies, there is already more
than enough to indicate the need for further
inquiry into how the health of this tissue
can aect so many interconnected systems.
Myofascial release techniques show promising
outcomes in enhancing mobility, increasing
proprioception, supporting injury prevention,
promoting tissue healing, regulating
inammation and immune function, and
optimizing tissue resilience. As SMFR has so
few side eects, I believe it’s our opportunity to pursue further study to see
how we can best use this simple, cost-eective modality that could have a
signicant impact on pain, inammation, injuries, tissue
health, and possibly pathologies such as cancer. 
T C, LAc, MAOM, E-RYT, is an
internationally recognized expert on myofascial release, yoga,
and wellness. Tiany is the founder of Yoga Medicine, a school
that trains yoga teachers to work with healthcare providers, and
the founder of the non-prot Yoga Medicine Research Institute.
She leads myofascial release trainings for teachers, healthcare
providers, coaches, and others throughout the world. Go to www. to nd an instructor or training program near
Author note: anks to the Fascia Research Congress
for promoting the work of so many researchers who
help bring this information to the public, and many
thanks to all the researchers out there doing the work.
1. Beardsley, C., and Škarabot, J., “Eects of self-
myofascial release: A systematic review,” Journal of
Bodywork and Movement erapies 19, no. 4 (2015):
Uses of Niacin
Niacin (nicotinic acid) is one of
eight water-soluble B vitamins,
essential for more than 50 vital
metabolic processes, including
converting food into glucose,
metabolizing fats and proteins,
supporting nervous system
function, and repairing DNA.
Niacin likewise has numerous well-
established clinical applications,
including reducing atherosclerosis
progression, mitigating migraine
and tension headaches,
suppressing inammation, and
relieving anxiety, depression,
and insomnia. As a detox
agent, niacin shows promise in
facilitating the elimination of toxins
concentrated in fat molecules,
due to its therapeutic effect
upon free fatty acids. Though
niacin’s detoxication enhancing
mechanisms have not been
systematically reviewed, clinician-
researcher Jonathan Prousky,
ND, reported in the Journal
of Orthomolecular Medicine,
evidence supports niacin’s role
in optimizing the detoxication
pathways in the liver. “The results
demonstrate that niacin…does
augment detoxication by lowering
the body burden of lipid-stored
Detoxifying effects of
niacin were popularized by
Scientology Founder L. Ron
Hubbard, who prescribed aerobic
exercise, sauna therapy, lifestyle
modications, polyunsaturated oil
supplementation, and therapeutic
doses of niacin to support excretion
of toxins by sweat or sebum, and
ease complications associated with
excess fatty residues.
— Adapted from “Niacin for
Detoxication: A Little-known
Therapeutic Use,” by Jonathan Prousky.
ND, at
release techniques
show promising
well Being Journal Vol. 27 No. 2 March/April 2018 19
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Gut Bacteria &
A new study from Caltech
highlights the key role intestinal
bacteria may play in Parkinson’s
disease. The ndings may also
support more optimal treatment
strategies for the disease.
The landmark study supports
a growing body of research
examining the connection between
the brain and microbiome—the
diverse community of organisms
living on and within the body. The
Caltech microbiologists, led by
Sarkis Mazmanian, discovered for
the rst time that changes in gut
microbiome may play a critical
role in triggering Parkinson’s. In
fact, changes in the composition
of gut bacteria populations may
be actively contributing to the
deterioration of motor skills—the
hallmark of the neurodegenerative
Researchers have long
suspected a direct connection
to the gut since gastrointestinal
symptoms often precede
Parkinson’s disease. To test
the theory, the research team
compared the motor skills of mice
with and without the gut bacteria
associated with Parkinson’s. Though
both cohorts overproduced a
protein related to Parkinson’s,
germ-free mice performed
signicantly better at running on
treadmills, crossing a beam, and
descending from a pole.
The experts conclude, “The
discovery that changes in the
microbiome may be involved in
Parkinson’s disease is a paradigm
shift and opens entirely new
possibilities for treating patients.”
—Adapted from “Parkinson’s
Disease May Start in Gut,” by James
ResearchGate has not been able to resolve any citations for this publication.
Full-text available
Complementary and integrative treatments, such as massage, acupuncture, and yoga, are used by increasing numbers of cancer patients to manage symptoms and improve their quality of life. In addition, such treatments may have other important and currently overlooked benefits by reducing tissue stiffness and improving mobility. Recent advances in cancer biology are underscoring the importance of connective tissue in the local tumor environment. Inflammation and fibrosis are well-recognized contributors to cancer, and connective tissue stiffness is emerging as a driving factor in tumor growth. Physical-based therapies have been shown to reduce connective tissue inflammation and fibrosis and thus may have direct beneficial effects on cancer spreading and metastasis. Meanwhile, there is currently little knowledge on potential risks of applying mechanical forces in the vicinity of tumors. Thus, both basic and clinical research are needed to understand the full impact of integrative oncology on cancer biology as well as whole person health. Cancer Res; 1-4. ©2016 AACR.
Full-text available
Compiled by experts of international renown, Fascia: The Tensional Network of the Human Body brings together very different contributors who share the desire to bridge the gap between theory and practice as much as possible in our current knowledge of the human fascia. With contributions from over 100 specialists and researchers from throughout the world, this new volume will be ideal for all professionals who have an interest in fascia and human movement - physiotherapists, osteopathic physicians and osteopaths, chiropractors, structural integration practitioners, manual therapists, massage therapists, acupuncturists, yoga or Pilates instructors, exercise scientists and personal trainers - as well as physicians involved with musculoskeletal medicine, pain management and rehabilitation, and basic scientists working in the field.
