The Thoracolumbar fascia is a smooth interwound fibrous connective tissue. It completely surrounds the posterior thorax and abdomen while continuously running into the shoulder and neck region as the Nuchal ligament/fasciae. Made up of a fibrous band of connective tissue that is lined by a fluid ground substance. Ground substance is a well-built web of robust, flexible and stretchable tubules made up of elastic and collagen fibers. Other than it’s many interfascial attachments the thoracolumbar fascia also attaches medially to the Nuchal Ligament, the supraspinatus ligament and the tips of the spinous processes.
It’s main function is providing integral support to the vertebral column, in flexion, by joining with the posterior ligaments and having well developed fasciae tensions, alongside providing stability in the abdominal wall.
In its normal relaxed state the fasciae tissue is relaxed and wavy in arrangement.
During exercise the fasciae relaxes and contacts along side the sarcomeres (small muscle fibers) providing flexibility and stability. Over time the fasciae becomes less flexible and causes myofascial pain and restrictive movement throughout the lower back and torso, even the rest of the body. Stress and pressure from injury or exercise causes the fasciae to harden making scar tissue pockets allowing the fasciae to misalign from it original structure. Myofascial pain is a chronic type pain causing trigger points which cause furthermore referred pain in other areas of the body.
Treatment is limited as fasciae unlike muscle fiber cannot be stripped from abnormalities, it has to be stretched with adequate force directly applied to ensure remodeling and rebuilding of original fascial structure. Over time the body naturally remodels and increases the flexibility of the fasciae.