ARTICLE #2 

A CLOSER LOOK AT FASCIA

(Continued from: Equine Athletic Performance and Myofascial Structural Integration Therapy) 

April E. Johnston, MSc.

Advanced Equine Structural Integration Practitioner and Instructor

In my previous article, I discussed proper equine biomechanics and briefly touched on the connective tissue system.  Today I will explain to you what fascia is and how it bonds all parts of your horse together.

In the body, connective tissue known as fascia covers every muscle and wraps groups of muscles; other forms connect bones to bones (ligaments), and muscles to bones (tendons). Citrus fruit, such as oranges, are a good model for the horse’s connective and soft tissues- their segments are individualized by their own “connective tissue” -membranous skins, then there is a white, soft papery outer wrapping that holds the segments together, just as fascia connects muscle groups of similar function, like a “hamstring group”, and finally, an outer “skin” (peel). If you break open a segment, you will find that even the individual pieces of pulp are encased in tiny membranes, giving them shape and form. This fruit model almost exactly parallels how pervasive connective tissue/fascia is invertebrates. It goes from the intracellular matrix, to cell membranes, to muscles, groups of muscles, and finally, embedded with our skin. Thus, there is a continuum of constant information from our skin to our very cells, and because we are uniformly connected by skin, information is instantly messaged from the top of our heads down to each toe, including everything between. Until recently, this crucial system has been overlooked by anatomists; except for individual ligaments and tendons (who has not heard of the suspensory ligament?). Most anatomy books lump the rest of the gooey mess into the term “connective tissue”, glossing over its role in the body. Humans have constructed a model of pieces and parts, such as “biceps muscle, quadriceps muscle, Achilles tendon”.  Our health care system promotes this perspective, with specialists looking at each part in relative isolation (such as pulmonologists and obstetricians), but to the body, we are all one continuum of tissue.

Connective tissue itself is made up of a large percentage of collagen, with various other constituents that alter its viscosity and density relative to its position in a body. Its role in the body is essentially to connect and protect EVERYTHING, respond immediately to movement and allow the proper “give and take”. University research in both Europe and the United States has revealed information about connective tissue that is turning traditional views of the “muscular-skeletal fitness” on its head. For example, connective tissues have ten times more nerve endings than muscles. This fact alone indicates that connective tissue may have a far greater role in “fitness” and overall ability for the body to respond to training than “toning” muscles. Plastic surgeons in Europe, using tiny cameras, discovered a hydraulic communication system within the fascial web that, through pressure changes in microscopic fascial systems, immediately communicates any kind of stress to the rest of the fascial web, which instantly responds by providing support by counterbalancing tension/tightening. For example, if someone shoves you lightly, your body gives in one direction but the opposite side “catches” or provides recoil and keeps you from falling over. Your muscles and bones do not provide this protection from falling. Instead, the fascia, ligaments and tendons initiate the response and organize support through all the structures- ligaments, tendons, bones, muscles.  If the stress is sustained or repetitive, the connective tissue system, in an innate wisdom, lays down MORE connective tissue to strap up the system, much like we put extra tape on the stress areas of heavy packages we intend to mail.  

One fascinating fact, despite its membranous near-transparent appearance, fascia is much, much stronger than it looks. In fact, fascia can withstand over 2000 lbs. of force per square inch! If you have ever tried to tear the “white stuff” off a large cut of meat, you will have experienced the deceiving appearance.  It is easier to tear the muscle fibers apart than sheets of thick fascia.  This is one reason a torn ligament or tendon takes a long time to heal. When there is an injury to the body, such as a blow to a muscle, the connective tissue clamps down, providing a form of natural compression wrap to immobilize the injury site and reinforce surrounding tissues to take up the slack. For example, if a horse is lame in the right hind, the left shoulder and left hind will have more weight shifted onto them.  At a cellular level, more collagen fibers (fascia components) will be laid down to support the new greater strain placed on these areas- areas that compensate for the injury. 

The stubbornness of the connective tissue system can be problematic. Long after that hindquarter injury is healed, the thickening of the connective tissue does not go away. In fact, the extra fibers, like hyperactive scar areas, may tend to attract more and more thickening, which is called fibrosis. Over time, this excessive compensation pattern can result in reduction of movement and loss of elasticity.  It would be as if you had ballet slippers on that allowed free movement of the foot.  Then injured your foot, so on the good foot you would now put on a heavy boot to support all the weight. Even after the foot healed, you now cannot take off the heavy boot, and the difference in the covering of the two feet caused you to alter your movement. 

