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Jan 292013
The Morning Fuzz – What is it?In this video, Dr. Gil Hedley talks about fascia in the human body, what it is, and how it affects movement. Fascia’s function is the same in humans and horses. If the sight of a dissected human body is not disturbing to you, I encourage you to watch this video.


(This is an article that I wrote for my human massage therapy website. Again the same principles that apply to the human body also apply to that of a horse).

Update: Dr. Hedley has revised his video to include notes about what has been discovered since this video was filmed in 2005.

Have you ever heard of fascia? I had not until I went to massage therapy school.  Understanding fascia  is an important step toward understanding muscle movement and soft tissue pain.

The Thin White Skin

Most people have cut up raw chicken or beef.  Remember that ultra thin translucent or milky white ‘skin’ that is almost impossible to pull apart?  That is a layer of fascia. Do not confuse this with fat, fat is thick and dense. Fascia is thin, almost translucent or milky white and very strong.

What is Fascia?

Fascia is a connective tissue. It connects things, it binds muscle fibers together, it separates things, and plays a crucial role in movement. Fascia wraps around everything in the body, bones, muscles, arteries, veins, and organs. It provides support for tissues and organs while also separating the individual components in our bodies.  It is like a spider web wrapping around and running through the internal body.  Through the web of fascia, everything in the body is connected. Just as you cannot move part of a spider web without affecting the whole web, you cannot move part of your body without affecting the entire fascial web.

The Saran Wrap of the Body

An analogy often used for fascia is saran wrap. Like saran wrap wraps around a sandwich, fascia wraps around muscle, tendons, ligaments and organs. It is strong but  can stretch, moving with the various body parts. Like saran wrap it can stretch to the point of tearing.  Over stretched fascia can cause binding and restriction, limiting movement of structures. Torn fascia will cause pain and inflammation.

Unlike saran wrap, fascia is wet and slippery, allowing individual parts of the body to slide against each other. It can move with various body parts or it can initiate its own movement.


The cobweb looking matter is fascia interlaced with fibers have been teased away from a muscle. An excellent visual showing that fascia is integrated throughout the musculoskeletal system.

The Gooey Gristly Mess

Fascia has been largely ignored throughout medical history. It was considered the messy, slick, tough gristly stuff that stood between doctors and the internal body. Anatomists cut it away from muscles and organs during dissections thinking it was a covering that was not important.  Thanks to the work of people like Tom Myers and  Gil Hedley, the importance of fascia’s role in the body is beginning to be recognized.

“While every anatomy lists around 600 separate muscles, it is more accurate to say that there is one muscle poured into six hundred pockets of the fascial webbing. The ‘illusion’ of separate muscles is created by the anatomist’s scalpel, dividing tissues along the planes of fascia. This reductive process should not blind us to the reality of the unifying whole.” Tom Myers from his book  Anatomy Trains

Fascia: A Missing Piece in Puzzle of Muscle Pain?

The study of fascia is ongoing and its purpose and effects on the body are not fully understood. What is known at this time:

  • If fascia is distorted it affects the function of the muscle, soft tissues and other functions within the body.
  • When fascia sustains an injury it becomes inflamed and painful e.g. plantar fasciitis.
  • During the healing process fascia can thicken, lose moisture and glue structures together which restricts movement.
  • When movement in the body is restricted soreness, stiffness and muscle compensation occurs.

Muscle pain is complex with many variables that can contribute to its cause. The ongoing study of fascia and its role in the body may provide a missing piece of the puzzle in understanding muscle and soft tissue pain and injury.

Jan 292013

Note: Stress points should not be confused with acupuncture or acupressure points as they are different systems and treatments.

What Are stress points?

Stress points are tiny micro tears in the fibers that make up a muscle.

What Causes Stress Points?

The formation of a muscle and example of a stress point.

Individual fibers are wrapped together to form a muscle bundles.Muscle bundles are then wrapped together to form a muscle. Tiny tears in muscle fibers cause the development of stress points. Stress points can be found anywhere in the muscle but are mostly found near the connection to the bone.

