I thought the day would never come: Gwyneth Paltrow, purveyor of detox cleanses and elimination diets, has stumbled into a compelling area of science.
Last time I looked at the Oscar-winning actress's health advice, I found a panorama of pseudoscience, including ludicrous claims about the impact of "high levels of metals" and food sensitivities on the body.
Then came Paltrow's newsletter Goop, in which she published a Q&A with her "structural integrative specialist" describing a "secret organ" called the fascia.
"At its best," Paltrow writes, "the fascia is a thin membrane that covers all of our muscles. At its worst, it bonds together to create knots, pain, tension, and thickness, impeding our body's ability to exercise its full range of motion." Working the fascia will make you leaner and longer, she adds.
Surprisingly, there's some truth to Paltrow's claims: the fascia has indeed been an overlooked part of the body that scientists now suspect may have some relationship to pain, motion, and flexibility.
This is anecdote — the lowest form of evidence! — but I saw fascial treatment bring back a full range of motion to a friend's broken arm, alleviate scoliosis-related back pain in a cousin, and undo the debilitating low-back pain my brother had been suffering from for months. All had previously tried traditional physiotherapy, and nothing helped until they had their fascia manipulated by a specialist.
Not all of Paltrow's claims hold up, of course. She is, after all, the person who said that water has feelings. Fascial massage won't help you grow inches taller nor will it remove "toxins" and "thicknesses" in your body, as she claims.
But don't let her cast the shadow of pseudoscience on an interesting area of research that's worth knowing about.
The fascia's function is not clear but scientists are trying to find out
The fascia is a connective tissue that surrounds the organs, bones, muscles, nerves, and tendons, forming a three-dimensional matrix of support inside your body. Until very recently, mainstream medicine largely overlooked it.
"Anatomists would scrape the fascia away to look at the arteries and muscles and nerves," said Dr. Tom Findley, an MD and PhD who focuses on physical medicine and rehabilitation with the VA Medical Center in East Orange New Jersey.
Scientists believed that the fascia was passive, serving no purpose beyond providing structure and support. So the fascia was ignored, dubbed the "Cinderella of body tissues."
Then, scientists started to look more closely at the fascia and hypothesize that it's more than just encasing. They found that the fascia is alive with nerves, that abnormalities in it may be linked to conditions like back pain and fibromyalgia, and that it plays a key role in the body's potential for flexibility and range of motion.
The science is still nascent though even skeptics are converting. As Wallace Sampson, an alternative medicine debunker based at Stanford University recently told i09, "Most scientists, even those wary of alternative therapies, admit that the field of fascia research is a field of neglect, and remains sorely under-investigated."
Biomedical research articles mentioning the word "fascia" in Medline database. (Courtesy of MLTrends.)
When the VA's Findley went to medical school 30 years ago, he said, "We knew about cardiac rehabilitation, we knew about muscles, nerves and bones. But then it got to the soft tissue, and all we knew was if you heated a rat tail, you could stretch it."
Back then, there were only a few fascia-related journal articles published every year. Now, there are several hundred.
There's even a Fascia Research Congress, which Findley co-founded with the aim of bringing the scientific method to his field. The conference first convened at Harvard Medical School in 2007, and has since become a regular meeting point for an increasing numbers of academics and practitioners from leading institutions around the world.
Studying the fascia's link to pain is a promising research area
This community of doctors, scientists, and alternative-medicine practitioners are now using techniques like ultrasound, fMRIs, and biopsies to learn more about the connective tissues.
The best accepted theory right now is that the fascia play a role in myofascial pain syndrome, explained Dr. Kevin Fleming, medical director of the fibromyalgia and chronic fatigue clinic at the Mayo Clinic in Rochester, Minnesota.
"WHEN PALTROW SAYS [THE FASCIA] ARE WHAT'S RESPONSIBLE FOR A LOT OF DISCOMFORT, THAT'S NOT ENTIRELY TRUE." Myofascial pain involves bands of muscle in the body tightly contracting, and becoming very tender to the touch. "The fascia around those muscles gets hypersensitive so the nerves that serve that area create something called hyperalgesia, or increased pain sensitivity," said Fleming.
Because the fascia fibers run in many directions, one review of the evidence reads, "when fascia in one area is stretched, it can cause tightness, restriction, and pain in another part of the body," and this is known as "referred pain."
Fleming added, "When Paltrow says that there's this lining of tissue around your muscles and that's what's responsible for a lot of discomfort, that's not entirely true."
That's because doctors like Fleming believe it's the interplay among the fascia, nerves, and muscles that can lead to pain, not just the bunching and stiffening of the fascia that Paltrow refers to.
Patients like Paltrow swear by "fascial manipulation" — but science is in its infancy
To treat this pain, researchers are studying whether fascia can be manipulated for therapeutic benefit. "Rolfers," "structural integrators," and some massage- and physio-therapists already use manual techniques, including trigger point therapy, to do the "fascial manipulation" or "myofascial release" patients like Paltrow (and a number of my family members) swear by.
Here too, the science is still very much in its infancy. Beyond powerful stories from patients, no one has been able to prove that fascial therapy has the curative effect.
"This is the cutting edge," said Findley, "taking these astute clinical observations and figuring out ways to study them.
"The theory is that if you get in there, move things around and loosen things up, the fascia can move freely and it doesn't hurt anymore," he added. "The proof of that is a whole different story."
Because the medical community is not clear on fascia's function, it has not been conferred the status of an organ; organs, after all, must exercise a specific function.
In the future, hopefully science will catchup to the patient anecdotes. For now, in a 2013review of evidence on the fascia, Findley wrote that "the manual stimulation of sensory nerve endings may lead to tonus changes in muscle" and that fascia " may influence the normal or pathological processes in a wide variety of organ systems" — but also that more research is needed to understand how and why.
So, unsurprisingly, Paltrow overreaches with her claims that fascial therapy can fix anything that's wrong with the body — even shortness. Fascia may not be an organ. It may not be a secret, or the holy grail of body pain. But she's right to highlight an interesting area of scientific inquiry.