Jo Ann Goes to Summer School

by Jo Ann Graser

​In early August I attended a five-day dissection workshop called “Fascial Anatomy Summer School” that provided a deep dive into the inner workings of the human body. The lab-based workshop consisted of an intimate exploration of fascia and its relationship to other structures in the body.

The course was held at the Institute for Anatomical Research in Colorado Springs and was led by Dr. Carla Stecco, an Orthopedic Surgeon from Padova, Italy. Dr. Stecco is an expert and innovator in fascial research and has taught all over the world. She is slated to be a keynote speaker at the Fascial Congress in Montreal this Fall.

Each workshop day began with a lecture on a specific topic and then we would head to the lab for hands on exploration. The amount of material we covered in five days was quite overwhelming and it’s still taking me time to process everything I learned. I want to give you all some snippets of information that I found interesting and relevant to the work we do together in the studio (and hope you do to). I realize the bulleted items below represent a huge information dump. Take your time to digest it and please reach out to me with any questions or comments. 

The points below are some key take-aways from the course, if you aren't into all of the details, just check out the bolded text:

• Fascia is connective tissue that surrounds every part of our body. It supports and connects muscles, tendons, ligaments, tissues, organs, nerves, joints, and bones. When fascia is healthy it is flexible and moves with you. When it is tight, it restricts movement and can cause pain and mobility issues.
• Our superficial fascial layer, which resides just below our skin, is a network of soft tissue that transmits input from our external world into our bodies. It functions as a sensory organ, responding to the gentlest stimuli and instructing our deeper structures on how to respond.
• Superficial fascia is responsible for exteroception (sensory inputs that relate to the world outside the body).
• Deep fascia is responsible for interoception (sensory inputs that relate to the world inside the body).
• Superficial fascia reacts differently depending on the necessary function of the body at a particular location (example: the fascia on the back of your hand glides, but the fascia on the palm of your hand doesn’t).
• Superficial fascia has the most sensory fibers, making it an autonomic sensory organ (autonomic sensory system acts mostly unconsciously and regulates bodily functions and is the primary mechanism in the fight-or-flight response).
• At the midline of the body, both front and back, the superficial and deep fascia join. They are not separated by fat or organ tissue.
• Myofascial expansion occurs where anatomical continuity is important to function. Fascia can expand into our muscle tissue in addition to surrounding the muscle. Fascia also expands into our bones as periosteum (vascular connective
• tissue).
• Joint stability relies on good fascial connections.
• High repetitions of movement can lead to breakdown of fascial tissue resilience, leading to instability in the muscles, bones and joints. Stability is important for better movement outcomes.
• The process of our various tissues developing rigidity starts early in our development (rigidity is defined as the point at which the tissue cannot be stretched further). Children and adolescents who overtrain risk a lower threshold of rigidity and consequently joint dysfunction.
• Things that improve fascial movement: heat (hot shower), movement and hydration.
• Visceral fascia (fascia surrounding our organs) is largely autonomic. The only organ that attaches to our locomotor system are the lungs. The lungs have the voluntary function of communication.
• Our intercostal muscles (the muscles between the ribs) are directly connected to the visceral fascia of the heart and lungs.
• There is no sensation in deep visceral fascia. Pain is felt as sensations move toward the surface structures of the body.
• As nerves migrate through the body, there are many possibilities for points of compression.
• Nerves cross the deep fascia as they travel toward the skin.
• The openings in the deep fascia where the nerve passes have very specific spatial organization so the nerve doesn’t get compressed every time the fascia is stretched.
• Nerves are fully embedded in adipose (fat) tissue to protect them from compression.
• Certain areas of the body have more protection for the nerves. The sciatic nerve (extends from the lower end of the spinal cord down the back of the thigh and divides above the knee joint) has more adipose tissue protecting it than the ulnar nerve (transmits signals to the forearm and hand).
• The Thoracolumbar Fascia (TLF) is a transitional area between the lower and upper extremity where force transfer occurs.
• TLF connects joint systems in the hips, pelvis, lumbar and thoracic spine.
• Even the arm and neck fascia “connect” to the TLF via the glenohumeral (where the head of the humerus inserts in the scapula).
• This web of fascial connections extends into the cervical and even the skull.
• The gluteus maximus (large muscle in the buttocks) has a lot of fasciae and its function is huge and wide-ranging.
• Pelvic floor pain can be a result of fascial immobility in the gluteus maximus.
• Tight fascia in the feet and ankles can add to pelvic floor pain.
• It is important to treat the body in a global way to treat pain and dysfunction.

The exploration I was gifted through this workshop was life-changing and incredibly moving. Our bodies are such marvels of design and function, and it was an honor to be allowed such access and opportunity for learning.