Research.
Every peer-reviewed study on fascia in one place — graded for strength of evidence, summarised in plain language for clinicians, researchers, and curious patients.
We grade studies from A to 1A+++ using the Fascia Research Database rubric — 1A+++ is the strongest.
- A2014
Skin, fascias, and scars: symptoms and systemic connections
Bruno Bordoni, Emiliano ZanierThis review article explores how skin, fascia, and scars are interconnected and can affect the entire body. The authors describe the skin as an organ that communicates with the nervous system and other structures. When…
fasciaOsteopathicSkinscarringscar - A2014
The cervical myodural bridge, a review of literature and clinical implications
Dennis E Enix, Frank Scali, Matthew E PontellThis literature review examines the cervical myodural bridge, a soft tissue connection between deep suboccipital muscles and the dura mater surrounding the spinal cord. This bridge appears to anchor the spinal cord and…
fasciarectus capitis posterior majordura materMyodural Bridgeobliquus capitis inferior - A2014
Clinical and symptomatological reflections: the fascial system
Bruno Bordoni, Emiliano ZanierThis narrative review discusses the fascial system as a continuous network of connective tissue that gives form and function to the entire body. The authors note that despite its importance in transmitting force, coordi…
fasciapainlow back painOsteopathicneck - A2014
Mechanotransduction and extracellular matrix homeostasis
Jay D Humphrey, Eric R Dufresne, Martin A SchwartzConnective tissues are dynamic, constantly adapting even at rest. Cells within these tissues continually sense mechanical cues from their environment through a process called mechanotransduction. In response, they maint…
fasciaextracellular matrixIntegrinsmechanosensingmechanoregulation - A2014
Clinical Relevance of Fascial Tissue and Dysfunctions
Werner Klingler, M Velders, K Hoppe, M Pedro, Robert SchleipFascia is a continuous network of connective tissue that supports the entire body. Traditionally seen as a passive structure, recent research shows it plays a more active role. Fascia contains contractile elements that…
fasciaMyofascial painlumbar fasciadysfunction - A2013
Fascia Research Congress Evidence from the 100 year perspective of Andrew Taylor Still
Thomas W Findley, Mona ShalwalaThis review paper examines research from the first three International Fascia Research Congresses through the perspective of Andrew Taylor Still, the founder of osteopathic medicine. Over a century ago, Still described…
fasciaextracellular matrixfibroblastOsteopathic medicinefascia anatomy - A2013
Applications and Emerging Trends of Hyaluronic Acid in Tissue Engineering, as a Dermal Filler, and in Osteoarthritis Treatment
Amir Fakhari, Cory BerklandThis narrative review summarizes knowledge about hyaluronic acid (HA), a naturally occurring polymer found in the body's connective tissues and fluids. The authors describe how HA contributes to the structural propertie…
fasciaHyaluronic acidcrosslinkingdermal fillerviscosupplement - A2013
Hyaluronan: A Simple Polysaccharide with Diverse Biological Functions
Kevin T Dicker, Lisa A Gurski, Swati Pradhan-Bhatt, Robert L Witt, Mary C Farach-Carson, Xinqiao JiaThis review paper describes hyaluronan (HA), a simple sugar molecule found abundantly throughout the body's connective tissues. Despite its simple structure, HA has a surprising array of biological functions. It helps o…
hyaluronanfasciawound healingsynthasehyaluronidase - A2013
Plantar fascia anatomy and its relationship with Achilles tendon and paratenon
Carla Stecco, Marco Corradin, Veronica Macchi, Aldo Morra, Andrea Porzionato, Carlo Biz, Raffaele De CaroThis study investigated the detailed anatomy of the plantar fascia and its connection to the Achilles tendon. Dissections of human cadavers revealed that the fascia is more closely linked to the paratenon (the tendon's…
hyaluronanfasciaFasciacyteachilles tendonparatenon - A2013
Training principles for fascial connective tissues: Scientific foundation and suggested practical applications
Robert Schleip, Divo Gitta MüllerConventional sports training often emphasizes muscles, cardiovascular conditioning, and coordination, yet most overload injuries occur within the body's connective tissue network, or fascia. This review article proposes…