Is there a stiffness in your horse that cannot be explained by an injury?  Repetitive motion that causes structural micro-stresses can cause this kind of compensation pattern as well. In humans that have jobs that are repetitive, this is well documented: tennis players develop larger muscles and associated fascial thickening in the dominant arm. All bodies where motion, flexion, and extension are unequal on either side of the body are susceptible to this, because the role of connective tissue is to avoid injury and breakdown by supporting whatever pattern the body is doing the most. Thus, if you slouch at your desk all the time, your fascial holding patterns will continue to make slouching your normal way of being, and over time, being straight and tall, which is actually more balanced, becomes far more difficult and uncomfortable than slouching (no wonder our mothers told us to stand up straight!) When retraining a horse that has developed in an imbalanced way, the trainer and rider are confronted not only with the challenge of overcoming the horse’s mental blocks to being ridden differently, but often physical weakness and imbalance in the horse. Many trainers think this means building up muscle on the topline through lunging and correct riding; they may often find it difficult to overcome one-sided or directional weaknesses. Many times, this may be more the fault of tight compensation patterns that inhibit freedom of movement and thus slow down balanced muscular development. Think of it much like a human wearing a set of body pajamas that are way too tight in one shoulder and the opposite hip and being asked to do yoga and gymnastic exercises with equal flexibility on both sides.  Thus the “upside down” horse described previously may get with a trainer that can really help the horse engage, but that retraining may be long and arduous, addressing the myofascial restrictions through repeated strengthening of a more correct pattern. This can take a really long time. As one dressage trainer who used me a lot stated: “I can spend three months retraining a pattern just to get to a starting point to then go forward, or I can use you to reshape their body and cut that time in half”. 

The following is an example of a typical progression of symptoms resulting from fascial constrictions in the shoulder area.  A girthy horse may simply be trying to tell you that there are fascial restrictions in key muscle groups behind the shoulder and in the chest between the forelegs that actually connect the chest and underside of the pelvis- thus inhibiting their ability to truly engage their hind end and making it almost impossible to have true rear-to front connection (and thus impulsion!). To compensate for this restriction, horses will often “pop” a shoulder, lean in on one side, or counter-flex other parts of their body in a desperate search to balance themselves and to ease the burning pinch of fascial adhesions being tugged. However, in finding a position of comfort that avoids opening the fascial restriction, the horse is inadvertently strengthening an imbalanced pattern. This causes further fascial restrictions (often opposite side and forward of the original imbalance) as the body applies irregular contralateral tension for balancing the whole horse. As training progresses, they may start rearing, kicking out, hunching their back, nipping when girthed, and resist being caught. Their polls, withers, and pelvises take the brunt, and chiropractic exams reveal rotations, fixations, and chiropractic subluxations. The horses are adjusted and massaged, get special magnetic and or thermal blankets but the tight connective tissue restrictions are not permanently addressed by this treatment.  The pain and stiffness returns, so the chiropractor repeatedly adjusts the same general areas. The nerves affected in these joints send signals to muscles, causing spasms. Massage temporarily relieves this situation, but with resumption of training, the pattern takes over and re-emerges. The farrier tries new and more inventive shoeing, which may also help for a time, but remember that the foot is being shod or trimmed to a body out of balance! The result in the end is that horses will often get increasingly more resistant and irritable, or simply shut down.  From that point, saddle fit is checked repeatedly; often thousands of dollars are spent on new saddles, new shoes, chiropractic care, acupuncture, nuclear scintalligraphy, or steroid injections. In the worst cases the horse's attitude is blamed on temperament instead of pain, and they are sent down the road, still hurting. A veterinary exam may reveal hot spots of soreness, inflammation, and spot-lameness, and  may show that the hocks are sore, the tendons are stressed, the back is tight; these symptoms are justified, but not the originating issue. Instead of focusing on a singular joint, limb, or area of the body, we could ask “What do all the symptoms tell us and what do we need to do to help our horses?”

In the final article of this series, I will explain a phenomenal therapy that can help horses restore equilibrium.                

April Johnston is a former research scientist who re-trained as an equine structural integration practitioner in 2008. She has been teaching equine bodywork since 2010. In 2015 she and Dr. Kelleyerin Clabaugh, DVM co-founded  The Equine Institute, which has three science based programs in equine fascial integration therapy, veterinary technology education and horse owner education.