Injury, chronic pain due to an old injury, repetitive practice of a particular maneuver,  a slip or fall, illness such as colic or upper respiratory infections, even arthritis are a few things that can set in motion the development of stress points. Stress points can develop anytime muscles are stressed and overworked.

Can You Feel A Stress Point?

Yes. Stress points feel hard and rigid in the muscle. At times they are easy to find, feeling like a small marble or BB in the muscle. Other times they are harder to detect, feeling more like a small flat thumbtack in the tissue.  Many times these knots or bumps are located within a ridged band running along the muscle.  A horse will always react by twitching or moving away when pressure is applied to the correct spot. Stress points can develop throughout the length of the muscle, but are most often found near the ends of the muscle, where the muscle turns into tendons which connect to the bone.

What Are The Symptoms Of A Stress Point?

Acute Phase: The first indication of stress point development is localized tenderness with heat and inflammation. If just a few muscle fibers are involved the injury might not be noticed unless direct pressure is applied to the spot where the tearing occurred. The more muscle fibers that are involved the more noticeable the injury. 72 – 96 hours after the initial injury the stress point can often be felt, treated and resolved quickly.

Chronic Phase: If stress points are not treated soon after injury, these tiny muscle knots start to affect the muscle and the surrounding tissues. Other fibers in the muscle begin to tear because they are overloaded picking up the work of the previously injured and now immobile fibers. In time the muscle which was the origin of the injury begins to lose elasticity and mobility. The body begins to compensate, using other muscles in other areas of the body for movement. This sets off a chain reaction. The other muscles become overused, sore, stiffness sets in and lameness may occur. By now the area showing signs of tenderness or lameness is often far removed from the original injury.  During this time the other compensating muscles create stress points which will also require treatment.

Example: your horse gets kicked in chest while turned out with another horse. There is a small area tender to the touch but otherwise he seems fine.  Weeks to months later, the horse is suddenly off in the opposite back hindquarter. Chances are you have completely forgotten about the kick, or dismissed it because it was in the chest. However, it is quite possible that this new problem is due to overwork and strain of opposite back and hindquarter muscles caused by stress points in the chest.

How Are Stress Points Treated?

Stress points must be treated manually. The exact location must be found, pressure applied to relieve the spasm caused by torn fibers, and then friction applied to break up adhesions that were formed when the body restricts movement of the fibers in the healing process.  Once the stress point is properly treated along with other manual therapy techniques and proper exercise to restore muscle and body balance, true healing occurs.

Treating the muscle with heat, cold, laser therapy, ultra-sound therapy and medications will bring temporary relief in many cases. However, these methods address a larger area and do not specifically address stress points. These treatments sometimes relax the stress point but they do not resolve it and they do not address the adhesions.  Both the point and adhesions must be treated to restore full mobility.

Stress Points Are Undetectable In Imaging Processes

It is important to remember that stress points cannot be diagnosed through imaging processes. They do not show on X-rays (which are usually not used for diagnostic purposes for soft tissue injury), ultra-sounds or even MRIs. Why is this? During the natural movement of a muscle, ‘bumps’ occur along the muscle as the individual fibers shorten and lengthen. Stress points and the tiny knots caused by muscle restriction are as of now undetectable through imaging from the normal ‘bumps’ that occur during muscle movement. This is an oversimplified answer to a very complex mechanism, but it allows basic understanding of the process.

Find the Source To Treat the Problem

Stress points are one of the major components overlooked when dealing with a horse with undiagnosed muscle pain. It is natural to be drawn to the location of soreness and lameness and try to fix that area. However when dealing with muscular and soft tissue dysfunction it is important to remember that everything in a body is connected and works together. Always remember, the area that is sore or where lameness is evident, maybe a result, not be the source or cause of the problem. Until the original source is found and treated, the problem will continue.