Webinar: What is Fascia?
The Science Behind The Hype
Monday 17th August 7pm.

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What Is Fascia? The Tissue, the Hype and the Evidence

Fascia is having a very long moment.

Every time you open a laptop it’s being released, stretched, hydrated, blasted, scraped, vibrated and occasionally spoken about as though it communicates with the spirit world. It apparently stores trauma, creates adhesions, dries out and sits around beneath the skin waiting for someone with the correct branded implement or therapy to sort it out.

There are fascia guns, blasters, rollers and rubbers and who knows what else waiting in the wings. Many of those promoting these ideas, ironically also feel free to criticise medicine for being too reductionist: focussed on structures and symptoms rather than the whole person, while happily blaming a wide range of human experiences on a single tissue.And of course have a special technique or tool to correct it.

Reductionism in harem pants?

Fascia is real. “The fascia” is less helpful

Fascia is not by any means an imaginary tissue or simply anatomical packing material. It’s a vital part of the connective-tissue system that supports, separates and links structures throughout the body. But the same word is also used for tissues with very different arrangements and roles.

Superficial fascia is the fascia that sits beneath the skin, holding the adipose tissue in place and expanding to accommodate it. Body fat doesn’t just float around, it needs structure and the fat cells - adipocytes - sit within a three-dimensional framework of collagenous fibres. These run from the underside of the skin towards deeper layers, linking superficial and transitioning seamlessly to become the tissue we refer to as deep fascia. (Fede et al., 2025).

The character of the arrangement may change as the fibres go deeper, with deep fascia containing more densely arranged collagen bundles, but the ingredients, collagen stay the same. Deep fascia is tends to be arranged in two or three layers of collagen bundles, with loose connective tissue between them allowing for sliding (Stecco et al., 2008).In the limbs it can form layered sheets around groups of muscles whereas elsewhere it blends with septa, retinacula, tendons and the sheet like tissues known as aponeuroses.

As the function and density of collagen bundles change, the names do as well. An aponeurosis is a broad, sheet like structure through which muscular force can be transmitted, whereas epimysium is the connective-tissue covering around an individual muscle. The name change continues into the perimysium and endomysium within the muscle and towards tendons at its ends, appearing wet and more delicate when examined, but still collagenous in nature. It’s a highly complex and continuous system organised around muscle fibres and force transmission, changing around the body according to the needs it meets, rather than some kind of external external wrapper that can be peeled away (Purslow, 2020).

The key ingredient, collage, is the most common protein in the human body contributing to ligaments, tendons, cartilage and the periosteum surrounding bone as well as the fascia. Bone also contains collagen, although this doesn’t make bone fascia,The cornea of the eye has collagen too and I’ve yet to see corneal release techniques advertised, although give it a minute.

Continuity is not sameness, and sharing an ingredient doesn’t turn every connective tissue into one enormous organ.

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Living tissue, not magical fabric

Fascia, along with all other connective tissues, tend to be less cellular than other structures, without it being completely inert. Fibroblasts maintain its extracellular matrix and blood vessels, nerves travel through it and its properties can alter with age, load, injury, inflammation, immobilisation and disease. The key is that fascia is the product of the cell, rather than cellular behaviour being the primary function of fascia.

Cells within the fascia will alter its behaviour when certain inputs are provided, and it’s these behaviours that have created interests as well as leaps towards hasty conclusions.

In an ex-vivo mouse-tissue study, 30 minutes of sustained stretch was associated with changes in fibroblast nuclear shape (Langevin et al., 2010). This is very interesting cellular biology, showing that living cells notice their mechanical environment.

However it doesn’t tell us that pressing someone’s back for 90 seconds releases fascia, or reorganises collagen into any particular tensegrity shape. and this is where fascia culture goes off the rails. Interesting laboratory observations are not the same as explaining what hands are doing in a living person.

You can’t release fascia. It’s not a box of doves!

I’ve been teaching and working on people for three decades so know all to well that hands affect people.Touch can change and shift an enormous number of things, including sensation, pain attention and muscle activity.Pressure during hands on work shifts fluid and (temporarily) deforms soft tissue.People do get off couches feeling different.

All of this is the important work that manual and movement therapists undertake every day all over the world.But none of it proves that fascia was ‘stuck’ and has now been ‘released.’

In terms of fascia nothing really changes from a hands on session and we should be pretty happy that it doesn’t.Dense connective tissue aka fascia is designed to tolerate substantial load. One study estimated that producing even 1% compression or shear in dense tissues, m would require forces far beyond those normally delivered by manual therapy (Chaudhry et al., 2008). Softer superficial tissues can deform more easily, but temporary deformation is not permanent remodelling.

