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.
- A++2007
Ascorbate in pharmacologic concentrations selectively generates ascorbate radical and hydrogen peroxide in extracellular fluid in vivo
Qi Chen, Michael Graham Espey, Andrew Y Sun, Je-Hyuk Lee, Murali C Krishna, Emily Shacter, Peter L Choyke, Chaya Pooput…High-dose intravenous Vitamin C (ascorbate) can selectively kill some cancer cells without harming normal cells. Researchers have proposed this is because ascorbate acts as a prodrug, creating hydrogen peroxide and othe…
ascorbic acid " cancer " vitamin C " pharmacokinetics - B2007
Functional Anatomy of the Female Pelvic Floor
James A Ashton-Miller, John O L DeLanceyThis review of the female pelvic floor's functional anatomy explains how it prevents incontinence and organ prolapse. It details two key systems: sphincters that keep the urethra closed, and a supportive "hammock" of mu…
functional anatomy; female pelvic floor; levator ani muscles; urethra; prolapse; incontinence; vaginal birth - B2007
Cytokines, Inflammation and Pain
J-M Zhang, J AnThis review chapter describes the role of cytokines—small proteins that cells use for communication—in inflammation and pain. The authors explain that there are both pro-inflammatory and anti-inflammatory types of cytok…
inflammationcytokinepainhyperalgesia - A++2007
A suspensory system for the sacrum in pelvic mechanics: Biotensegrity
Stephen LevinThis 2007 publication by Stephen Levin, available only by title, appears to describe a model for understanding the mechanics of the pelvis. The title suggests a 'suspensory system' for the sacrum, framing its function w…
biotensegrityPelvisKinematicssacrummovement - A2006
Passive muscle stiffness may be influenced by active contractility of intramuscular connective tissue
Robert Schleip, Ian L Naylor, Daniel Ursu, Werner Melzer, Adjo Zorn, Hans-Joachim Wilke, Frank Lehmann-Horn, Werner Kli…This paper proposes the hypothesis that connective tissue within muscles, specifically the layer known as the perimysium, can actively contract. This contraction, likely driven by specialized cells called myofibroblasts…
fasciamuscle stiffnessperimysiummyofibroblaststonic muscle - A++2006
Low-intensity tensile loading increases intratendinous glucose uptake in the Achilles tendon
J Bojsen-Møller, K K Kalliokoski, M Seppänen, M Kjaer, S P MagnussonTendons have traditionally been considered to have low metabolic activity, but this study investigated whether light loading could affect this. Six participants performed low-intensity, intermittent calf muscle contract…
tendon metabolism; tendon mechanical function; connective tissue; imaging - B2006
Hyaluronan fragments: An information-rich system
Robert Stern, Akira A Asari, Kazuki N SugaharaThis narrative review explores the diverse roles of hyaluronan (HA), a key component of the extracellular matrix. Despite its simple chemical structure, HA's biological function changes dramatically and often opposition…
hyaluronanextracellular matrixglycosaminoglycanshyaluronidaseOligosaccharides - A2006
Adhesive capsulitis of the shoulder: evaluation with MR arthrography
Joon-Yong Jung, Won-Hee Jee, Ho Jong Chun, Yang-Soo Kim, Yang Guk Chung, Jung-Man KimThis study evaluated the usefulness of MR arthrography for diagnosing adhesive capsulitis, also known as frozen shoulder. Researchers retrospectively analyzed images from 28 patients, half with the condition and half se…
frozen shoulderAdhesive capsulitisShoulderMagnetic resonanceArthrography - B2006
Hyaluronan Fragments Act as an Endogenous Danger Signal by Engaging TLR2
Kara A Scheibner, Michael A Lutz, Sada Boodoo, Matthew J Fenton, Jonathan D Powell, Maureen R HortonHyaluronan (HA) is a common component of the body's connective tissue. This study investigates how different sizes of HA molecules affect the immune system. When tissue is injured, large HA molecules are broken down int…
hyaluronanhafasciaextracellular matrixtisssue - A+++2006
Mechanisms of interstitial flow-induced remodeling of fibroblast-collagen cultures
Chee Ping Ng, Melody A SwartzThis study investigates how the movement of fluid through tissues, known as interstitial flow, influences the organization of connective tissue cells and collagen. Researchers found that slow fluid movement causes colla…
extracellular matrixRemodeling - A++2006