fasciaStretchingfascial netCollagen renewalelastic recoil - A2013
A pilot study of myofascial release therapy compared to Swedish massage in Fibromyalgia
Ginevra Liptan, Scott Mist, Cheryl Wright, Anna Arzt, Kim Dupree JonesThis small pilot study compared the effects of myofascial release (MFR) and Swedish massage on women with fibromyalgia. Participants received either MFR or Swedish massage for 90 minutes weekly over four weeks. While bo…
fasciaMyofascial releaseFibromyalgiamassage therapycentral sensitization - A2013
Dosed Myofascial Release in Three-Dimensional Bioengineered Tendons: Effects on Human Fibroblast Hyperplasia, Hypertrophy, and Cytokine Secretion
Thanh V Cao, Michael R Hicks, David Campbell, Paul R StandleyThis laboratory study investigated how different amounts and durations of simulated myofascial release (MFR) affect lab-grown human tendon tissue. Researchers applied varying degrees of stretch for different lengths of…
fasciamusculoskeletal manipulationsFibroblaststendons - A2013
Helical Structure of the Cardiac Ventricular Anatomy Assessed by Diffusion Tensor Magnetic Resonance Imaging With Multiresolution Tractography
Ferran Poveda, Debora Gil, Enric Marti, Albert,aluz, Manel Ballester, Francesc CarrerasIn this animal study, researchers used advanced magnetic resonance imaging (MRI) and computer modeling to visualize the complex fiber structure of the heart muscle in dogs. They developed an automated method to trace th…
fasciaheartifdfusion magnetic resonance imagingdiffusion tractographyhelical heart - A2013
Sensory findings after stimulation of the thoracolumbar fascia with hypertonic saline suggest its contribution to low back pain
Andreas Schilder, Ulrich Hoheisel, Walter Magerl, Justus Benrath, Thomas Klein, Rolf-Detlef TreedeThis experimental study investigated the role of the thoracolumbar fascia as a potential source of low back pain. Researchers injected a pain-inducing saline solution into the fascia, back muscles, and subcutaneous tiss…
fasciaThoracolumbar fascialow back painhypertonic salineerector spinae muscle - A2013
Earthing (Grounding) the Human Body Reduces Blood Viscosity—a Major Factor in Cardiovascular Disease
Gaétan Chevalier, Stephen T Sinatra, James L Oschman, Richard M DelanyThis small study investigated how direct physical contact with the earth, known as 'grounding' or 'earthing', affects blood properties. Ten healthy participants were grounded for two hours using conductive patches on th…
fasciaearthinggroundingearth surface electronscardiovasclar disease - A2013
Purine receptor mediated actin cytoskeleton remodeling of human fibroblasts
Nanna Goldman, Devin Chandler-Militello, Helene Langevin, Maiken Nedergaard, Takahiro TakanoThis laboratory study investigated how certain molecules, called purines, affect human fibroblast cells. Previous research has shown that acupuncture can trigger the release of purines like ATP. The researchers exposed…
fasciacytoskeletonacupunctureFibroblastscalcium signaling - A2013
Molecular assembly and mechanical properties of the extracellular matrix: A fibrous protein perspective
Lisa D Muiznieks, Fred W KeeleyThis review article examines the extracellular matrix (ECM), the dynamic network of molecules surrounding our cells. The authors focus on fibrous proteins like collagen and elastin, which form the structural backbone of…
fasciaextracellular matrixcollageneastinself-assembly - A2013
Primo Vascular System: Past, Present, and Future
Byung-Cheon Lee, Walter J Akers, Xianghong Jing, M Isabel Miguel Perez, Yeonhee RyuAs only the title of this article was available, this summary is necessarily limited. The title, "Primo Vascular System: Past, Present, and Future," suggests this is a review article. It likely covers the history of the…
fasciaprimo vascular systemeditorial - A2013
Histological analysis of the rectus capitis posterior major’s myodural bridge
Frank Scali, Matthew E Pontell, Dennis E Enix, Ewarld MarshallThis cadaver study investigated a small tissue bridge between a suboccipital muscle (rectus capitis posterior major) and the dura mater, the protective covering of the spinal cord. Using microscopic analysis on tissue f…
