Let's first start with the extreme.  This extreme condition of flexibility is called the Ehlers-Danlos syndrome.  This is also commonly referred to as hypermobility (Yew et al., 2021) or being “double jointed”.  “The initial genetic findings on EDS were related to alterations in fibrillar collagen” (Gensemer et al., 2021).  Additionally, EDS is associated with facia issues as researched by Wang (Wang et al., 2023).  We are not going to cover this extreme, but it is worthy of note, as a basic understanding of the topic, collogen and facia are involved with flexibility with facia being the primary player. 

So, what is facia?  “Fascia is the soft tissue component of the connective tissue system that permeates the human body forming a whole body continuous three-dimensional matrix of structural support. It is a viscoelastic matrix which envelops muscles, bones and organs and is a continuous network throughout the body. It plays an important role in transmitting mechanical forces between muscles” (Findley et al., 2012). Think of it as a chemical spider web that connects the tips of your toes to the top of your head.

Johns Hopkins has stated, “Fascia is a thin casing of connective tissue that surrounds and holds every organ, blood vessel, bone, nerve fiber and muscle in place. The tissue does more than provide internal structure; fascia has nerves that make it almost as sensitive as skin. When stressed, it tightens up.

Although fascia looks like one sheet of tissue, it’s actually made up of multiple layers with liquid in between called hyaluronan. It’s designed to stretch as you move. But there are certain things that cause fascia to thicken and become sticky. When it dries up and tightens around muscles, it can limit mobility and cause painful knots to develop” (Johns Hopkins, 2024).

What does the anatomy of the fascia look like? “The fascia is formed by three fundamental structures: 1. Superficial fascia, 2. Deep fascia, 3. muscle related layers: Epi-, peri- and Endo-mysium.

1. Superficial fascia is comprised of the subcutaneous loose connective tissue containing a web of collagen, as well as some fibers of mostly elastin. It is absent in the soles of the feet, the palms of the hand and in the face. Within its meshes, this contains fat.
2. Deep fascia is formed by a connective membrane that sheaths all muscles. It is devoid of fat and forms sheaths for the nerves and vessels, envelops various organs and glands.
3. Epimysium comprises the fascia that encloses each single muscle and is continuous with perimysium and endomysium. It is directly involved in the play of tension between the muscle spindles and the Golgi tendon organs” (Findley et al., 2004).

Some examples of the impact of life on facia.  Let's say you strain a muscle while you are working out.  Facia is also involved in the case if you sit too long, say on a long bus ride, car trip, or an overseas flight.  The result is what is termed inflammation aka, you are in many cases just plain stiff.  “With acute inflammation, fascia tightens and loses its pliability. Long term postural positioning which prevents full excursion of the fascia, and possibly some short-term processes may also shorten fascia.  When this happens, stretch of the fascia to what was previously a pain free range may cause pain to be felt at distant sensitive areas such as nerves and blood vessels. By releasing its tightness by manual therapy or other techniques, pressure is relieved on these areas and blood circulation becomes normal” (Findley et al. 2012)

In this video from Celeste, seriously consider point number four.  In this case fascia is formed via emotional trauma (Celeste, 2020).  Basically, how this works is, basically, your fascia is connected to your brain and your fascia in a way acts as a biological thumb drive.  As a personal example, at age 53, a First Nations massage therapist used a deer antler to break up an adhesion in my diaphragm.  This adhesion manifested itself as a side stitch when under heavy athletic load.  When she broke up the adhesion, I immediately and vividly remembered when the bicycle handlebar hit me under my right rib cage when I was 10 years old.  I vividly recalled the location on the street, the smells of the neighborhood, and the weather.  Once broken up the side stitch has not returned. 

An actual video of actual fascia moving is found here by (Woods, 2013) https://www.youtube.com/watch?v=JgNoUrNlgr4

SciShow has a fun basic video on fascia (SciShow, 2019) https://www.youtube.com/watch?v=T-UsSmD7miI

An excellent general video on fascia is found here, RAD, 2024.  https://www.youtube.com/watch?v=gdzIeHp-Khs

Some take aways from RAD:

• Fascia is 90% collogen and water.
• Fascia aids in the muscle groups sliding and gliding between each other.  (aka sheets of Teflon)
• Fascia provides liquid lubricity via hyaluronan
• Fascia is the largest sensory organ in the body and thus communicates with the brain.
• Fascia is a muscle stabilizer and a force transmitter
• Damaged fascia typically generates an adhesion. Think of an adhesion as a form of an internal scar that forms between two or more fascia groups.  (RAD, 2024)

How is an adhesion defined?  From the Australian state of Victoria, health office (HSG), they define “an adhesion as a band of scar tissue that joins two surfaces of the body that are usually separate. The formation of scar tissue is the body's repair mechanism in response to tissue disturbance caused by surgery, infection, injury (trauma) or radiation” (HSG, 2024).

Now we have an idea of the stuff that sticks our muscles together, how do we rid, or reduce fascia?  We really don’t have many options per se, but what we do have are the following:

• Breathing improvement via diaphragm facial release techniques.
• General Yoga
• Learn to relax in all situations
• Specific and directed muscle group stretching exercises
• Deep tissue massage of an area using various tools
• Epsom salt soaks
• IMHO the best for runners and swimmers - - - The Hurdle Drill

We now consider stretching before and after a workout.  There is much controversy about what is best.  I can safely say, that from experience with runners, hurdle drills before and after a workout seems to work best.  But here is what the literature has to say. 

