 I'm Eileen Crisco, and I'm your new friend as we journey to take your health back. We're coming to you live from the studios of Think Tech Hawaii, located in Pioneer Plaza, right in the heart of downtown Honolulu. Today, our topic of discussion will be on fascia awareness, training to enhance quality of life. Joining me today is clinical dietitian and exercise physiologist Kelly Marshall. Kelly is currently practicing medical nutrition therapy at Lina'i Community Health Center and is co-investigator on a metabolic research study with the Queen's Medical Center here on Oahu. She's been a movement educator for well over a decade, and she specializes in a variety of movement modalities, including yoga, dance, and most recently, fascia-focused training. Kelly, it's great to have you on the show. Thank you, Eileen. It's great to be here. It's a great way to build on all the great information that Anthony shared with us about fascia a couple weeks ago. Yes. Anthony Crisco was here a couple of weeks ago. He's a founding member, one of the founding members of the fascia research society, and he shared so much information. We wanted him here today again, but he had an exciting opportunity to do some educational work working with the fascial net-placination project in Germany. Awesome. He'll be back soon. Good. I want to hear what you have to say about the application of fascia awareness. Great. So to recap what Anthony taught last week, there was so much information, and I just want to review some of the information just so we're familiar with what fascia is again. It's fascia is all over the body, so remembering what Anthony said, where isn't fascia, right? So fascia is not just the plantar fascia that many people have problems with at the bottom of their foot. It penetrates the body. It doesn't just pack things like our muscles. It's all around. Again, where isn't fascia? It's also a sensory organ. In fact, it's the largest organ system of the body. The skin is not the largest organ system. And again, sensory organ. So there are 100 different sensory receptors in fascia. Imagine that. Fascia responds to touch. It responds to pressure and load. So we're going to learn how to be able to manipulate our fascia so that we can have a decent response so that we can really take our health back and reconnect with our fascia. Great. Okay. It's made of cells, proteins, and also water. So normally when I say cells and proteins, my audience just wants to run away. They're not very comfortable with that subject. It's not on their radar, daily radar. So as a clinician, how do you explain fascia? Well, that was a great recap of what we're dealing with when we're looking at all of the scientific aspects of the fascia. And you're right. It is really easy for people to check out when they start hearing things like cells and protein because we're just not familiar with it. So usually when I'm working with my patients or clients, I'll try and paint a picture for them. It's not the prettiest picture, but I actually use the term snotty spiderweb to give this image of this fluid, this hydrated web, and then I describe to them that this is literally connecting us head to toe, surface of our skin, deep into our cells. It is, like you said, penetrating. It's wrapping around things, but actually we are literally suspended in this web. And so it's very important to acknowledge that because it's what really shows us how the fascia and working with it is able to produce so many benefits. Right. Right. So how do you, do they still understand, after that explanation, can they visualize the fascia? No, it's still really difficult to get away from this idea that it's the saran wrap around muscles. So sometimes I use different ways of explaining it, like I'll tell them, oh, if I had this magical tool where I could extract your entire fascial network, you would literally collapse to the floor, bones and all. So just to show them how we are truly suspended in this web. I see. So fascia has a, it's responsible for architecture. Yeah, exactly. Okay. I'm thinking about out there in nature, another example is a wilted plant, right? The plant still has hope, it's not dead, and we can bring life back to the plant by providing water so that the plant can suck up that water and regain its ability to stand. Yeah, its structure. And that's actually, so that's a really neat example because it truly shows how the water provides structure, how when we bring the fluid into this system that it's able to support us. Another great place that you can look in nature to see an example of this is citrus fruit. So I think we have a slide here for everybody to visualize. If you think about the skin or the peel of the fruit, that would be like our skin. And of course this is a very simplified example, but if we start to take that peel back, we can see the pith, that white stuff, and it's easy to see how it's fibrous. And then as you start to follow it down around the orange segments, you see how it becomes a little thinner. And then if you continue to follow it, if you were to actually break one of those segments open, if you look down at the bottom of the picture there, you can actually see where this membrane goes down and wraps around each one of those tiny juice vesicles. So this really is the very simple but effective example of how we have different layers of the fascial tissue and how these layers vary in thickness and their