fasciacervical spinerectus capitis posterior majorMyodural Bridgecervical dura mater - A2013
Nociception originating from the crural fascia in rats
T Taguchi, M Yasui, A Kubo, M Abe, H Kiyama, A Yamanaka, K MizumuraThis animal study investigated how the crural fascia, the connective tissue around the lower leg muscles, might be a source of pain signals in rats. Researchers found that this fascia is densely populated with nerve fib…
fasciacrural fascianociceptorsactivity-dependent change in conduction velocity (ADCCV)twin pulse difference (TPD) - A2013
Metabolic control of hyaluronan synthases
Davide Vigetti, Manuela Viola, Evgenia Karousou, Giancarlo De Luca, Alberto PassiThis narrative review explores how a cell's energy and nutritional status regulate the production of hyaluronan (HA), a key component of the extracellular matrix. HA is synthesized by enzymes called HAS, which require s…
fasciaGlycosaminoglycanO-GlcNacylationUDP-GlcUAUDP-GlcNA - A2013
Histological examination of the human obliquus capitis inferior myodural bridge
Matthew E Pontella, Frank Scali, Dennis E Enix, Patrick J Battaglia, Ewarld MarshallThis cadaver study examined the connection between a deep neck muscle, the obliquus capitis inferior (OCI), and the dura mater, the tough outer layer covering the spinal cord. Researchers dissected tissue from eight cad…
fasciacervical spineMyodural Bridgeobliquus capitis inferiordura - A2013
Anatomic connections of the diaphragm: influence of respiration on the body system
Bruno Bordoni, Emiliano ZanierThis review article explains why the diaphragm muscle is a critical crossroads of information for the entire body. The authors describe its extensive anatomical, fascial, and neurological connections, which link it to s…
fasciadiaphragmPelvisphrenic nervevagus nerve - A2013
Visceral and Somatic Disorders: Tissue Softening with Frequency-Specific Microcurrent
Carolyn R McMakin, James L OschmanThis review article explores a technique called Frequency-Specific Microcurrent (FSM), which uses microampere-level electrical currents to treat various health conditions. A consistent finding is a rapid and palpable so…
fasciafrequency-specific microcurrentvisceral diseasesomatic disease - A2013
The Primo Vascular System as a New Anatomical System
Miroslav Stefanov, Michael Potroz, Jungdae Kim, Jake Lim, Richard Cha, Min-Ho NamThis review paper proposes the existence of a "primo vascular system" (PVS) as the physical, anatomical basis for the meridian system of traditional Eastern medicine. According to the authors, this previously unknown sy…
fasciaEvolutioncirculatory systemnew morphologicalfunctional theory - A2012
Myoton Pro: A Novel Tool for the Assessment of Mechanical Properties of Fascial Tissues
Aleko Peipsi, Ricardas Kerpe, Heike Jäger, Sonja Soeder, Christopher Gordon, Robert SchleipThis research entry, for which only the title is available, appears to introduce a device called the MyotonPRO. The title suggests its purpose is to assess the mechanical properties of fascial tissues, such as their sti…
fasciaMyotone Pro - A2012
Massage Therapy Attenuates Inflammatory Signaling After Exercise-Induced Muscle Damage
Justin D Crane, Daniel I Ogborn, Colleen Cupido, Simon Melov, Alan Hubbard, Jacqueline M Bourgeois, Mark A TarnopolskyThis study investigated how massage therapy affects skeletal muscle at a cellular level after exercise-induced damage. Researchers took muscle biopsies from 11 young men after an intense workout; one leg received 10 min…
fasciamassage therapyinflammatory cytokinesstretchstrain - A2012
Real-time imaging of cortical areas involved in the generation of increases in skin sympathetic nerve activity when viewing emotionally charged images
Luke A Henderson, Alexandra Stathis, Cheree James, Rachael Brown, Skye McDonald, Vaughan G MacefieldThis study investigated which brain regions are involved when our bodies react to emotional images. Researchers simultaneously measured brain activity with fMRI and skin sympathetic nerve activity (SSNA), a marker of th…
fasciaMRIIASP imagesmicroneurographyskin sympathetic nerve activity - A2012
Hyaluronic acid, A key molecule in skin aging
