The meaning of fascia in a changing society

Abstract

Fascia is an anatomical term whose meaning has evolved during the past four hundred years. It is generally applied to the body’s fibrous membranes and the tissue they are composed of, yet this concept appears to be unevenly interpreted and frequently overlooked by bioscientific, clinical, and community health writers. This is of concern as an institutional attachment to a traditional yet possibly not up-to-date understanding of fascia might not best serve the complex health needs of present-day New Zealand (NZ) society.

A recent change in the way fascia is acknowledged in the literature may signal a shift from traditional anatomical knowledge to its more holistic interpretation within an emerging interdisciplinary discourse field. This investigation aims to discover whether there may be a similar difference in the way fascia is comprehended by NZ’s multiple discipline-spanning healthcare community within the context of NZ society’s health system, as that diversity, should it exist, might affect cross-disciplinary and broader community discussion about the morphology, performance, and remedial treatment of the body and its soft tissue elements. This study’s use of a transdisciplinary perspective and interpretative methodology for fascia research is linked to Heidegger’s epistemic directive that it is necessary to develop new ways of observing phenomena if we want to expand, rather than simply enhance, pre-existing knowledge of the phenomenon in question. Ethnographic fieldwork methods (semistructured interviews and participant observation) were used to obtain data about how knowledge of fascia is included within the baccalaureate-level anatomy instruction of dentists, doctors, massage therapists, midwives, occupational therapists, osteopaths, and physiotherapists; and in five (Anatomy Trains, CranioSacral Therapy, Fascial Kinetics, Kinesio Taping, and Manual Lymphatic Drainage) introductory-level bodywork seminars, mainly attended by practicing massage therapists and physiotherapists. The research explores how the above-mentioned groups of students’ instructors (this study’s participants) understand and teach their students about fascia. Thematic analysis of the pooled interview transcripts and fieldnotes reveals disparities in how fascia is construed by the participants, and also in how and to what extent it is portrayed to their respective cohorts of students. This study indicates that the participants generally construe fascia either as a range of distinct inert membranous structures, or as a pervasive dynamic soft connective tissue system that manifests in a variety of interrelated forms. While both viewpoints are consistent with the way fascia is concurrently described in the amassed literature, the data suggest the emergent and ostensibly more expansive interpretation of fascia is likely to have been prompted by changes in the fabric of society and its healing practices rather than the continuous progression of an established body of scholarly knowledge. From a Foucaudian position this study’s exposure of what appears to be a discontinuous progression in how fascia is known is important, as such a change could conceivably be enduring and far reaching in its effect. It may therefore be timely to carefully reconsider our own views on this subject.