Distribution and change of collagen types I and III and elastin in developing leg muscle in rat
Tomoyuki Kurose, Youko Asai, Emiko Mori, Daisuke Daitoku, Seiichi KawamataThis animal study on rats investigated how the connective tissue components collagen types I and III and elastin develop in leg muscles from birth to eight weeks of age. The results show that muscle connective tissue de…
CollagenMyofascia - A2006
Pathophysiological model for chronic low back pain integrating connective tissue and nervous system mechanisms
H M Langevin, K J ShermanThis paper proposes a theoretical model for how chronic low back pain might develop and persist. The authors hypothesize that fear of pain leads to reduced movement, which in turn causes physical changes and inflammatio…
fasciaConnective tissuechronic Low Back Painneuroplasticityconnective tissue remodeling - A+2006
Dynamic Shear Stimulation of Bovine Cartilage Biosynthesis of Proteoglycan 4
Gayle E Nugent, Nicole M Aneloski, Tannin A Schmidt, Barbara L Schumacher, Michael S Voegtline, Robert L SahThis laboratory study on cartilage from young cows investigated how mechanical forces affect the production of a key lubricating molecule, proteoglycan 4 (PRG4). Researchers applied different types of loads to cartilage…
ProteoglycansCartilagePRG4dynamic shear stressstatic compression - A2006
Mechanisms of Mechanotransduction
A Wayne Orr, Brian P Helmke, Brett R Blackman, Martin A SchwartzThis review describes mechanotransduction, the process by which cells sense and respond to physical forces. The researchers explain that nearly all living organisms, from bacteria to humans, are sensitive to mechanical…
extracellular matrixcytoskeletonmechanotransductionfocal adhesion - A2006
Fibroblast spreading induced by connective tissue stretch involves intracellular redistribution of a- and b-actin
Helene M Langevin, Kirsten N Storch, Marilyn J Cipolla, Sheryl L White, Thomas R Buttolph, Douglas J TaatjesResearchers investigated how fibroblasts, the primary cells in connective tissue, respond to mechanical stretching. In this ex vivo study, they stretched samples of subcutaneous tissue for 30 minutes and observed change…
fasciamechanical stressfibroblastmechanotransductionSubcutaneous tissue - A2006
Migration of tumor cells in 3D matrices is governed by matrix stiffness along with cell-matrix adhesion and proteolysis
Muhammad H Zaman, Linda M Trapani, Alisha L Sieminski, Drew MacKellar, Haiyan Gong, Roger D Kamm, Alan Wells, Douglas A…This study investigated how tumor cells move in a three-dimensional environment similar to body tissues. Researchers found that in addition to the cell's ability to adhere to and pull on its surroundings, the stiffness…
extracellular matrixmatrix metalloproteinasecell motilityEGF receptor - B2006
Viscoelastic Retraction of Single Living Stress Fibers and Its Impact on Cell Shape, Cytoskeletal Organization, and Extracellular Matrix Mechanics
Sanjay Kumar, Iva Z Maxwell, Alexander Heisterkamp, Thomas R Polte, Tanmay P Lele, Matthew Salanga, Eric Mazur, Donald…Cells maintain their shape and interact with their surroundings using internal tension cables called stress fibers. Using a microscopic laser to cut individual stress fibers inside living cells, researchers studied how…
extracellular matrixcytoskeletonactinstress fiber - A2006
Subcutaneous Tissue Fibroblast Cytoskeletal Remodeling Induced by Acupuncture: Evidence for a Mechanotransduction-Based Mechanism
Helene M Langevin, Nicole A Bouffard, Gary J Badger, David L Churchill, Alan K HoweIn this mouse tissue study, researchers investigated how rotating an acupuncture needle affects fibroblasts in the connective tissue under the skin. They found that rotation caused the fibroblasts to actively change sha…
fasciacollagenfibroblastcytoskeletonmechanotransduction - B2006
Letter to the Editor concerning ‘‘A hypothesis of chronic back pain: ligament subfailure injuries lead to muscle control dysfunction’’ (M. Panjabi)
Robert Schleip, Andry Vleeming, Frank Lehmann-Horn, Werner KlinglerThis letter to the editor comments on a hypothesis that chronic back pain can arise from minor injuries to spinal ligaments, disrupting their sensory function and leading to faulty muscle control. The authors agree with…
Thoracolumbar fasciaproprioceptionlow back painBiomechanicsHypothesis - A++2006