Eleni Papakonstantinou, Michael Roth, George KarakiulakisThis review article discusses the role of hyaluronic acid (HA) in skin aging. The authors explain that youthful skin's plumpness and resilience are largely due to its high water content, which HA is uniquely able to ret…
CD44fasciaHyaluronic acidhyaluronic acid synthaseshyaluronidases - A2012
A RHAMM Mimetic Peptide Blocks Hyaluronan Signaling and Reduces Inflammation and Fibrogenesis in Excisional Skin Wounds
Cornelia Tolg, Sara R Hamilton, Ewa Zalinska, Lori McCulloch, Ripal Amin, Natalia Akentieva, Francoise Winnik, Rashmin…In this animal study, researchers investigated how to reduce scarring during skin wound healing. They developed a peptide, P15-1, designed to interfere with signals from fragmented hyaluronan, a molecule involved in inf…
hyaluronaninflammationfasciaextracellular matrixfibrosis - A2012
The thoracolumbar fascia: anatomy, function and clinical considerations
Frank H Willard, Andry Vleeming, M D Schuenke, L Danneels, Robert SchleipThis overview paper examines the anatomy and function of the thoracolumbar fascia (TLF), the complex sheet of connective tissue in the lower back. The authors describe its multiple layers, which separate and connect the…
fasciathoracolumbarfascia - A2012
Earthing: Health Implications of Reconnecting the Human Body to the Earth’s Surface Electrons
Gaétan Chevalier, Stephen T Sinatra, James L Oschman, Karol Sokal, Pawel SokalThis 2012 review paper explores the concept of 'earthing' or 'grounding,' which involves direct physical contact with the Earth's surface electrons. The authors propose that modern lifestyles separate humans from this c…
fasciaearthinggroundingearth surface electrons - A2012
Primo Vascular System as a New Morphofunctional Integrated System
Miroslav Stefanov, Jungdae KimThis narrative review summarizes research on the primo vascular system (PVS), a proposed anatomical network found throughout the body. The authors describe the methods and instruments used to study this system, primaril…
fasciacancerphysiologyMorphologyprimo vascular system - A2012
A theoretical framework for the role of fascia in manual therapy
Nigel Simmonds, Peter Miller, Hugh GemmellThis theoretical paper explores why different types of manual therapy, such as soft tissue work and joint manipulation, often seem to produce similar results. The authors compare these approaches based on their effects…
fasciaManual TherapyMyofascialManipulationautonomic nervous system - A2011
Correlations Between Fasciology and Yin Yang Doctrine
Hui Tao, Mei-Chun Yu, Hui-Ying Yang, Rong-Mei Qu, Chun Yang, Xin Zhou, Yu Bai, Jing-Peng Wu, Jun Wang, Ou Sha, Lin YuanThis theoretical paper explores correlations between "fasciology," a model based on 3D reconstruction of connective tissue, and the traditional Chinese doctrine of yin and yang. According to fasciology, the body can be…
fasciafasciologyfascial anatomytwo-system theoryyin yang doctrine - A2011
Fibroblast cytoskeletal remodeling contributes to connective tissue tension
H M Langevin, N A Bouffard, J R Fox, B M Palmer, J Wu, J C Iatridis, W D Barnes, G J Badger, A K HoweThe mechanical properties of connective tissue, such as its elasticity and resistance, have traditionally been attributed to its non-cellular matrix. This study investigated the role of fibroblasts, the cells residing w…
fasciaConnective tissuefibroblastcytoskeletal remodeling - A2011
Anatomical Connection Between the Rectus Capitis Posterior Major and the Dura Mater
Frank Scali, Eric S Marsili, Matthew E PontellIn this anatomical study, researchers dissected 13 cadavers to investigate a connection between a deep neck muscle and the dura mater, the protective covering of the spinal cord. In 11 of the 13 specimens, they found a…
fasciacervical spineposterior atlantoaxial interspacerectus capitis posterior majorspinal dura - A2011
Hyaluronan as an Immune Regulator in Human Diseases
Paul W Noble, Jiurong Liang, Dianhua JiangThis 2011 narrative review explores the role of hyaluronan (HA) in the immune system. While intact HA is a normal part of the extracellular matrix, fragments of HA produced during tissue injury can act as signals. These…
hyaluronanfascia - A2011
The extracellular matrix: an active or passive player in fibrosis?