Full-text available
The term 'fascia' has been applied to a large number of very different tissues within the hand. These range from aligned ligamentous formations such as the longitudinal bands of the palmar fascia or Grayson's and Cleland's ligaments, to the loose packing tissues that surround all of the moving structures within the hand. In other parts of the body the terms 'superficial' and 'deep fascia' are often used but these have little application in the hand and fingers. Fascia can be divided into tissues that restrain motion, act as anchors for the skin, or provide lubrication and gliding. Whereas the deep fascia is preserved and easily characterized in anatomical dissection, the remaining fascial tissue is poorly described. Understanding its structure and dynamic anatomy may help improve outcomes after hand injury and disease. This review describes the sliding tissue of the hand or the 'microvacuolar system' and demonstrates how movement of tissues can occur with minimal distortion of the overlying skin while maintaining tissue continuity.
Background: Numerous techniques have been employed to treat myofascial pain syndrome. Self-myofascial release (SMFR) is a relatively new technique of soft tissue mobilization. The simplicity and portability of the SMFR tools allow it to be easily implemented in any type of fitness or rehabilitation program. It is an active method and can be used by anyone at home or at the workplace. Objective: To review the current methods of SMFR, their mechanisms, and efficacy in treating myofascial pain, improving muscle flexibility and strength. Methods: PubMed, Google Scholar, and PEDro databases were searched without search limitations from inception until July 2016 for terms relating to SMFR. Results and conclusions: During the past decade, therapists and fitness professionals have implemented SMFR mainly via foam rolling as a recovery or maintenance tool. Researchers observed a significant increase in the joint range of motion after using the SMFR technique and no decrease in muscle force or changes in performance after treatment with SMFR. SMFR has been widely used by health-care professionals in treating myofascial pain. However, we found no clinical trials which evaluated the influence of SMFR on myofascial pain. There is an acute need for these trials to evaluate the efficacy and effectiveness of SMFR in the treatment of the myofascial syndrome.
In myofascial manipulation an immediate tissue release is often felt under the working hand. This amazing feature has traditionally been attributed to mechanical properties of the connective tissue. Yet studies have shown that either much stronger forces or longer durations would be required for a permanent viscoelastic deformation of fascia. Fascia nevertheless is densely innervated by mechanoreceptors which are responsive to manual pressure. Stimulation of these sensory receptors has been shown to lead to a lowering of sympathetic tonus as well as a change in local tissue viscosity. Additionally smooth muscle cells have been discovered in fascia, which seem to be involved in active fascial contractility. Fascia and the autonomic nervous system appear to be intimately connected. A change in attitude in myofascial practitioners from a mechanical perspective toward an inclusion of the self-regulatory dynamics of the nervous system is suggested.
Conventional sports training emphasizes adequate training of muscle fibres, of cardiovascular conditioning and/or neuromuscular coordination. Most sports-associated overload injuries however occur within elements of the body wide fascial net, which are then loaded beyond their prepared capacity. This tensional network of fibrous tissues includes dense sheets such as muscle envelopes, aponeuroses, as well as specific local adaptations, such as ligaments or tendons. Fibroblasts continually but slowly adapt the morphology of these tissues to repeatedly applied challenging loading stimulations. Principles of a fascia oriented training approach are introduced. These include utilization of elastic recoil, preparatory counter movement, slow and dynamic stretching, as well as rehydration practices and proprioceptive refinement. Such training should be practiced once or twice a week in order to yield in a more resilient fascial body suit within a time frame of 6-24 months. Some practical examples of fascia oriented exercises are presented.
Crystalline interfacial water layers have been observed at room temperature on both hydrophobic and hydrophilic surfaces − in air and subaquatically. Their implication in biology (and evolution) was postulated in a visionary paper in 1971 by Szent Györgyi. Today, they are believed to play a fundamental role in protein folding. A recent X-ray diffraction study reports on their presence on crystals in contact with their growth solution. Their subaquatic persistence on hydrophobic solids was reported in 2007. Their relevance in nanoscale phenomena is reflected by the multidisciplinary focus in their study. In the course of a systematic exploration of interfacial water layers on solids we discovered microtornadoes, found a complementary explanation to the surface conductivity on hydrogenated diamond, and arrived at a practical method to repair elastin degeneration using light. The result was rejuvenated skin, reduced wrinkle levels, juvenile complexion, and lasting resilience.
This study examined a potential cellular basis for strain hardening of fascial tissues: an increase in stiffness induced by stretch and subsequent rest. Mice lumbodorsal fascia were isometrically stretched for 15 min followed by 30 min rest (n=16). An increase in stiffness was observed in the majority of samples, including the nonviable control samples. Investigations with porcine lumbar fascia explored hydration changes as an explanation (n=24). Subject to similar loading procedures, tissues showed decreases in fluid content immediately post-stretch and increases during rest phases. When allowed sufficient resting time, a super-compensation phenomenon was observed, characterised by matrix hydration higher than initial levels and increases in tissue stiffness. Therefore, fascial strain hardening does not seem to rely on cellular contraction, but rather on this super-compensation. Given a comparable occurrence of this behaviour in vivo, clinical application of routines for injury prevention merit exploration.