Barbell Shrugged

What you need to know about fascia

Doug Larson

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  • Hi my name is javier these injuries of mine never seem to stop. I have an ac joint problem people saying to hunch back that true? Now it’s my right bicep so tight and going towards my inner elbow I actualy looseing patience if you can help please would be appreciated and ive been to phiso countless of times

    • Javier,

      It sounds like your front shoulder is very tight. Could be anything causing the problem, but I would guess that you’re pressing and dipping a lot. What does your training look like right now?

      Could very well be that you need to rest, then prioritize soft tissue and position work for a while before lifting heavy and moving often again.


    • Javier,

      Thank you so much for sharing. I see a lot of shoulder issues with CrossFiters and overhead lifting activities. Think of the shoulder as a part of the whole kinetic chain. Make sure you are foam rolling your thoracic spine, doing some backbends over the foam roller maybe even with a PVC pipe in your hand which can help open up your chest and the anterior part of your shoulder complex. If you’re doing a lot of computer work during the day you could be closing down on that AC joint and front of the shoulder. Make sure and get up stretch the connective tissue with in the anterior part of your shoulder. Hope that helps otherwise find a good physical therapist or bodywork expert in your local area.

  • I am going to have to come see you! I happen to live in Phoenix, so I would love to come by and get some extra work done. I do foam rolling, band stretching, and I use MobilityWOD’s Supernova for more localized work. I don’t have any nagging injuries per se, but I do have some strange pain twangs/numbness that happen in certain positions that I think might be a result of being so tight in some places, so getting that addressed by a professional is something I am interested in. Soon as I am financially able, I will be visiting!

    • Kelsey,

      Would love to have the opportunity to meet you and work out any kinks. It will also be a great learning experience and can give you some tools for future use. Please don’t hesitate to call me. 6232087575 or email me at I hope to see you soon. Way to be on top of your mobility and tissue work.

  • Hey and thanks for a great article! I was just wondering if you maybe had a good routine that I could try? Or maybe point me in the right direction on YouTube, or another website…

    Best regards

  • I had a traumatic wrist injury, dorsal barton fracture with sheering, etc. The wrist was rebuilt, joint line is good and I’ve been cleared (this was last summer) to do any movements. The capsule around the wrist is very tight and even with months of PT I have very limited flexion and extension. To do pushups / burpees / etc I’m on the knuckles on the palm side and a front rack position isn’t happening.

    Is there anything you can recommend to continue to loosen up the tissues around my wrist / forearm so that I might gain a little more flexibility.

    Thank you.

    • Derek,

      Sorry to hear about the wrist fracture and some of the struggles that you are currently going through. The wrist is a very tricky joint as there is not a lot of room within the bones to begin with. When you have trauma, and then surgery it can really cause that space to become even more narrow. I am guessing that not only is the capsule and wrist area limited but also the surrounding fascial/soft tissues into the forearm. Try using a voodoo band along the forearm to help break up fascial restrictions. You could bring the wrist into flexion and extension with the band on. You could also try taking a mobility band and attach it to the pull-up rack (low) then place it along the wrist joint while you are on your hands and knees- try and rock forward into wrist extension while the band is pulling your forearm backwards. (you may have seen this for ankle mobility). Here is a similar pic ( Get some extensive tissue work done by a massage therapist or PT/Chiro that is trained in myofascial work. Not all PTs are trained in working with soft tissues. Also know that your structure is changed and you may always need periodic tissue/joint mobility done by a professional.
      Let me know if that works or if you need other suggestions

  • Great article Dr. Hefferon. I myself am considering going back to school for DPT (I have my bachelors in engineering). I am also looking into Chiropractic as another option. I would love to someday have a practice such as yourself that is integrated with strength and conditioning and preventing/treating injuries. Any thoughts or suggestions between going the physical therapy vs. chiropractic route?


    • Adam,
      Go back to school buddy!! I am sure you would make a great PT or Chiro- you will be able to change a lot of peoples lives over your career – not to mention the opportunity to interact with a lot of special individuals.

      Of course I am biased to Physical Therapy 🙂 but I will say that a lot of my current knowledge in fascia and soft tissue work was not taught in PT school- most schools do not offer a lot of extensive soft tissue/myofascial work. I have been able to take extensive courses in FSTT (functional soft tissue transformation (which was created by a massage therapist and chiro :)). If you become a PT or Chiro make sure to branch out beyond your field of expertise- as there are a lot of healthcare professionals doing some awesome things.

      I wish you the best of luck Adam

  • Great help Dr. Hefferon, I’m hoping to go back to University next year to begin studying PT. I’m excited to learn about classic PT, but FSTT and neurological injury rehab are also areas I’d like to explore, how much does a classic undergrad course cover these more fringe areas of practice?
    Cheers, Jamie.

    • Jamie,
      Congrats on the decision to go back to school and pursue PT!!! It will be an amazing decision that you will not regret. Most undergrad courses will cover the basics in human anatomy, biomechanics and physiology. Depends on the school/professor whether or not they cover the functions of fascia and soft tissue mobilization. You will not get much intervention (myofascial release, joint mobilization/manipulation ect.) until you are in PT school. There are so many good – FREE references out there on You Tube and the internet along with courses that you could take that will supplement your current knowledge base.