T N Wight, S Potter-PerigoFibrosis, the excessive buildup of scar tissue, can be understood as a wound healing process that has gone awry. Normally, specialized cells called myofibroblasts help repair tissue and then disappear, but in fibrosis,…
fasciaprovisional extracellular matrixmyofibroblatcollagenhyaluronan proteoglycans - A2011
Hyaluronan: From Extracellular Glue to Pericellular Cue
B P TooleHyaluronan is traditionally seen as a biological 'goo' that lubricates joints and holds connective tissues together. This review describes how hyaluronan also functions as an important signaling molecule, or cue, in the…
hyaluronanfasciasignal transductioncancer - A2011
Fascia and the mechanism of acupuncture
Steven Finando, Donna FinandoThis theoretical paper re-evaluates the mechanisms of acupuncture. The authors propose that fascia, the body's connective tissue network, is the structure that explains how acupuncture works. They argue for this model b…
fasciaacupunctureShamPlaceboMechanism - A2011
Fibroblasts and Myofibroblasts: What are we talking about?
Jennifer Baum, Heather S DuffyThis 2011 narrative review explores the roles of fibroblasts and myofibroblasts, two key cell types in the heart's connective tissue. Once considered static, research indicates these cells are dynamic and play an active…
fasciafibroblastMyofibroblast - A2011
ExtracellularMatrix Degradation and Remodeling in Development and Disease
Pengfei Lu, Ken Takai, Valerie M Weaver, Zena WerbIn this review, the authors describe the extracellular matrix (ECM) as a dynamic structure that is constantly being remodeled. This process of breakdown and rebuilding is essential for normal bodily functions like tissu…
fasciaextracellular matrixmatrix remodeling - A2011
Chronic Disease: Are We Missing Something?
James L OschmanThis 2011 editorial by James L. Oschman poses a question in its title: "Chronic Disease: Are We Missing Something?". Without an abstract or full text available for summary, the specific perspective or argument presented…
fasciachronic diseaseearthing - A2011
Remodeling and homeostasis of the extracellular matrix: implications for fibrotic diseases and cancer
Thomas R Cox, Janine T ErlerIn this perspective article, the authors discuss how the extracellular matrix (ECM) is constantly being remodeled, a process essential for normal bodily functions like wound healing and tissue maintenance. When this rem…
fasciaextracellular matrixcancerfibrosisstiffness - A2011
Sensory Innervation of the Nonspecialized Connective Tissues in the Low Back of the Rat
Sarah M Corey, Margaret A Vizzard, Gary J Badger, Helene M LangevinIn this animal study, researchers investigated the sensory nerves in the nonspecialized connective tissue of the rat low back, an area where knowledge is limited. Using 3D reconstruction and dye-labeling techniques, the…
fasciaConnective tissueinnervationlow back painmusculoskeletal pain - A2011
Dynamic fascial release and the role of mechanical/vibrational assist devices in manual therapies
Zachary ComeauxThis review article explores the use of mechanical vibration devices in manual therapy. The author examines several such tools, including percussion vibrators, vibrational platforms, and deep tissue oscillation. The art…
fasciaConnective tissuevibrationpercussion vibrationtonic vibratory reflex - A2011
Elevated [11C]-D-Deprenyl Uptake in Chronic Whiplash Associated Disorder Suggests Persistent Musculoskeletal Inflammation
Clas Linnman, Lieuwe Appel, Mats Fredrikson, Torsten Gordh, Anne Söderlund, Bengt Långström, Henry EnglerDiagnosing chronic whiplash-associated disorder (WAD) is often difficult, as standard structural imaging methods seldom show clear signs of injury. This study used Positron Emission Tomography (PET) with a tracer molecu…
inflammationfasciaWhiplash - A2011
High and Low Molecular Weight Hyaluronic Acid Differentially Regulate Human Fibrocyte Differentiation
A S Maharjan, D Pilling, R H GomerFollowing tissue injury, immune cells called monocytes can differentiate into fibrocytes, a cell type involved in healing and fibrosis. This study investigated how different sizes of hyaluronic acid (HA) affect this pro…
hyaluronanfasciafibrocyte differentiationmonocyte - A2011
Pandiculation: Nature’s way of maintaining the functional integrity of the myofascial system?