Quantum Events of Biophoton Emission Associated with Complementary and Alternative Medicine Therapies: A Descriptive Pilot Study
Marius Hossu, Ronald RupertThis descriptive pilot study investigated biophoton emission (BPE), an ultra-low level of light emitted by living organisms that may reflect overall health status. Researchers measured BPE from the neck and lower back o…
fasciaManual Therapybiophotonsultraweak photons - A+++2006
The key to left-right asymmetry
Clifford J TabinThis summary explores how vertebrates establish left-right asymmetry during embryonic development. Research indicates that cilia are essential components in breaking initial symmetry, supported by an asymmetric signalin…
EmbryologySignaling - 1A+2006
Cellular mechanotransduction: putting all the pieces together again
D E IngberThis review discusses how cells sense and respond to mechanical forces, a process called mechanotransduction. While many individual molecules involved in this process have been identified, it is less clear how they work…
mechanical ! mechanosensation ! mechanochemical ! prestress ! tensegrity - A2006
Connective tissue: A body-wide signaling network?
H M LangevinThis paper proposes that loose connective tissue functions as a body-wide communication system, in addition to its structural role. The author hypothesizes that this tissue network is mechanosensitive, meaning it respon…
Loose connective tissuemechanosensingsignaling - B2006
A hypothesis of chronic back pain: ligament subfailure injuries lead to muscle control dysfunction
Manohar M PanjabiThis paper presents a hypothesis for the cause of chronic back and neck pain. The author suggests that minor injuries to spinal ligaments, which may not be severe enough to cause a complete tear, can damage the sensory…
low back painBiomechanicsNeck painWhiplashHypothesis - A++2005
Myofibrillar and collagen protein synthesis in human skeletal muscle in young men after maximal shortening and lengthening contractions
Daniel R Moore, Stuart M Phillips, John A Babraj, Kenneth Smith, Michael J RennieThis study compared how two types of maximal muscle contractions affect muscle and collagen repair in young men. Participants performed both shortening (concentric) and lengthening (eccentric) contractions with their le…
eccentric; concentric; resistance exercise; z-band streaming - A2005
Mechanical control of tissue growth: Function follows form
Donald E IngberThe full text of this 2005 article has not yet been summarized by our team. The title, "Mechanical control of tissue growth: Function follows form," suggests a focus on how mechanical forces influence the development an…
fasciamechanotransductionmorphogenesis - A++2005
Deleterious effects of omitting breakfast on insulin sensitivity and fasting lipid profiles in healthy lean women
Hamid R Farshchi, Moira A Taylor, Ian A MacdonaldThis randomized crossover trial investigated how breakfast habits affect metabolism in healthy, lean women over two-week periods. The results suggest that omitting breakfast led to impaired insulin sensitivity and highe…
omitting breakfastinsulin sensitivity - A+2005
Human Bone Collagen Synthesis Is a Rapid, Nutritionally Modulated Process
John A Babraj, Kenneth Smith, Daniel J R Cuthbertson, Peter Rickhuss, James S Dorling, Michael J RennieResearchers developed a new method to directly measure bone collagen synthesis in young, healthy men. Contrary to previous assumptions, the results showed that bone collagen formation is a surprisingly rapid process, ev…
metabolismnutritionmatrix proteinstable-isotope tracerproline - A2005
Active fascial contractility: Fascia may be able to contract in a smooth muscle-like manner and thereby influence musculoskeletal dynamics
Robert Schleip, Werner Klingler, F Lehmann-HornFascia is typically viewed as a passive tissue that transmits force from muscles. This paper explores the hypothesis that fascia may also be able to actively contract on its own, similar to smooth muscle. Researchers po…
fasciaConnective tissueMyofascial releaseMyofibroblastproprioception - A2005
Cell–Matrix Entanglement and Mechanical Anchorage of Fibroblasts in Three-dimensional Collagen Matrices
H Jiang, F GrinnellResearchers studied how fibroblasts, a key connective tissue cell, behave within a three-dimensional collagen matrix that mimics body tissues. They found the cells' ability to engulf particles (phagocytosis) was reduced…
