I have always encouraged my patients to introduce gentle touch, massage and movement as early on as possible after surgery. A lack of touch, massage and movement can cause issues with mobility for years to come, which are totally avoidable! To offer my patients more information on what fascia is and why post-op movement is so important, I recently teamed up with Cadence Dubus, founder of Brooklyn Strength. Cadence teaches Fascia Release, a unique workshop she developed integrating her love of anatomy and physical healing. She offers these workshops tailored to specific populations, most recently in partnership with the OUT Foundation NYC for recent recipients of Top Surgery. Below is an outline of what we discussed during our 30 minute live video discussion as well as the full live video at the end!
What is Fascia?
Fascia is a thin casing of connective tissue that surrounds all of our body parts including our organs, muscles and even blood vessels. Fascia allows independent movement between tissue layers and makes our motions fluid and uniquely "human".
Imagine many thin layers of saran wrap encasing these internal body parts and you will get a better idea of what fascia is and how it works. These thin layers of tissue do more than provide internal structure; fascia has nerves that make it almost as sensitive as skin.
Fascia can become tight and restrictive due to poor posture, scoliosis, trauma, repetitive strain, chronic inflammation and surgical scars.
Fascia and Scarring After Surgery
When you have surgery, there are the scars that you see on the surface of your skin and then there are underlying scars that are not visible to the eye. This underlying scar tissue can be uncomfortable, firm, and tight and thus restrict your movement. For example, if you’ve recently had top-surgery or a breast augmentation, the underlying scars can lead to difficulty in moving your shoulders in a fluid and natural motion.
The good new is that if you have scars from surgery or other reasons, it is never too late to improve them! You can start treating scars years after they have fully healed and still see great improvement in the way they look, their texture and movement that may have been restricted due to scar tissue.
What does this have to do with fascia? As you now know, fascia is made up of layers of connective tissue which encase our muscles, organs etc. What often happens after top surgery (and other procedures) is that due to a lack of massage and movement, your fascia will adhere to the underlying scar tissue which is overlying the muscle underneath. If the muscle is restricted this will ultimately lead to painful or restricted movement.
How can you avoid the “adhesion” of fascia to scar tissue?
It takes your body around 6 weeks to fully heal (in cases without any complications). However, I recommend that at around 3-4 weeks, you start to incorporate gentle touch and massage into your daily healing regimen. This enables your nerve endings to wake up and find their way out to the skin in a normal way. If you do not touch your body, it will become hypersensitive! Even if you have numbness, your body needs feedback so be sure to incorporate gentle touch and massage into your healing regime early on.
Gentle touch, massage and movement help stop the adhesion of tissue and fascia from happening. It creates the space for your tissue to be able to “slide” and thus not adhere to the fascia. Without the ability of your tissue to slide freely, your fascia will adhere and begin to build up more and more layers in the same area which, if left unchecked, can lead to imbalances in your posture and pain and discomfort in other areas of your body.
Another great way of creating space for your tissue is certain rhythmic movements which can bring back some of the fluidity and buoyancy of fascia and create resilience to injury (be sure to connect with Cadence from Brooklyn Strength to learn about the exact movements!).
At what point can I start fascia release?
Once you have fully healed, which is around 6 weeks for most patients, I highly recommend that you start thinking about how to keep the fascia around your scar tissue healthy and mobile! If you think of fascia as thin layers of a saran wrap-like material, in order to break those layers down, you need to tear the layered adhesions from each other on a microscopic level. In order to do that you have to have a fixed point and a point moving away. The great thing is that until you can see someone like Cadence in person, a foam roller can act as the “fixed point” from which you roll off to create the release.
Cadence offers really amazing and informative classes on how to incorporate movement and break up fascia for post-op top surgery patients.
She is offering my patients a special intro deal if you want to learn more about fascia release and movement and how it might benefit you. You will receive 15% off your first session with code Hazen15!
If you missed our IG live, here it is again for you to view.
I hope you find this topic as fascia-nating as I do and that it helps empower you to feel confident about what you can do to encourage proper healing during the weeks after your surgery.
Until next time,
Dr. Alexes Hazen