composition. Yes, I really appreciate that slide because it really shows how though you have different layers of this fascia tissue, it's all connected. So connection, connection, very important to connect our mind with our fascia. And just to keep our fascia hydrated, healthy, and connected all throughout our body. Since it's everywhere. Absolutely. It's a great job of showing that continuity between the surface and then deep within the structure as well. Right. Wonderful. Yeah. So you're here to talk about fascia awareness training. There's so many training modalities out there. We have cardiovascular training, there's Zumba, there's CrossFit. Is fascial awareness training similar to those modalities? I'm so glad that you brought this up because it's very important to understand kind of where this plays in. So the first thing we need to recognize is that fascial awareness training is not one particular thing, but it's actually a concept that we use to identify and then address the imbalances that we see in body tissue. So we look at a person and we can see, okay, there's holding patterns here in the hip. It allows us to see where do we have tissue that is actually over-lengthened or maybe overstretched from sitting. Our back muscles get overstretched versus where do we have shortening of the tissue where it's a lot more dense and we feel that tightness, if you will. So as you can see, it's much more, fascial awareness training is much more than burning calories and losing weight. It is the foundation to all of the movements that we do, both physical activity related and just everyday life. So depending on the person, later on in the training program, it would be common to see something like Zumba or CrossFit as part of the program that address certain aspects of the fascial awareness training. Okay, I understand. With, let's say, CrossFit, we're addressing, a lot of times people think we're addressing just the muscle or there's a cardiovascular aspect, but from what I understand now about fascia, you're really training and conditioning the connective tissue. Exactly. That's what lines or tendons in our other soft tissue structures. Can you give us some examples of specific movements that's involved with fascia awareness training? Yeah, everything. No, truly everything, but yes, it is important to systematize things so that we understand actually what's happening and this is really the fun part of fascia awareness training and what allows us to tailor it to an individual. Okay, so we're going to get a little scientific here, but it's the best way to understand how certain movements affect the fascial network. So there's four primary properties of the fascia. So we'll start with viscosity, it sounds like a fancy word, but all we're really saying here is that we're describing the thickness of a liquid. So if you think about water versus honey, water is thinner, it moves very quickly so it is less viscous, whereas honey is a lot thicker and if you were to watch it drip, it takes longer, it's sticky and so this comes into play with the fascial network because we're looking for a certain level of viscosity depending on what we're doing. We don't want it to be too thin, too fluid, but we don't want it to be too thick or sticky either and so this is the key to finding that right viscosity. Right, when I think of viscosity, I think of motor oil. So motor oil is slippery and that seems like a property that we want with our fascia, between the fascial layers and between our muscle layers so that we have a gliding action. Absolutely. Yes, and so when I think about honey, you mentioned honey, stickiness. You know how that feeling sometimes when you're walking or you get out of bed, you plant your foot and your muscles just aren't working with you. You feel like something is sticking, you really have to shake it out or do something to alleviate that friction. Yeah, yeah, that's the worst. Right, but yeah, that's a perfect example and I love how you use the motor oil as well because this idea of sliding and gliding is so important because you know if you think about this tissue suspending our organs and our blood vessels and what not, if it's sticky and it can't glide, that means that the blood vessel can't expand how we need it to. It means that the pancreas can't function the way that we need it to. So yes, it's very pervasive in how it works. So if we were to talk about what types of modalities affect viscosity, the first thing that comes to mind is actual manual therapy or what I'll call body work for our discussion. This is like therapeutic massage. So you will actually talk to body workers and they will say that they can, as they work on the individual, they can feel that change in viscosity in the tissue almost immediately. So it's pretty neat stuff. Wow. So you mentioned massage and body work. What are other types of body work that is felt in Christ? Yeah, yeah, and these would be different movement modalities that also go into it and then this actually takes us into our next property. So our first one is viscosity. So the second one we're going to talk about is elasticity. So I've brought you a toy here, old school slinky toy. So elasticity, if we were to define it simply, is just the ability of something, in this case tissue, to be stretched and then to return to its natural form. So you could see this with a rubber band as well, but we choose to use a slinky because