From Rubini, 2007, “Strength and flexibility are common components of exercise programmes; however, it is not clear how best to include both of these elements in a single training programme. It is common practice among athletes, coaches and recreational exercisers to perform a stretching routine before a strength training session. Stretching exercises are regularly recommended, even in many textbooks, with the claimed purpose of preventing injury and muscle soreness, or even enhancing performance. However, as highlighted in recent review articles, this recommendation lacks scientific evidence” (Rubini, et al., 2007). 

Rubini goes on to say, “Although most studies have found acute decreases in strength following stretching, and that such decreases seem to be more prominent the longer the stretching protocol, the number of exercises and sets, and the duration of each set have, in general, exceeded the ranges normally recommended in the literature” (Rubini, et al., 2007).  To summarize Rubini, “when recommending flexibility exercises, one should consider other underlying issues, such as the safety of the participants, possible increases in injury risks and the unnecessary time expenditure. Many mechanisms underlying stretching exercises still demand investigation so that links between the observed effects, their causes and the consequences may be constructed” (Rubini, et al., 2007).

Now, the summary message here is that in order to address adhesions, no matter how small, stretch smartly and make the stretch to be muscle group specific.  In the case of running, most adhesions are in the hip flexor and hip extensor area.  The best stretch that the I have been able to find is the hurdle drill. 

To review.  There are five different components to the hurdle drill.  There are, in this example, 10 hurdles placed end to end.

1. Step Overs
2. Giant Steps
3. Side Steps
4. Backwards
5. Unders

When you warmup say at a track meet, 20 minutes before your event, do 10 Step Overs with the right leg leading.  Then repeat with the left.  Do all five that way.  This takes about 10 minutes.  If you say are still tight in the calf’s, then do calf stretches (muscle group specific).  Once completed, do what is termed stride-outs which takes a few minutes until you feel warm and damp on your back.  A couple of examples are here:

From JDW Fitness, 2022. https://www.youtube.com/watch?v=EKF4gw2x0ts

One takeaway is the exaggerated arm drive and knee lift.  Remember your arm drive is critical to your speed.  The other is wearing a sweat suit.  Don’t forget there is fascia just below your skin and being warm keeps it “happy”. and Cavill Outdoors and Coaching, 2021. https://www.youtube.com/watch?v=AXbdeDCiTUk and Bobby McGee, 2013. Karaoke Drill. https://www.youtube.com/watch?v=94ixIbZPrHc

One interesting nugget of knowledge is that when strideouts and hurdles drills are combined, just before you run, coupled with anticipation of the race, your brain is now becoming engaged along with loading of the tendons and blood flow is increasing throughout your body.  Sort of a running version of fight or flight.

Now, go to the line, remove your sweats and now you are ready to run.  When done, put your sweats back on and stay warm by sitting in an oversized bean bag.  Don’t go wandering around until your running day is done.

All the best and hang loose

References

Bobby McGee, 2013. The Karaoke Running Drill - How to Warmup for Running https://www.youtube.com/watch?v=94ixIbZPrHc

Elisha Celeste, 2020.  #FastFasciaFacts, EPO 1-8, https://www.youtube.com/watch?v=apCb1J5RH-Ihttps://www.youtube.com/watch?v=bpCGGFzKVgI

Findley, Thomas & Chaudhry, Hans & Stecco, Antonio & Roman, Max. (2012). Fascia research – A narrative review. Journal of bodywork and movement therapies. 16. 67-75. 10.1016/j.jbmt.2011.09.004.

Gensemer, C., Burks, R., Kautz, S., Judge, D. P., Lavallee, M., & Norris, R. A. (2021). Hypermobile Ehlers-Danlos syndromes: Complex phenotypes, challenging diagnoses, and poorly understood causes. Developmental dynamics: an official publication of the American Association of Anatomists, 250(3), 318–344.

HSG, 2024. Health, State Government of Victoria, Australia © Copyright State of Victoria 2024. https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/adhesions

JDW Fitness, 2022. https://www.youtube.com/watch?v=EKF4gw2x0ts

Johns Hopkins University, 2024. The Johns Hopkins Hospital, and Johns Hopkins Health System. All rights reserved. https://www.hopkinsmedicine.org/health/wellness-and-prevention/muscle-pain-it-may-actually-be-your-fascia

Rad Roller, 2022.  What is Fascia, and Why is it Important? 2022, https://www.youtube.com/watch?v=gdzIeHp-Khs

Ron Wood, 2013. Fascia Magnified 25x, https://www.youtube.com/watch?v=JgNoUrNlgr4

Rubini, E.C., Costa, A.L.L. & Gomes, P.S.C. The Effects of Stretching on Strength Performance. Sports Med 37, 213–224 (2007). https://doi.org/10.2165/00007256-200737030-00003

SciShow, 2019. Fascia: The Body’s Remarkable, Functional Glue. https://www.youtube.com/watch?v=T-UsSmD7miI

Tina J. Wang, Antonio Stecco, Robert Schleip, Carla Stecco, Carmelo Pirri, Change in gliding properties of the iliotibial tract in hypermobile Ehlers–Danlos Syndrome, Journal of Ultrasound, 10.1007/s40477-023-00775-7, (2023).

Yew, K. S., Kamps-Schmitt, K. A., & Borge, R. (2021). Hypermobile Ehlers-Danlos Syndrome and Hypermobility Spectrum Disorders. American family physician, 103(8), 481–492.