Fascinating Fascia and Shiatsu
West meets East?
For many years, western medicine has not found a mechanism that relates how balancing energy in the meridians (also called channels) of traditional eastern medicine could actually operate in the body. More recently, the research into interstitial connective tissue, fascia, suggests that the meridians could be operating through the spaces created by these tissues as well as through the connective tissues themselves.
As a scientist, who has come to believe in Equine Shiatsu because of how I have seen it work and make a difference for the horses I work with, I find this quite exciting. Over the next few posts, I will explore more about this.
First, lets look at what fascia is.
What is fascia?
Until recently, fascia was regarded as inert packaging encasing organs, muscles and bones. (If you have ever prepared meat for cooking, it is the white stuff you cut away as it can be tough and chewy and is not so nice in your food! It looks sometimes very strong , tough and wiry, and sometimes like a thin film.) Anatomists would clear it away during dissection to study the structure, biology and functions of different parts of the body.
Fascia is now recognised as a functional system that operates around the entire body, connecting every part with every other part. It is made up of a continuous three-dimensional network or web of connective tissue that connects and surrounds every muscle, bone, nerve, blood vessel and organ in the body, enabling it to operate as a single unit. Recently, the definition of fascia was broadened from ‘interstitial connective tissue’ to include all collagenous based soft tissues in the body. This definition includes some tendons, ligaments, bursae, and the collagenous layers that surround muscle fibres and entire muscles (endomysium, perimysium, and epimysium).
Fascia is the largest system in the body. It influences the overall shape of the body and plays a crucial role in movement, structural support, posture and proprioception (awareness of body position). The fascia enables muscles and organs to glide across each other, reducing friction during movement. More recent research is uncovering its role in moderating many of the regulatory systems in the body.
Structure
Fascia is soft tissue that is primarily composed of collagen. It has a variety of structures from very delicate three-dimensional web-like structures to more dense structures that appear more fibrous.
Collagen is piezoelectric, meaning it can convert mechanical stress into electrical signals and vice versa. It is thought that these electrical signals can influence cellular activity, potentially contributing to tissue adaptation and healing. This may contribute to the fascia providing a body-wide communication.
Nine Myofascial Kinetic Lines were discovered in humans that directly connect fascia in lines, or meridians that traverse the body. (This is a whole subject to explore in itself – more in another post). More recently vet anatomists at a Danish University searched for and found these lines also in horses. I was fortunate to attend a CPD course delivered by one of the researchers, Viebeke Ebrond, on this topic. It is fascinating.
Several researchers found that fascia planes correspond to the location of certain acupuncture points. Even more exciting (I think, anyway!) is that the connected myofascial lines correspond well with the distribution of acupuncture meridians. The conclusion of research by Peter T Dorsher, MD states “The strong correspondence of the distributions of the acupuncture and myofascial meridians provides an independent, anatomic line of evidence that acupuncture Principal Meridians likely exist in the myofascial layer of the human body.”
This anatomical correspondence between myofascial lines and TCM Meridians is a great start. However, from a Chinese research perspective (Bai et al in 2011) further functional and therapeutic research into fascia was required to demonstrate whether working with fascia can simulate the widespread therapeutic effects that acupuncture (and Shiatsu!) can achieve through working on the TCM meridians.
By 2024, a body of evidence is emerging on fascia as a regulator of the body’s sensory input, as it is a moderating interface between many tissue types in the musculoskeletal, endocrine, and autonomic nervous systems (Slater et al).
Why Fascia Matters! Fascia has a range of functions
Fascia is now considered one of the most functionally diverse bodily components. Fascia acts as a dynamic and interconnected network that provides a structural framework to the body and supports cellular health, facilitates fluid exchange, and regulates various metabolic, physiological and communication processes throughout the body.
Structural support framework. The fascia holds bones, muscles and organs in position by tension and compression forces of the soft tissues (tensegrity). The fascia envelopes the whole body under the skin, giving the body the shape that we see.
Structure and protection. Fascia surrounds, supports and protects every nerve, muscle, blood vessel, and organ in the body. Fascia facilitates recovery during trauma through developing scar tissue. The fascia stores adipose tissue (fats) as an energy store, insulation and cushioning.
