One factor that makes my work as a doctor and physical trainer challenging is the dearth of knowledge about the fascia among laypeople.

You would understand my frustration if you’ve ever tried searching for fascia resources online outside of scientific publications.

Most websites characterize the fascia as a connective tissue. While that may be partly true, the fascia is much more than that.

The fascia is a tissue but also a system. The fascia connects but also senses, communicates, transmits force, protects, and provides an environment for the entire body to function in an integrated manner.

It can be challenging to grasp how the fascia can have so many responsibilities in our anatomy. So, to make it easier to understand, let’s separate the fascia into different types. I’ll describe each classification and explain how they impact your daily life.

Superficial Fascia

Superficial fascia consists of loosely packed and interwoven collagen and elastic fibers, with the latter being much more abundant. This composition makes the superficial fascia much more pliant than other types of fascia.

It is found in the bottom layer of the skin—the hypodermis, also known as subcutaneous tissue. It divides the hypodermis into two layers: the superficial adipose tissue (SAT) and deep adipose tissue (DAT).

Like our skin, the superficial fascia occurs throughout the body. However, its thickness varies according to its location. It is thicker:

• on the trunk and thins out towards the hands and feet;
• on the feet than the hands; and
• on the front compared to the back of the body.

Although aptly named for its location in the body, nothing about the superficial fascia’s role is superficial. Here are just some of the functions the superficial fascia carries out:

Holds the skin in place

The superficial fascia and skin ligaments (found between the adipose tissues) form a three-dimensional network in the hypodermis. Together, they dynamically anchor the skin to the muscles beneath them.

They are the reason why our skin can stretch in different directions and still snap back into place. The ubiquity of elastin in the superficial fascia allows this to happen. However, the superficial fascia loses elasticity as we age, partly explaining why we lose skin tone and form wrinkles.

Provides pathways to nerves and blood vessels

In addition to upholding the skin’s structure, the superficial fascia supports essential body parts traversing the hypodermis.

As the nerves and blood vessels travel through and across the hypodermis, the elastic superficial fascia prevents them from being crushed or stretching too much.

Conditions like varicose veins and deep vein thrombosis can arise from an alteration in the superficial fascia’s elasticity.

Organizes the skin, fat, and muscles

The superficial fascia, together with the SAT and DAT, separates the skin from the muscles, permitting independent movement between the two.

They also prevent the deep fascia from activating when normal pressure is applied to the skin. At the same time, they minimize the disruption of the skin during muscular contraction.

The superficial fascia and the skin ligaments also organize the fat tissue in the hypodermis.

Deep Fascia

Compared to the superficial fascia, deep fascia has a higher amount of collagen fibers, making it less elastic and more stable.

Deep fascia is commonly classified into two: aponeurotic and epimysial. The latter envelops specific individual muscles, while the former covers and connects entire groups of muscles. An example of aponeurotic fascia is the thoracolumbar fascia, which encompasses the deep muscles of the back.

Aponeurotic fascia tends to be thicker and can be easily separated from the underlying muscles. It occurs in two to three layers, separated by loose connective tissue. Meanwhile, epimysial fascia is only one thin sheet and is more tightly connected with the muscles they enclose.

The deep fascia can also be classified more specifically, depending on which structure they support:

• bones (periosteum and endosteum)
• cartilage (perichondrium)
• nerves (epineurium, perineurium, and endoneurium)
• muscles (epimysium, perimysium, and endomysium)

While there is utility in knowing about these different types of deep fascia, it is more important for laypersons to think of the deep fascia as a continuous web which carries out the following functions:

Stores energy

The abundance of collagen in the deep fascia allows it to store energy. Like a slingshot, our fascia accumulates energy as it is stretched, and then releases that energy to power our movements.

This phenomenon was first investigated in the 1980s by scientists curious about the excellent jumping ability of kangaroos despite having lean hind legs. They discovered that their power comes not from their muscles but their fascial recoil.

Unfortunately, the ability of fascia to store energy decreases when it is stretched for too long. That’s why individuals with hypermobility, who have looser collagen in the fascia, struggle with overfatigue and many other issues.

Perceives external and internal stimuli

The deep fascia is rife with sensory receptors, making it the most extensive sensory system in the body. It contains an abundance of the following:

• nociceptors, which initiate the sensation of pain to signal our body about damage;
• proprioceptors, which tell how our body is positioned in space and motion;
• thermoreceptors, which perceive changes in temperature; and
• mechanoreceptors, which feel pressure and vibration.

These sensory receptors are crucial in keeping us safe by being highly attuned to our environment. They are also fundamental to motor coordination, and essentially all movement.

Fascial densification, overuse, and injury disturb this neural network, making the fascia less responsive to external and internal stimuli. Dysfunction in the fascia also irritates the nociceptors, leading them to produce stabbing and stinging pain.

Visceral Fascia

Visceral fascia protects and holds our visceral organs in place. Unlike the superficial and deep fascia, visceral fascia does not occur throughout the body. It is only found from the neck down to the pelvic floor.

Aside from enclosing our internal organs, visceral fascia acts as a pathway for the blood vessels and nerves to enter them. It also provides a drainage route for the organs.

A group of researchers propose classifying visceral fascia into two: investing and insertional. The former shapes the individual organ, while the latter connects the organs to the musculoskeletal system.

Healthy visceral fascia can maintain its tension while being able to stretch to accommodate the organs’ movement.

This tension can be negatively affected by trauma, infection, and inflammation. When the visceral fascia becomes too tight, it restricts the organs’ natural movement. When it becomes too loose, the organ can prolapse. Both of these conditions can lead to disease and pain.

How to Keep Your Fascia Healthy

Because the fascia occurs in many different forms, it also carries out a plethora of functions. We’ve actually only begun to scratch the surface of what the fascia does for us. In addition to everything above, the fascia also helps with force transmission, immune function, and neural regulation.

Thus, the importance of keeping our fascia healthy cannot be overstated. It affects every single thing that our body does. That’s why I have designed an exercise system to remodel the fascia—Rev6.

My exercises, borne out of decades of clinical and therapeutic experience, help treat the densifications in our fascia that promote pain and injury. The most beautiful part is that they benefit all types of fascia.

As I have emphasized throughout this blog, the superficial, deep, and visceral fascia are all connected into one fascial system. That means any exercise that improves the tone of the superficial and deep fascia also impacts the visceral fascia.

When you train in Rev6, you don’t only develop flexibility and strength. You also upgrade your body’s efficiency and overall function. If you want to reap all these benefits, here is where you can get started.