fibroblastcollagen matrixcell-matrix addesion - A2005
An Introduction to Human Biophoton Emission
Roeland Van Wijk, Eduard P A Van WijkThis narrative review explores biophoton emission, the ultraweak light naturally produced by all living systems, including the human body. The authors compiled and analyzed existing research, which has investigated how…
acupuncturebiophotonsSkinultraweak photon emissionconsciousness - A+2005
Nutraceutical Therapies for Degenerative Joint Diseases: A Critical Review
ROBERT GOGGS, ANNE VAUGHAN-THOMAS, PETER D CLEGG, STUART D CARTER, JOHN F INNES, ALI MOBASHERI, MEHDI SHAKIBAEI, WOLFGA…This 2005 critical review examines the role of nutrition in managing degenerative joint diseases like osteoarthritis. The authors suggest that while nutritional factors are crucial for cartilage health, dietary programs…
articular cartilagenutritionosteoarthritisnutraceuticalVitamin C - C2005
An in vivo microanalytical technique for measuring the local biochemical milieu of human skeletal muscle
Jay P Shah, Terry M Phillips, Jerome V Danoff, Lynn H GerberMyofascial pain is common, but the biochemical environment within the muscle tissue is not well understood. This paper describes a new microanalytical technique developed to measure this environment directly in living h…
myofascial trigger points; musculoskeletal pain; microdialysis; soft tissue pain; pressure pain threshold - A++2005
Vitamin D
Adriana S Dusso, Alex J Brown, Eduardo SlatopolskyThis narrative review summarizes research on vitamin D, which is well-known for its essential role in calcium balance and bone metabolism. However, research has revealed a wider range of actions, including influencing c…
vitamin D metabolism; vitamin D receptor; calcium homeostasis; transcriptional regulation; rapid steroid actions - A++2005
Obstetric anal sphincter injury ten years after: subjective and objective long term effects
Eva Uustal Fornell, Leif Matthiesen, Rune Sjödahl, Göran BergThis prospective observational study followed women for ten years to evaluate the long-term effects of obstetric anal sphincter injuries. Researchers found that anal function, particularly continence for gas and liquid…
anal sphincter injury; incontinence; anal pressure - A+2005
Coordinated collagen and muscle protein synthesis in human patella tendon and quadriceps muscle after exercise
Benjamin F Miller, Jens L Olesen, Mette Hansen, Simon Dossing, Regina M Crameri, Rasmus J Welling, Henning Langberg, Al…Researchers investigated how strenuous exercise affects protein synthesis in both muscle and tendon. In this study, healthy young men performed one-legged kicking exercises, and biopsies were taken over the next 72 hour…
Muscletendonexercisecollegen syntes - A2005
A stromal address code defined by fibroblasts
G Parsonage, A D Filer, O Haworth, G B Nash, G E Rainger, M Salmon, C D BuckleyThis 2005 review article explores how immune cells (leukocytes) navigate within the body's tissues. The authors propose that fibroblasts create a "stromal address code" that acts as a local guidance system. This code di…
inflammationfibroblaststromal adress codeleukocyte - C2005
Distribution of cannabinoid receptor 1 (CB1) and 2 (CB2) on sensory nerve fibers and adnexal structures in human skin
Sonja Ständer, Martin Schmelz, Dieter Metze, Thomas Luger, Roman RukwiedThis study mapped the precise location of cannabinoid receptors CB1 and CB2 in human skin. Using immunohistochemical methods, researchers found these receptors in numerous structures, including nerve fibers, mast cells,…
Cannabinoid receptorsCutaneous nerve fibersNociceptionItchHuman skin - A2005
Cannabimimetic Effects of Osteopathic Manipulative Treatment
J M McPartland, A Giuffrida, J King, E Skinner, J Scotter, R E MustyIn this dual-blind, randomized controlled trial, researchers investigated whether osteopathic manipulative treatment (OMT) could produce cannabis-like effects. Thirty-one healthy subjects received either OMT or a sham t…
CannabinoidsEndocannabinoidsMyofascial releaseFibromyalgiaMyofascial trigger points - A2005
Dynamic fibroblast cytoskeletal response to subcutaneous tissue stretch ex vivo and in vivo