If a therapist could significantly reshape healthy fascia with their hands in a few minutes, sitting on a hard chair would be an extreme body-modification practice.

Long-term, repetitive loading, injury, healing, surgery and biological adaptation can indeed change connective tissue, but that is very different from claiming that a particular direction of hand pressure selectively releases a fascial line.

Similarly ‘hydrating the fascia’ is more marketing than reality. Fascia isn’t like a sponge that dries out because it didn’t get rubbed or rolled and drinking more water (or special water formula ) doesn’t wash adhesions out of a hamstring.Lie on a roller if it feels good, but other than that feeling, your fascia is unimpressed.

Scars are real. Scar-tissue release less so

Scar tissue is a genuine response to injury, with different types of collagen getting laid down and reorganised over time. Scars can be painful, sensitive, adherent or restrictive and there is plenty of evidence that manual approaches can be hugely helpful, with a systematic review showing benefit for several scar-related outcomes. (Deflorin et al., 2020).

Careful and responsible scar care is one thing, but scar tissue will always be scar tissue and mobilising localised tissue is not the same as releasing scars and in my view shouldn’t be confused or even named as such.After all, if post-surgical tissue were fragile enough to be freed by hands on approaches, surgeons would issue very different aftercare instructions.

The established outcomes of good scar management are demonstrably valuable enough without the theatrical and biologically nonsensical language that often surrounds ‘scar tissue release.’

Fascia as an emotional storehouse

Trauma can profoundly affect the physical body, affecting pain, sleep, breathing, muscle tone, memory and much more and people may sometimes experience powerful emotions during treatment.Many therapists will have witnessed clients who have had ‘releases’ during sessions such as shaking, twitching, crying or other types of ‘emotional release.’

The leap from a client responding to a caring touch to the idea that the fascia somehow is the warehouse for these feelings, is a stretch not supported by any grasp of the physiological properties of connective tissue.

These responses are evidence that a whole person, with a brain, nervous system, history and social world, is being touched and educing that person to their fascia is no more holistic than reducing them to a single muscle, or a blood-test result.

Fascia deserves better than being turned into some kind of mystical onesie. It is a hugely varied, adaptable connective tissue with fascinating relationships to movement, force and sensation. Making grandiose and sciency sounding claims about it with no evidence to back them up, doesn’t make it more important. It just makes the industry look a bit silly.

Manual therapy doesn’t have to release fascia and movement can help without stretching it into a new shape. A useful practice doesn’t become useless because its traditional explanation is wrong or better because it got more complicated.

“Hold on to your practice strongly and your theory lightly.” Gil Hedley

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References

Chaudhry, H., Schleip, R., Ji, Z., Bukiet, B., Maney, M. and Findley, T. (2008) ‘Three-dimensional mathematical model for deformation of human fasciae in manual therapy’, Journal of the American Osteopathic Association, 108(8), pp. 379–390. doi: 10.7556/jaoa.2008.108.8.379.

Deflorin, C., Hohenauer, E., Stoop, R., van Daele, U., Clijsen, R. and Taeymans, J. (2020) ‘Physical management of scar tissue: A systematic review and meta-analysis’, Journal of Alternative and Complementary Medicine, 26(10), pp. 854–865. doi: 10.1089/acm.2020.0109.

Fede, C., Clair, C., Pirri, C., Petrelli, L., Zhao, X., Sun, Y., Macchi, V. and Stecco, C. (2025) ‘The human superficial fascia: A narrative review’, International Journal of Molecular Sciences, 26(3), article 1289. doi: 10.3390/ijms26031289.

Langevin, H.M., Storch, K.N., Snapp, R.R., Bouffard, N.A., Badger, G.J., Howe, A.K. and Taatjes, D.J. (2010) ‘Tissue stretch induces nuclear remodeling in connective tissue fibroblasts’, Histochemistry and Cell Biology, 133(4), pp. 405–415. doi: 10.1007/s00418-010-0680-3.

Purslow, P.P. (2020) ‘The structure and role of intramuscular connective tissue in muscle function’, Frontiers in Physiology, 11, article 495. doi: 10.3389/fphys.2020.00495.

Stecco, C., Porzionato, A., Lancerotto, L., Stecco, A., Macchi, V., Day, J.A. and De Caro, R. (2008) ‘Histological study of the deep fasciae of the limbs’, Journal of Bodywork and Movement Therapies, 12(3), pp. 225–230. doi: 10.1016/j.jbmt.2008.04.041.