the fascia is not always linear. It's not always straight like a rubber band. So the slinky really demonstrates the complex structure of the proteins that are within the fascia. Yes, I do know that collagen has a helical structure. So this winding of the slinky reminds me of that helical structure of collagen. So the winding, talking about structure, probably gives this potential energy, which becomes kinetic energy, right? Yeah, it fuels our movement. Yes, I would love to have this spring in my step, right? Yes. Jump up, then you can decelerate, accelerate again, jump up and down. Jumping rope for two minutes, kind of like when we were 10. Right, right, yeah, exactly, elasticity is the property of youth. This is what we think of when we think of young people. They're very resilient. They're able to jump off of things and not injure themselves. So yes, this is the property that we're talking about. And this is often what we lose with being sedentary. And so the way that we understand elasticity now, the research is actually telling us that we can train it, regardless of how old we are or what we've been through in our lives. There are ways to affect it. So to answer your question about what types of movements are involved with this practice, in terms of elasticity, we're talking about what we used to see with Jane Fonda and Richard Simmons in ballistic exercise, which we do have to be careful with, because it is, as we'll see later, you can injure the tissue. But when done methodically, it is the short burst of almost bouncy exercise that trains the elasticity of that tissue. And it is possible to bring it back, so. Nice. So I'm trying to imagine what the fascia of somebody with a sedentary lifestyle would have. Probably less coils, right? Yeah, it just like, you know, when you mess up your slinky, and then it like doesn't go back. Yeah, I think that's my, that used to be my lower back. So yeah, that's a great question. So OK, so we've got viscosity. We've got elasticity. So the ability to be stretched and then return to form. So your next toy here is going to demonstrate plasticity. So plasticity is the ability of, in this case, tissue to be stretched and not tear. So this is a very important property of our tissue, especially when we're talking about things like stretching, yoga, things like that. So if you hold this in your hand and you very quickly affect it, it's going to snap very much like what you would see with an injury. Right, wow. I could imagine Achilles tendon snapping like this if you don't take care of your fascia. Exactly. Well, hold that thought. Well, the next thought, we're going to take a break here, Kelly. So we're going to have a 60 minute commercial break and we'll be right back on Think Tech Hawaii. Sounds good. Hi, I'm Dave Stevens, the host of Cyber Underground every Friday here at 1 PM on ThinkTechHawaii.com. And then every episode is uploaded to the Cyber Underground, that library of shows that you can see of mine on YouTube.com. And I hope you'll join us here every Friday. We have some topical discussions about why security matters and what could scare the absolute bejesus out of you if you just try to watch my show all the way through. Hope to see you next time on the Cyber Underground. Stay safe. Hi, I'm Pete McGinnis-Mark. And every Monday at 1 o'clock, I'm the host of ThinkTechHawaii's research in Munna. And at that program, we bring to you a whole range of new scientific results from the university, ranging from everything from exploring the solar system to looking at the earth from space, going underwater, talking about earthquakes and volcanoes, and other things which have a direct relevance not only to Hawaii, but also to our economy. So please try and join me 1 o'clock on a Monday afternoon to ThinkTechHawaii's research in Munna. And see you then. Aloha, Hawaii. This is Eileen. I'm the host of Taking Healthy Back. And we're on ThinkTechHawaii live with Kelly Marshall. Kelly is here today talking about fascia awareness and how to improve your quality of life with fascia awareness. So you just asked me about the different ways that we can affect the fascia. So we were going through the properties. We had talked about viscosity and thickness of fluid and how we want it not too thin, not too thick. We also talked about elasticity. So this was our slinky showing how we want our tissue to be able to stretch and then return to its normal form. So we finished where we left off with the plasticity. So we had given an example. If you just move into the tissue very quickly, it is possible for it to snap or to tear. And this is what we see with injury. But if you were to take it and give it the time that it needs to extend, you see that it is able to stretch and actually hold that stretch without injuring itself. So this is the defining characteristic of plasticity. And you see this type of work with movements like yin yoga, where you're holding the postures for several minutes, I mean two, three, sometimes up to seven, 10 minutes. Yeah, and then also with manual therapy, again with the body work, if you have a body worker that is trained to do traction work where they actually are tractioning their skin, this is also going to affect the plasticity, the ability of the tissue to release. And this is really where we see the lasting change when we're trying to create space in our body where we're feeling pain or discomfort. Right. I