H M Langevin, N A Bouffard, G J Badger, J C Iatridis, A K HoweIn this animal study, researchers investigated how fibroblasts, the primary cells in connective tissue, respond to mechanical stretch. By stretching subcutaneous tissue from mice, both in tissue samples (ex vivo) and in…
Connective tissueTensegritymechanotransductionmusculoskeletal manipulationsacupuncture - A+++2005
Interstitial fluid flow induces myofibroblast differentiation and collagen alignment in vitro
Chee Ping Ng, Boris Hinz, Melody A SwartzThis in vitro study examines how the movement of fluid through tissues, known as interstitial flow, influences connective tissue cells. The researchers found that even low levels of flow, similar to what occurs during s…
fluid flow - A2005
Cell tension, matrix mechanics, and cancer development
Sui Huang, Donald E IngberDoctors can often diagnose cancer by feeling for tissue stiffness, and this study explores how this mechanical property contributes to cancer development. The researchers suggest that the stiff extracellular matrix in t…
extracellular matrixcancercytoskeletonmechanotransduction - A2004
Consciousness and Quantum Information Processing: Uncovering the Foundation for a Medicine of Light
Bruce D Curtis, J J HurtakThis theoretical paper suggests a deeper connection between consciousness, light, and the body's information systems. The authors discuss how biophotons (biological light) may play a role in the body's self-organization…
biophotonsultraweak photons - A2004
Fibroblasts form a body-wide cellular network
Helene M Langevin, Carson J Cornbrooks, Douglas J TaatjesIn this mouse study, researchers investigated how cells called fibroblasts connect to one another within loose connective tissue. Using various microscopy techniques, they found that fibroblasts form an extensive, web-l…
Connective tissueSubcutaneous tissueConnexinGap junctionsCell signaling - B2004
Experimental approaches to hyaluronan structure
Mary K Cowman, Shiro MatsuokaIn this literature review, researchers summarize experimental studies on the structure of hyaluronan (HA). In conditions similar to the body (neutral, physiological salt solution), HA behaves as a long, semi-flexible po…
hyaluronanviscosityPolysaccharidePolymer solutionOsmotic pressure - A2004
TGF-beta signaling and the fibrotic response
Andrew Leask, David J AbrahamThis 2004 narrative review discusses the molecular basis of fibrotic diseases, which are characterized by excessive production and deposition of connective tissue. The authors summarize the state of knowledge concerning…
sclerodermaCTGFSmadMAP kinaseprostacyclin - C2004
Myofascial Pain, Fibromyalgia or Fibrositis?
J M S PearceThis critical analysis examines the diagnostic labels myofascial pain, fibromyalgia, and fibrositis. The author argues that these terms, often used for non-specific musculoskeletal pain, lack consistent physical or labo…
Myofascial pain. FibromyalgiaFibrositisNociceptorCentral pain - A2004
Frozen Shoulder: MR Arthrographic Findings
Bernard Mengiardi, Christian W. A. Pfirrmann, Christian Gerber, Jürg Hodler, Marco ZanettiResearchers used a specific type of MRI, an MR arthrogram, to identify the characteristics of frozen shoulder. They compared images from 22 patients with the condition to 22 healthy control subjects. The study found tha…
frozen shoulderAdhesive capsulitisMR imagingArthroscopy - A2004
Role of Extracellular Matrix in Adaptation of Tendon and Skeletal Muscle to Mechanical Loading
MICHAEL KJÆRThis review discusses how the extracellular matrix (ECM), particularly collagen, adapts to mechanical loading in tendons and muscles. Physical activity stimulates both the creation and breakdown of collagen, a process e…
collagentendonsMechanical loadingECMskeletal muscles - A++2004
Factors associated with pelvic floor dysfunction with emphasis on urinary and fecal incontinence and genital prolapse: an epidemiological study
EVA UUSTAL FORNELL, GUN WINGREN, PREBEN KJØLHEDEThis epidemiological study surveyed Swedish women aged 40 and 60 about pelvic floor dysfunction. The results indicate that urinary incontinence, fecal incontinence, and genital prolapse often occur together. Factors str…
obesityanal sphincter ruptureurinary incontinence; fecal incontinence; genital prolapse; risk factors; epidemiology - A++2004
Biophotons, microtubules and CNS, is our brain a “Holographic computer”?