Luiz Fernando BertolucciThis paper explores the hypothesis that pandiculation—the involuntary stretching and yawning most animals do upon waking—serves a key role for the locomotor system. Beyond preparing the nervous system for wakefulness, t…
fasciaConnective tissuemyofasciayawningsleep-wake rhythm - A2011
Sensory Innervation of the Thoracolumbar Fascia in Rats and Humans
J Tesarz, U Hoheisel, B Wiedenhöfer, S MenseThis study investigated the nerve supply of the thoracolumbar fascia (TLF), the connective tissue of the low back, in both rats and humans. Researchers found that the fascia is richly innervated with sensory nerves, but…
fasciaNociceptionThoracolumbar fascialow back painimmunohistochemistry - A2011
Assessing the influence of FDM to the postoperative healing processes in distal fracture of the radius
Tomasz TesznerResearchers investigated if the Fascial Distortion Model (FDM) could improve recovery following surgery for a common wrist fracture. In this study, 65 patients were divided into two groups; one received standard rehabil…
fasciaManual Therapyfasciaefascial distortion modelreductionism - A2011
Hyaluronan in intestinal homeostasis and inflammation: implications for fibrosis
Carol A de la MotteThis narrative review explores the role of hyaluronan (HA) in intestinal health and disease. Chronic intestinal inflammation can lead to fibrosis, or scarring, a process driven by inflammatory signals and specialized ce…
hafasciaextracellular matrixfibrosismesenchymal cells - A2010
How much time is required to modify a fascial fibrosis?
Ercole Borgini, Antonio Stecco, Julie Ann Day, Carla SteccoThis study investigated how long it takes for manual therapy to alter a palpable sensation of fascial "fibrosis" and reduce discomfort. Researchers worked with 40 people experiencing low back pain, applying the Fascial…
fasciaConnective tissueManual Therapylow back painManipulation - A2010
Possible Applications for Fascial Anatomy and Fasciaology in Traditional Chinese Medicine
Yu Bai, Lin Yuan, Kwang-Sup Soh, Byung-Cheon Lee, Yong Huang, Chun-lei Wang, Jun Wang, Jin-peng Wu, Jing-xing Dai, Jano…This theoretical paper proposes a new framework for understanding anatomy, called "fascial anatomy," and a new field of study, "fasciaology." The authors suggest that the body's fascial network may be the anatomical bas…
fasciameridiansacupointsprimo-vesseltraditional Chinese medicine - A2010
Spontaneous and visible light-induced ultraweak photon emission from rat eyes
Chao Wanga, István Bókkonb, Jiapei Daia, István AntalcIn this in vitro study on rats, researchers found that isolated parts of the eye—the whole eye, lens, vitreous humor, and retina—emit extremely faint light, or photons. This photon emission occurred both spontaneously a…
fasciabioluminescent photonslipid peroxidationdiscrete dark noiseretinal phosphenes - A2010
Fluorescent Nanoparticles for Observing Primo Vascular System Along Sciatic Nerve
Zhao-Feng Jia, Byung-Cheon Lee, Ki-Hoon Eom, Jin-Myung Cha, Jin-Kyu Lee, Zhen-Dong Su, Wen-Hui Yu, Pan Dong Ryu, Kwang-…In this animal study, researchers injected fluorescent nanoparticles into rats at an acupuncture point to trace their path. The particles traveled along the sciatic nerve, revealing a previously hard-to-detect structure…
fasciaacupunctureSCIATIC NERVEprimo vascular systemprimo-vessel - A2009
Mechanotransduction at a distance: mechanically coupling the extracellular matrix with the nucleus
Ning Wang, Jessica D Tytell, Donald E IngberIn this narrative review, the authors explore how mechanical forces can influence the cell nucleus from a distance. Research has often focused on how external forces are converted into chemical signals at the cell's sur…
fasciaextracellular matrixcytoskeletonmechanotransductioncell nucleus - A2009
The Hard Life of Soft Cells
P A Janmey, J P Winer, M E Murray, Q WenThis brief review explores how cells function as both mechanical and chemical machines. Cells constantly generate and respond to physical forces within their environment, the extracellular matrix. The stiffness of this…
fasciamechanotransductionsubstrate stiffnesscell mechanics - A2009
From mechanotransduction to extracellular matrix gene expression in fibroblasts
Matthias Chiquet, Laurent Gelman, Roman Lutz, Silke MaierThis 2009 review article explores how connective tissue cells, or fibroblasts, sense and respond to mechanical forces from their environment. Cells attach to the surrounding extracellular matrix via adhesion contacts, w…
fasciaextracellular matrixfibroblastcytoskeletonmechanotransduction