      Good luck buddy


  • Dr. do you promote Graston technique to help with fascia/miofascial release to help with range of motion?

    If so, as an athlete, what is the best way to incorporate this therapy in my training cycle to help my ankles (that are filled with scare tissue and my knee from surgery). Right now I do it 2 to 3 times a week and seeing improvement with a bunch of foam rolling and stretching! However I work out 5x a week, sometimes twice a day and scared if I release too much can I put myself in danger of an injury….please advise for optimal use of this technique.

    • Ian,

      Sounds like you are really on top of your tissue work and overall mobility- nice work!! Graston is a great technique to improve tissue extensibility and can free up a lot of congestion to increase ROM. Graston is just one of many ways to break up connective tissue congestion. Tissue work can be ongoing especially if your tissues are subject to more stress (running, CrossFit ect.). Stability is just as important as mobility- mobility without stability = instability. With that said- get as much ROM as you can but make sure you are stabilizing the new ROM with a variety of movements (increase the load, height, direction, speed, work at end range and mid ranges). Once you feel like the initial tissue congestion is gone use Graston as a maintenance tool along with Dynamic three dimensional (3D) stretching.

      Best of luck – thanks for sharing


      • For stability, should I incorporate a bit more single leg work/balance work to help stabilize the new ROM? I squat 3 times a week, full snatches and cleans twice a week, and quite a bit of running/play hockey one day a week/sometimes soccer.

        • Ian,
          You got it!! You are getting some stability with the power lifting but it would be good to integrate SL dynamic strength training/proprioceptive work as well- especially since you play soccer and hockey. This will decrease your chances of ankle or knee issues in the future. Agility work, SL balance with overhead punching in 3 directions, static lunge with med ball toss against the wall, ladder drills, SL skiers, quick feet drills using the soccer ball ect. You will have the mobility, power, strength, conditioning, proprioception, speed and reduce your chances of injury. Good luck buddy- glad to see you on such a great path to wellness


  • Dr. Hefferon,
    Most of my life I played basketball (insert ankle injury here) and didn’t maintain good flexibility. Over the past 2 years I have been trying to correct this with MobilityWOD techniques and stretching. I won’t say I’m religious about my therapy but I do my best.
    I have very limited ankle ROM. I tried stretching and banded work but haven’t seen significant improvement. Do you have any suggestions? I sought a PT once and their techniques helped some but after my sessions were over I could feel it kind of regressing. When I push my knee forward and out to stretch my calf, I feel sharp pain in the front of my ankle. Thanks for the help!

    • James,
      Man I feel your pain- played a lot of basketball in my day and experienced many ankle sprains. In fact, I try to keep up on my right ankle mobility as it can be the source of other pains. If there is a pinch in the front that usually means there is a increased congestion along the anterior aspect of the ankle (joint compression). Need to get more space within the talocrural joint and surrounding soft tissues in order to get into a normal calf stretch. This is a similar traction stretch I use for ankle tightness – You can also use a KB/lacrosse ball underneath your calf for tissue mobilization while the bands are around your ankle. Consider going back to a physical therapist that is trained in manual therapy and myofascial. Hope these suggestions help- let me know if you need further help.


  • Aloha! I absolutely love Barbell Shrugged. It goes hand in hand with my daily morning ritual of coffee and reading. I’m currently a CrossFit coach/athelte and student going to school for physical therapy. Articles like this fascinate me and I want to know as much as I can! Do you happen to have an intern/mentorship program? You’re in the exact place that I hope to be in the future and figured reaching out would be only beneficial, even just to hear your story better. Thank you for taking the time to read this and hope to be in contact soon!

    -Coco L.

  • About 8 weeks ago I tore my medial meniscus in my left knee approximately 75% and a Dr sewed it back together last week. I will be on crutches for a few weeks putting little weight on it. I believe I did it doing front pause squats. I always start w the bar and build up gradually so I wasn’t stupid about that. I am very interested in NOT doing the same thing w my right knee. Do you think I did something wrong? Is there anything I can do to try to avoid it in the future? My pain happened anytime I went below 90 degrees which my Dr told me I should not be doing. I am 45 years old btw. What are your guys thoughts? Thank you for your time I appreciate it. Kb

    • Hi Kevin,

      Soft tissues dictate your flexibility and range of motion (Bones are not fused). With that said, someone should have plenty of range of motion to do a squat below 90°. Proper neuromuscular control and strength is also very important. Incrementally loading the system is something to consider in another words not jumping up too fast in weight. Make sure you have plenty of flexibility within your knee, hip, ankle and thoracic spine along with good control during the squat. There is no reason why you shouldn’t be able to get back to doing squats again and prevent yourself from injuring your knee.

      Best of luck


  • What do you think of the fascia blaster? I’m not looking for an endorsement, just a general idea of if you think it’s effective and/or damaging. Thanks!

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