F Grass, H Klima, S KasperThis theoretical article explores the idea that cells in the nervous system might communicate using light, specifically biophotons. The authors suggest that neurons have ideal characteristics for this, such as their str…
biophotonsultraweak photons - B2004
Protection from Fluorescein Isothiocyanate-Induced Fibrosis in IL-13-Deficient, but Not IL-4-Deficient, Mice Results from Impaired Collagen Synthesis by Fibroblasts
Jill E Kolodsick, Galen B Toews, Claudia Jakubzick, Cory Hogaboam, Thomas A Moore, Andrew McKenzie, Carol A Wilke, Cara…In this animal study, researchers investigated the drivers of lung fibrosis in mice. The team compared mice genetically deficient in the immune molecules IL-4, IL-13, or both. Results showed that mice lacking IL-13 were…
fibroblastCell signalingcollagen synthesisalfa-SMA - B2004
Lactate metabolism: a new paradigm for the third millennium
L B GladdenFor a long time, lactate (often called lactic acid) was considered a metabolic waste product responsible for muscle fatigue. This 2004 review article describes a major shift in scientific understanding that began in the…
LactateglycolysisO2muscle fatigueanoxia - A2004
Integrins in Mechanotransduction
Akira Katsumi, A Wayne Orr, Eleni Tzima, Martin Alexander SchwartzThis 2004 review article examines how cells sense and respond to physical forces, a process known as mechanotransduction. The authors focus on integrins, a class of proteins that anchor cells to their surroundings and a…
mechanotransductionIntegrins - A2003
Biophoton emission of human body
S Cohen, F A PoppResearchers measured the very faint light, or "biophotons," emitted by the human body using a special photon detector. They found that these emissions are not random, but seem to reflect the body's left-right symmetry a…
BiophotonBiological regulationBiological rhythmsHuman body measurmentLeft right symmetry - A+2003
Stress shielding of patellar tendon: effect on small-diameter collagen fibrils in a rabbit model
Tokifumi Majima, Kazunori Yasuda, Takamasa Tsuchida, Kunio Tanaka, Kiyoshi Miyakawa, Akio Minami, Kozaburo HayashiIn this animal study, researchers investigated the effects of mechanical unloading, or "stress shielding," on the patellar tendon in rabbits. The scientists completely released the tendon from its normal stress for thre…
Stress shielding · Patellar tendon · Collagen fibril diameter · Ultrastructure - A++2003
Stimulation of type II collagen biosynthesis and secretion in bovine chondrocytes cultured with degraded collagen
Steffen Oesser, Jürgen SeifertThis laboratory study investigated how degraded collagen affects cartilage cells. Researchers cultured chondrocytes from cows and added collagen hydrolysate (small collagen fragments) to their environment. They found th…
Collagen hydrolysate; Collagen secretion; Chondrocyte metabolism; Type II collagen; Cell culture (Bovine) - A2003
The myofibroblast in wound healing and fibrocontractive diseases
G GabbianiDuring wound healing, cells called fibroblasts can transform into a more specialized type called myofibroblasts. These myofibroblasts have contractile properties, much like muscle cells, which help to pull the edges of…
inflammationα-smooth muscle actinstress fibresTGF-β1 fibronectintension - A2003
Vitamin C, respiratory infections and the immune system
Harri HemiläThis 2003 publication by Harri Hemilä explores the relationship between Vitamin C, respiratory infections, and immune system function. As only the title is available, specific conclusions regarding the study's exact res…
Vitamin CAscorbic acid - A2003
Vibrations and their Indication in Sport-Injuries
U G Randoll, F F HennigThis paper discusses the cell-biological basis of bodily function, which is relevant for understanding sports injuries. The authors emphasize that all cells in the body are embedded in the extracellular matrix, a fluid-…
Therapy / Vibrations