I got a really interesting question the other day from somebody who saw one of my videos.
He asked: "How can there be a quick recovery from tendinitis, which is tendon degeneration, if it takes collagen (what tendons are made of) 100 days on average to regenerate?" This question was about tendons, but it applies equally well to fascia, since fascia are made up of collagen as well.
I have to say, this is a really excellent question, maybe the best one I've ever gotten.
First of all, you have to remember that "degeneration" doesn't always equate to "destruction".
Degeneration in the context of tendonosis (or fasciosis) can mean several things, one of which is the destruction of the collagen fibers.
This is sometimes seen with Levaquin patients, and in those cases recovery generally does take several months, if it happens at all.
But most of the time it simply implies a degeneration in function or ease of movement rather than actual damage to the collagen fibers themselves.
What happens is this: in much the same way that adhesions affect muscle tissue, tendons and fascia that are affected by tendinitis or fasciosis develop points or sections along the fibers that begin to bind together.
When it comes to muscle fibers, the mechanism is pretty clear.
Tiny fibers are grouped into bundles (like piano wires) to create larger fibers, which are in turn grouped into still larger bundles (like bridge cables), until you have a three-part structure, which is what most people think of as "the muscle".
These bundles slide along each other at every level when a muscle is functioning normally, but when adhesions develop they stick at certain points, which then causes pain during movement.
A competent physical therapist can usually find these areas simply by feeling along the muscle.
Then s/he can use finger pressure to break up the adhesions and get the muscle back into proper working order.
With tendons and fascia, the situation isn't as clear.
One factor is that collagen doesn't contract...
but it does stretch and have some tensile strength.
Perhaps because of this, simple finger pressure or massage is usually not enough to break up the adhesions that form.
This is partly because collagen isn't as flexible as muscle fiber, and partly because the location of the tendon or fascia itself can be harder to get at.
Also, since tendon and fascia fibers don't slide along each other the way muscle fibers do, the theory is that the collagen fibers somehow get intertwined, developing what might be visualized as "crosshatches" of collagen.
What's needed is a way to re-align the fibers so that they no longer interfere with each other.
Some type of "collagen comb" that could go through the fibers and straighten them out would be the best.
But since that's not possible, the next choice is specialized exercises that, over the course of a couple of weeks, will usually have the same effect.
This does not have to cost a lot of money.
There is a large body of research that indicates that simple tendon and fascia strengthening exercises done at home can be just as effective as platelet-rich plasma, cortisone shots and other such "cutting-edge" treatments.