Can we alter the thoracolumbar fascia?

There seems to be a myth propagated through the Social Media which states that fascia cannot be altered via manual therapy. So, what does research really say? Two studies, published in the January 2017 issue of Journal of Bodywork and Movement Therapies, evaluated the effect of self-myofascial release via foam rollers on the thickness and mobility of the thoracolumbar fascia.

In the first study by Sanjana, Chaudhry, and Findley from the USA evaluated the MELT method, a self-treatment that used soft balls and foam roller. Using ultrasound imaging, the thickness of thoracolumbar connective tissue was analyzed in 22 volunteers with chronic lower back pain pre- and post-treatment. The results showed that, immediately after 30mins of MELT self-treatment, participants exhibited a significant decrease in connective tissue thickness and pain. The thickness of the perimuscular zone connective tissue  decreases 27% after treatment. A similar result was also found after 4 weeks of MELT treatment. A significant increase in flexibility (as measured by forward bending test) was also observed.

In another study by Griefahn et al. from University of Applied Science Osnabrück, Germany, 38 healthy athletic active men and women were randomly assigned to a Foam Roller Group, a Placebo Group, and a Control Group. After the intervention, the Foam Roller Group showed an average increase of 1.79 mm in the mobility of the thoracolumbar fascia as measured by sonography. The Placebo Group had a slight average improvement of 0.17 mm, while the Control Group showed a non-significant improvement. Nevertheless, no significant changes were observed with regard to the lumbar flexion and mechano-sensitivity of the treated muscles.

Both studies demonstrated that the connective tissue is a viscoelastic material, i.e., it is composed of solid-fluid components, and it will change with applied stress via manual therapy.

References

Sanjana F, Chaudhry H, Findley T. Effect of MELT method on thoracolumbar connective tissue: The full study. Journal of Bodywork and Movement Therapies. 2017 Jan 31;21(1):179-85.

Griefahn A, Oehlmann J, Zalpour C, von Piekartz H. Do exercises with the Foam Roller have a short-term impact on the thoracolumbar fascia?–A randomized controlled trial. Journal of Bodywork and Movement Therapies. 2017 Jan 31;21(1):186-93.