imagine that it would take a while or a lot of injury or a lot of dryness to get to the point where your soft tissue would snap like that, right? So if your soft tissue does snap like that, is there the ability to heal? Yeah, and this does get really tricky because depending on the degree of the injury, it's always possible that there might have to be a surgical intervention, but let's say there is surgical intervention. Let's say your Achilles tendon totally snaps and you have to have it reattached. After the post-surgery process and the person is healed, there is definitely a role for addressing the facial network in this regard because while they're healing, that fascia is going to try to protect the structure so it's going to become more sticky and it's going to provide more structure. And then eventually as it's healing, having somebody go in there and work on that and release it and in this case, affecting the plasticity of it will definitely improve comfort and functionality. And actually what you're bringing up here is perfect because it leads into this final property of fascia which is remodeling. So it's super important to differentiate this from how muscle tissue acts because we go out, we hit a really hard workout, we feel the soreness in our muscle and we see those gains, you know, over a relatively short period of time, weeks and months. When you're talking about the fascial network, it requires a lot more patience and you don't always feel it. And when you do feel it, it can be kind of confusing. If you have a lot of pain in your shoulder, in one spot, and then you get body work done, you actually will usually feel that pain kind of, I don't want to say it's pain but discomfort, you'll feel it almost spread out and start to release and then you might notice things, you know, farther down the chain. And so these are all important things to understand about remodeling because we have to understand that when we roll out, we may feel some remodeling happening over the next day or two, but the lasting changes are actually going to take months and even years. So to truly restructure all the imbalances in the body or most of them anyway, you're looking at anywhere from one to three years to really see these changes and the practice has to be diligent and consistent before we lose these gains very quickly. Okay, that's good information. So if you do have surgery, a lot of scar tissue, chronic inflammation from not moving enough or moving too much sometimes, right? Yeah, absolutely. Then we do have hope that you can restore your fascia and bring back those qualities that you just talked about. That's great. It sounds like, where do you start with this process? I know, right? Yeah, it's pretty crazy. That's pretty well for a program. Yeah, so I have spent the last several years trying to figure this out. My scientific mind naturally wants to put things into systems and to put it into a program so that anybody can do it with the right training. And what I've found, at least what I believe right now is I really feel strongly about this process starting with body work. But before we even get there, it's important to have an assessment done by somebody who understands the body in the terms of the fascial network. So that way you have a benchmark of where this person is at, what are their symptoms, where are they feeling it? And then once you document that, you connect them with the right type of body work. Like you said, there's many different types. So you connect that person with the right practitioner. They get this body work done, they're able to lay on the table and be totally relaxed. And then ideally, the movement educator and the body worker would be in communication with each other. So they start to develop this protocol for this individual to address each of their specific needs in an order that is going to make sense for the body and to be comfortable. The movement educator would also be responsible for teaching self-care practices, which is my favorite part of working with the fascia. Because how can you not love the fact that we can take responsibility and do most of this work on our own? I mean, there's no committing to appointments or pouring money into classes. You make this initial investment in your health and then your little team of fascia practitioners gets you to the spot where you can actually maintain most of this on your own. Right, I understand. So if you do alleviate or break down some of that scar tissue and reconnect with your fascia, your mind is able to process where you need healing, then you'll be able to administer self-care, take care of yourself, right? Absolutely. Right, much more cost effective than seeing a body worker every week or every month even. Yeah, absolutely. And I love that you brought up the point about making that mental connection because we truly do have to have this inner dialogue when we're doing this work. If I were to give you a massage and you're just thinking about your grocery list and whatnot, there has actually been research that shows the receiver, what their mental state is, where they focused and how that affects the work that's being done. So yeah, that mind connection is very important too. So what are your favorite tools for self-care? Oh my gosh, this is the hard one. So there is endless amounts and it seems like as fascia gains more popularity, it's just tool after tool after tool. So there are