Force transmission, locomotion & posture. Fascia enables both movement and stability, and it dynamically adapts according to the demands (physical and physiological) on it. The fascia facilitates smooth and coordinated movement by allowing muscles to slide and glide against each other, reducing friction during movement. (See a great video showing gliding by Equine Anatomy in Layers on Facebook)
Physiological and metabolic functions.
Sensory organ. Fascia houses more nerves than muscle or skin (apparently over 250 million nerve endings, with sensory neurons outnumbering motor neurons 9:1).
Sensory functions include proprioception (awareness of body position) and pain perception, including chronic pain that may be felt distant to the actual site of injury.
Neuroregulation. Fascia is closely connected with the central nervous system and autonomic nervous system (as fascia surrounds all nerves and parts of the body and especially in specific locations and nodes). Research is starting to uncover the functional importance of this. Fascia receptors respond to neurotransmitters. Fascia influences the release of neurotransmitters like serotonin, dopamine, GABA, and acetylcholine. Fascia is involved in the hypothalamic-pituitary-adrenal (HPA) axis. Fascia appears to act as a mediator between the autonomic nervous system, emotional regulation and immune regulation. Fascia is thought to play a role in the gut-brain axis as it encapsulates and compartmentalises the gut and the enteric nervous system (little brain), which produces the same neurotransmitters as the brain.
Fluid exchange. Fascia is a pathway for fluid exchange, including blood, lymph, and interstitial fluid. Mechanical pressure including movement and bodywork on fascia contributes to moving fluid, removing metabolic waste products and delivering nutrients. (In Shiatsu, moving Ki and removing blockages on certain meridians also specifically target fluid transmission and exchange.)
Regulation of metabolic and physiological processes. Fascia is involved in thermoregulation, inflammatory and immune responses, wound healing (developing scar tissue), and hormone production and transmission (the endocrine system). Fascial tissue also regulates blood pressure and blood flow to vital organs.
I hope you also find fascia quite fascinating!
The connection through fascia from head to toe can explain why working on the horse’s poll can influence the entire back, lumbar and sacroiliac region, or why working on the tail can influence the poll. (AND … There are also specific points on the shiatsu meridians which can influence locations elsewhere that are not described directly by the fascia planes/ myofascial lines. There are potential explanations when you look deep into the embryological process. That’s a story for another post!)
A few references:
Langevin HM, Yandow JA. Relationship of acupuncture points and meridians to connective tissue planes. Anat Rec. 2002 Dec 15;269(6):257-65. doi: 10.1002/ar.10185. PMID: 12467083.
Dorsher, Peter - Myofascial Meridians as Anatomical Evidence of Acupuncture Channels. Medical Acupuncture 21. 2009/06/01 doi: 10.1089/acu.2009.0631
Bai Y, Wang J, Wu JP, et al. Review of evidence suggesting that the fascia network could be the anatomical basis for acupoints and meridians in the human body. Evidence-based Complementary and Alternative Medicine : Ecam. 2011 ;2011:260510. DOI: 10.1155/2011/260510. PMID: 21584283; PMCID: PMC3092510.
Liz Eddy. The Art and Science of Equine Shiatsu: A practical guide. The Crowood Press, 2023. ISBN: 0719835062, 9780719835063 160 pages
Slater Alison M. , Barclay S. Jade , Granfar Rouha M. S. , Pratt Rebecca L. Fascia as a regulatory system in health and disease. Frontiers in Neurology Volume 15 – 2024. doi: 10.3389/fneur.2024.1458385 ISSN=1664-2295
Elbrønd, Vibeke & Schultz, Rikke 2015/05/05 - Myofascia - the unexplored tissue: Myofascial kinetic lines in horses, a model for describing locomotion using comparative dissection studies derived from human lines Medical Research Archives doi 10.18103/mra.v0i3.125
Viebke Ebrond EQUINE MYOFASCIAL KINETIC CONNECTIONS. CPD course that I attended at Horses Inside Out June 2022.
Gillian Higgins Fascia Release Techniques CPD course that I attended at Horses Inside Out June 2022.