Fascia: The connective thread between science and storytelling

The longer I’m around the so-called fascia movement, the less inclined I am to believe in simple stories.

In manual therapy and movement circles, fascia has become both hero and myth — a structure said to be “released,” “melted,” or “hydrated” through the right combination of hands, breath, tools, and intention. While these are comforting ideas, fascia doesn’t behave like a pliable film waiting to be coaxed into softness. It is a largely (although not entirely) inert connective tissue network that adapts only through habit, load, movement and most importantly, time. These simpler notions don’t diminish the value of hands-on work, but they do demand that we update both our language and our understanding if we want to remain relevant or accurate when the discussion turns to fascia.

Fascia as a potential continuum

In dissection, fascia reveals itself not as a discrete structure but as a potential continuum, a material conversation between muscle, nerve, vessel, and bone. When you trace it through a limb, there’s no clear boundary between one region and the next; the leg blends into the pelvis, the back into the neck. What we label in textbooks as “layers” are, in practice, gradients of texture and density, shaped by the forces of movement and load (Schleip et al., 2019). I say potential membrane because dissection is, by definition, a destructive process. The intent to demonstrate continuity must be present in the mind of the dissector before she begins; otherwise, separation and reduction will be the inevitable result.

Every layer we separate is a story we partly destroy

Fascia remodels in response to a mix of physical and chemical signals. The loads we place on it, the inflammation that follows, and the slow cellular conversations that reshape its fibres over time. The connective-tissue matrix respond to a mix of physical and chemical signals — the loads we place on it (mechanotransduction), the inflammation that follows, and the slow cellular conversations that reshape its fibres over time.

Repeated loading stimulates fibroblasts to remodel collagen and ground substance, altering tissue stiffness and viscoelastic properties (Wang et al., 2020). This process unfolds slowly, over weeks or months and can't be triggered by manual therapy. Our hands are simply not strong enough, nor the treatment duration long enough, for such structural change to occur. (Schleip, 2003)

“But something changes under my hands; I can feel it,” is the oft-repeated claim. I would agree. Something does change, but to suggest this is fascial in origin isn’t supported by physiology.

These immediate post-treatment effects are far more likely to be neurophysiological best thought of as a recalibration of proprioceptive input, autonomic tone, and pain modulation (Bialosky et al., 2009). The nervous system, not the fascia, mediates the sense of change. Fascia in this instance is a follower not a leader. While it can contract, this happens slowly, subtly and far beyond what can be palpated within a short clinical encounter.

Fascia is a storyteller, not just a mystical structure needing to be rubbed

Between science and storytelling

Fascia sits awkwardly between the disciplines of anatomy and manual therapy. Anatomists seek clear boundaries, whereas therapists seek experiential meaning. Fascia offers neither. It is too continuous to dissect cleanly and too adaptive to summarise neatly.

This November, I’ll be presenting at the Polish Fascia Symposium, a global meeting point for clinicians, researchers, and educators wrestling with these same questions. What do we truly know about fascia and what are we still imagining? The research community is gradually replacing mythology with measurable mechanisms: viscoelastic creep, fluid flow, nociceptive signalling, and the role of fibroblasts in long-term adaptation (Benjamin, 2009; Findley et al., 2021).

The therapy field is often slow to catch up however, with many of the same stories being repeated over and over again. The result is an acceptance of story as fact with the resultant difficulty of resisting reality when it dawns.

For all the science, dissection reveals a simple reality often missed in the research, namely the individuality of every body. Each donor tells a story in tissue that we can only ever guess at without the full life history beside laid it. Variations in fascial depth or joint position often spark speculation in a dissecting room. Was this dense thoracolumbar fascia from a builder, or the asymmetric deltoid of a violinist? The differences are obvious, but the biographies are gone and all we are left with is obvious variation and a lot of speculation.

Seeing the real thing

This is why, for me, dissection remains essential. You cannot understand fascia as a theoretical construct alone. You have to see how it folds, glues, slides and fuses in the real human body and is the reason I remain so committed to classes where practitioners can observe tissue as it truly is.

My Anatomy on Cadavers workshops are designed precisely for this: to bring practitioners face to face with the material truth of anatomy. No myths, no metaphors, just what’s present.

When you see fascia in its natural context, you realise it’s not a mystical structure waiting to be rubbed. Rather it’s a slow storyteller, recording the life long dialogue between structure and function and each new load, habit, or injury adds another line to the story.

Fascia never gets released, it just constantly gets its story added to

References

Benjamin, M. (2009) ‘The fascia of the limbs and back – a review’, Journal of Anatomy, 214(1), pp. 1–18.
Bialosky, J.E., Bishop, M.D., Price, D.D., Robinson, M.E. and George, S.Z. (2009) ‘The mechanisms of manual therapy in the treatment of musculoskeletal pain: a comprehensive model’, Manual Therapy, 14(5), pp. 531–538.
Findley, T.W., Schleip, R. and Chaitow, L. (2021) Fascia: The Tensional Network of the Human Body, 3rd edn. London: Elsevier.

Schleip, R. (2003) ‘Fascial plasticity – a new neurobiological explanation, Parts 1 & 2’,Journal of Bodywork and Movement Therapies, 7(1–2), pp. 11–19 and 104–116.
Schleip, R., Hedley, G. and Yucesoy, C.A. (2019) ‘Fascia as a body-wide communication system’, Journal of Bodywork and Movement Therapies, 23(2), pp. 195–203.
Wang, J.H.-C., Thampatty, B.P., Lin, J.S. and Im, H.-J. (2020) ‘Mechanobiology of tendon and other soft tissue: from molecules to tissue remodeling’, Journal of Orthopaedic Research, 38(10), pp. 2139–2154.