First let’s talk about the fascia!
Although fascia is not mainstream yet, a new appreciation of fascia has begun throughout the health and well-being industries as a way of explaining and treating injuries and diseases.
Fascia is a type of connective tissue that acts like a spider web or network in the body. It’s like a three-dimensional net that surrounds individual muscles, muscle bundles within individual muscles, groups of muscles, blood vessels, and nerves. It binds these structures together in much the same manner that plastic wrap is used to hold a huge sandwich together. It consists of several extremely thin layers, and is the tissue where the musculoskeletal system, circulatory system, and nervous system all unite. It acts like a network of information, relaying nerve impulses and reacting to stress and tension in the body.It runs from the top of the head to the tip of the toes, and like ligaments and tendons, it contains closely packed bundles of wavy collagen fibers that, when healthy, are oriented in an organized and parallel fashion and have a slippery quality, holding the organs but allowing them to glide over one another.
When fascia is unhealthy, largely due to inflammation or trauma, it becomes sticky and can form adhesions. Instead of the fibers running parallel to each other in an organized fashion with their normal degree of elasticity / flexibility, the fibers now run in every possible direction in all three dimensions and have an extremely diminished amount of organization and elasticity.
Because fascia is entirely continuous throughout the body, a restriction in one part will affect every other part that are connected to it.
If fascia is stuck, it squeezes the structures it surrounds, inhibiting movement and circulation. If fascia is not moving freely the whole area will experience pressure, malnourishment and ultimately painful restriction in movement and at rest. Nerve endings may become entrapped within a developing adhesion.
It’s also interesting to note that highly sensitive people tend to have more connective tissue disorders, or problems with the fascia, than hardy people.
It’s also important to note that fascial adhesions do not often show up on MRI. So a normal MRI doesn’t necessarily mean that there is nothing going wrong.
So it’s fair to say that properly functioning fascia and connective tissues are absolutely critical to one’s overall health, and should therefore be considered when treating any sorts of digestive health issues.
Here is a very interesting videos showing the fascia in real time.
A bit more about adhesions and how they form.
What are the main causes of adhesions:
- Surgery is a very common cause of adhesions (Up to 93 per cent of people who have abdominal surgery go on to develop adhesions.)
- Trauma in the area
- Chronic stress
- Poor posture/repetitive movement
Abdominal adhesions are bands of fibrous tissue that can form between abdominal tissues and organs. As we have already discussed, if the fascia is healthy, internal tissues and organs have slippery surfaces, preventing them from sticking together as the body moves. However, in response to tissue disturbance (caused by surgery, infection, trauma, radiation, etc), the body’s repair mechanism is the formation of scar tissue (Scar tissue is made of bunched up, disorientated and dehydrated fascia but it’s vital for injury repair too), causing the tissues and organs in the abdominal cavity to stick together.
Adhesions can also form as the result of day to day postural distortions and repetitive actions that many of us perform daily. When subjected to stress, strain or other unnatural forces, fascia detects this strain and attempts to help support the body. To do so, it begins to change chemically. Bonds begin to form between the collagen fibers that are abundant in fascia. This thickens its consistency and creates the perfect environment for adhesions to form, tightening the whole fascial system. On the other side, lack of activity, poor posture and lack of flexibility also causes once-supple fascia fibres to harden into place and restricts movement even further.
Fascia impacts the way you move physically but it’s also a sense organ which can contract independently of the muscles it surrounds and respond to stress without conscious command. Chronic stress causes the fascia fibres to thicken in an attempt to protect the underlying muscle.
How do adhesions affect digestion?
If you have digestive problems, considering adhesions may be an important factor for treatment and relief. Abdominal adhesions do not always cause problems, but they can kink, twist, or pull the small and large intestines out of place, contributing to abdominal pain, poor gut motility, bowel obstruction and constipation.
By affecting the mobility of the internal organ, it can affect the function of any of the digestive organs, including the liver (affecting detox pathways), pancreas (affecting enzyme secretion), stomach, etc.
If you have been diagnosed with SIBO and have been struggling to get rid of it, this could be an interesting connection. The small intestine is really long and loops its way through the abdomen, connected to our insides through several connection points. There are many opportunities for small adhesions to bind up the small intestine and inhibit motility and mobility (which could definitely contribute to SIBO recurring after treatment). For example, the right sacro-illiac joint is the attachment point for the end of the small intestine. When the sacrum is out of place (possibly due to local adhesions or tightest in the fascia in a distant location), the end of the small intestine can’t empty properly into the colon (ileocecal valve dysfunction).