hundreds out there. I have a handful of five that I like and depending on the shape, the size, what body part I'm working, I'll gravitate towards one or the other. But I would have to say if I had to only choose one, it would be a roller because it's the most applicable for the whole body. And my favorite roller, I actually have one right here, is the fashionator and Anthony just happens to be the one who came up with this design. You know, it seems very simple but what's important to realize is it's the method of application that really makes the difference. Now you can see this one, it is pretty hard so it's important to have that education and how to use it safely. The reason it's so magical is because of the diameter. So the size of this, if it were any bigger, it wouldn't allow me to put it onto certain parts of my body. So the way that this thing is made, literally you can roll yourself out head to toe. And you know, there are larger ones but this one easily is, you know, can take it with you anywhere. And yeah, I would have to say that is my fascination tool of choice if I had to select just one. That's great because it's portable and I've learned that that tool and the fascination method which is a methodical approach to rolling your body from toe to head has been, they're trying to incorporate the fascination method of self-care into a study for lupus and Sjogren's disease. So very, very interesting that such a simple tool, such a way to address inflammation and take care of metabolic diseases maybe. Yeah, yeah, potentially. And so this is actually the research that I do with Queen's Medical Center. We are looking at metabolic function and specifically we're interested in type 2 diabetes because it is so pervasive. But yeah, it's amazing how just using the simple tool and it doesn't even, you don't even have to do it for that long. You don't have to warm up before you do it. It's very straightforward, but you really can see changes. And as this research starts to come out and we're able to apply these things, we'll be able to say, you know, with a little bit more grounding, like yes, you do this and you're able to not only affect muscle tissue and how you feel physically but actually what's happening biochemically as well which is pretty profound. Yeah, so that is exciting. Get down to the chemical level, the molecular level and restructure, right, rebuild. Yeah, yeah, it's amazing. And being in the medical field, you know, we always have to be very careful about utilizing evidence-based practice and whatnot. So luckily we are part of what I like to think of kind of as the third generation. So we've got all these great people, the people that Anthony is actually shoulder to shoulder with right now that have pioneered all this research for us. And so it's allowing practitioners like me, you know, I have somebody referred to me for nutrition but I go call them out of the waiting room and I see how they get up out of the chair and walk across the room. And our visit may be more about, you know, the fascial integrity and what we can do to get them feeling better because who's thinking about eating healthy if you can't even stand at the stove and cook something. So yeah, it's really becoming like, we're literally in the smack dab middle of this paradigm shift of how we understand the human body and so yeah, it's pretty amazing. That's awesome Kelly. Can you tell us a little bit about your research? Just a couple of minutes on that. Yeah, sure. So basically, although metabolic research, what we're really looking at here is tissue integrity and if we can improve metabolic function with very minimal amounts of movement. So we're not talking exercise here, we're not talking burning calories or losing weight. We're very much looking at how does this snotty spiderweb, so to speak, how does it affect the function of our organs and how do we improve the health of it? Great, very exciting. I can't wait to see or hear about the outcome of that study. So we've learned a lot about fascia and do you have anything more to say? Maybe something to wrap up all the things we've learned about fascia awareness and how training can enhance your quality of life. Well, you know, as complicated as it is, it's really accessible to anybody. I mean, if you get connected with the right people, you really get a good understanding of your body's story. You can start to cultivate this, what we call kinesthetic awareness or understanding what's happening in our body. And then you find your body worker, you get trained in the self-care tools and the types of movements that are best for you. And yeah, anybody can do it. So it's a great thing. Great Kelly. So if we want to contact you, we have your phone number and email available and you can really teach people how to reconnect with your fascia, restore your fascia and how to enhance your quality of life. Absolutely and how simple it can be. It really only takes a few sessions to get going and yeah, it's a fun field to be a part of. So I appreciate you having me here to talk about it. Yes, I appreciate you here and we're really grateful for Think Tech Hawaii to give us this opportunity to talk about this possible paradigm shift in wellness and preventative care. Absolutely, yep, we're putting fascia on the map thanks to Think Tech Hawaii. So yeah, big shout out to them. Yes, join the fascination. Yeah, awesome. Thank you Eileen. You're welcome.