Disruptions in the psoas (more on that here) can cause inflammation, leading to small internal adhesions anywhere in the gut, and likely in some of the meters of the small intestine, affecting the function and motility of any of the digestive organs.
It’s also worth mentioning that they are also a common cause of chronic pelvic pain and infertility. Women with abdominal adhesions in or around their fallopian tubes have an increased chance of ectopic pregnancy.
What can you do?
- Adhesiolysis (surgery to cut the adhesions). The problem with adhesiolysis is that adhesions almost always reform, in about 70% of people.
- Address the underlying cause of adhesions (endometriosis, infection, inflammation, a tight/dry psoas, poor posture, chronic stress, etc)
- Visceral manipulation can be useful to break up adhesions.
How can Yoga help?
Regular yoga practice can help to slowly break down adhesions and encourages rehydration of your internal surfaces, especially when practiced with breath awareness. When you practice yoga, the constant squeeze and release action in the abdominal area (often called massaging the internal organs) can help release tension in the area and can enable better organ positioning and improved cellular function throughout, allowing your organs to function more efficiently.
Yoga can also help address poor posture, fascial adhesions that may be causing imbalances within the body and help to put the body back into alignment, all of which, as discussed above, can affect digestion. Please note that simply going to a yoga class will often not be enough. A thorough assessment with a yoga therapist will often be needed to truly address your personal underlying imbalances and correct these via a personalized yoga sequence.
Breathing exercises can be very useful for digestive problems in so many ways. If we think specifically about abdominal adhesions, belly breathing can help by “massaging” the organs. I find deep belly breathing while holding a twist especially useful.
As discussed above, chronic stress can be a contributor to unhealthy fascia. Yoga aids by switching our autonomic nervous system from Sympathetic (fight or flight) to Parasympathetic (rest, relax, repair, digest).
What asana do I recommend?
Here’s a few to get you started.
Reclining Pelvic Tilt
Lie on your back with your knees bent (about 90 degrees), feet on the floor hip width apart and your arms resting on the floor. Press the feet evenly into the floor. Soften your face, jaw, and belly. Establish an even and effortless breath, and let the breath deepen in the body, noticing the rise and fall of the belly with the breath. Then exhale deeply and slowly contracting all the abdominal muscles. Soften the abdomen as you inhale fully, letting the belly inflate and float up. Then exhale strongly and deeply again, slowly drawing the lower belly and navel toward the spine, and pressing the lower back into the floor, hollowing out the belly. Inhale, release the contraction, and let the back release from the floor passively as the belly fills again.
Note that the pelvis rocks gently. On the exhale, the tailbone moves up between the thighs, and the lumbar spine descends into the floor. On the inhale, the pubic bone moves down between the thighs, the tailbone moves into the floor, and the lumbar spine releases. Now as you exhale fully, sense the space between the pubic bone and the tailbone and contract and release here also. This is the pelvic floor, which is the supporting foundation for the contents of the pelvis.
Now, make the practice more subtle by keeping the pelvis still and stable so the contraction is only in the abdomen and pelvic floor. Imagine squeezing a sponge. Keep the chest, jaw, face, and arms relaxed. Ground gently through the legs to keep the pelvis stable. Repeat 5 times.
Position your elbows right under the shoulders, or slightly forward if you experience low back pain. Make sure your shoulders and neck are relaxed by bringing your shoulders away from you ears. Hold here for a few breaths, feeling your belly push against the floor as you inhale, and pulling away as you exhale. Rest down with your forehead in your hands as you feel the need, and then repeat.
Variation: If you do not experience any back pain while holding sphynx, you can try this variation. Support yourself with your left arm and bring the right foot up by bending the knee. Hold your foot in your right hand and gently push your foot in your hand, away from your buttock. Repeat on the other side.
Laying down twist.
Hold this position while breathing deeply in your belly.
Moving from downward facing dog to upward dog.
If you are an experience yogi, this is a very effective way to massage the internal organs. Come into downward facing down on an exhale and allow your belly to be sucked in under the ribs. As you inhale, move forward into upward dog, allow the belly to expand out. Repeat as many times as you like, being mindful to engage your core as you move from one asana to the other.
For the more advanced yogi, any other asana opening the belly area: bridge pose, camel pose, wheel pose, etc