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++2020
The Structure and Role of Intramuscular Connective Tissue in Muscle Function
Peter P PurslowThis narrative review analyzes the microscopic structure of intramuscular connective tissue—endomysium, perimysium, and epimysium—and its role in muscle function. Rather than acting simply as a container, this connectiv…
extracellular matrixMusclecollagenmechanotransductionperimysium - A++2019
Rehabilitation and nutrition protocols for optimising return to play from traditional ACL reconstruction in elite rugby union players: A case study
Gregory Shaw, Ben Serpell, Keith BaarThis case report followed two professional rugby players undergoing rehabilitation after an anterior cruciate ligament (ACL) reconstruction. In addition to a standard rehabilitation program, they received specific suppl…
collagenRehabilitationnutritionACL - A++2019
Mechanics and structural stability of the collagen triple helix
Michael W H Kirkness, Kathrin Lehmann, Nancy R FordeThis narrative review explores the mechanical properties of collagen, the body's primary structural protein. Collagen's unique triple helix structure is believed to be the source of its stability and resilience in tissu…
collagentriple helix - A2019
Oral Collagen Supplementation: A Systematic Review of Dermatological Applications
Franchesca D Choi, Calvin T Sung, Margit L W Juhasz, Natasha Atanaskova MesinkovskThis systematic review examined eleven clinical trials investigating the impact of oral collagen supplements on skin health. The findings suggest that collagen hydrolysates and peptides may improve skin elasticity, hydr…
wound healingcollagenskin aging - A+2019
Collagen changes in pelvic support tissues in women with pelvic organ prolapse
Runqi Gong, Zhijun XiaThis narrative review summarizes research on how changes in collagen are linked to pelvic organ prolapse in women. Collagen is a critical component of the pelvic floor, providing essential supportive functions. Studies…
extracellular matrixcollagenBiomechanicsPelvic organ prolapseSignaling pathways - A++2019
Effects of season long participation on ACL volume in female intercollegiate soccer athletes
Karen M Myrick, Andreas Voss, Richard S Feinn, Thomas Martin, Bernadette M Mele, Juan C GarbalosaThis study investigated how a competitive season affects the anterior cruciate ligament (ACL) in female collegiate soccer players. Researchers used MRI scans to measure ACL volume in 17 athletes before and after their s…
collagenAnterior cruciate ligamentintense physical trainingvolumetric changes in ligamentpre- to post season changes in ligament - A+++2018
Improvement of Functional Ankle Properties Following Supplementation with Specific Collagen Peptides in Athletes with Chronic Ankle Instability
Patrick Dressler, Dominic Gehring, Denise Zdzieblik, Steffen Oesser, Albert Gollhofer, Daniel KönigThis randomized, placebo-controlled study investigated the effect of specific collagen peptides on athletes with chronic ankle instability (CAI). Fifty athletes received either a daily collagen supplement or a placebo f…
collagennutritionAnkle sprainligaments - A+++2018
Effects of Plantar Vibration on Bone and Deep Fascia in a Rat Hindlimb Unloading Model of Disuse
Yunfei Huang, Yubo Fan, Michele Salanova, Xiao Yang, Lianwen Sun, Dieter BlottnerThis animal study investigated how disuse affects deep fascia and bone, and whether vibration could counteract these effects. Researchers used a rat model where hindlimbs were unloaded for 21 days to simulate disuse, wh…
extracellular matrixcollagenBonedeep fasciaBiomechanics - B2017
Mechanical properties of a collagen fibril under simulated degradation
David C Malaspinaa, Igal Szleifera, Yasin DhaheraThis study used computer simulations to investigate how collagen fibrils lose their strength. Researchers modeled three different types of degradation: the removal of cross-links, surface damage, and damage throughout t…
collagenMolecular dynamicsDegradationMMP - B2016
Matrix metalloproteinases (MMPs), the main extracellular matrix (ECM) enzymes in collagen degradation, as a target for anticancer drugs
Agata Jabłońska-Trypuć, Marzena Matejczyk, Stanisław RosochackiThis review article describes matrix metalloproteinases (MMPs), the primary enzymes responsible for breaking down collagen in the extracellular matrix. This breakdown process is normal and necessary for tissue remodelin…
cancercollagenAngiogenesisapoptosismetalloproteinase - B2016
Stretch-induced network reconfiguration of collagen fibres in the human facet capsular ligament
Sijia Zhang, Danielle S Bassett, Beth A WinkelsteinThe facet capsular ligament in the neck is a common source of chronic pain, often resulting from excessive stretching. This study investigated how the collagen fibers within this ligament reorganize when it is stretched…
collagenfibre realignmentfacet capsular ligamentcommunity detectiontime-dependent network - A+2015
Osmotic pressure induced tensile forces in tendon collagen
Admir Masic, Luca Bertinetti, Roman Schuetz, Shu-Wei Chang, Till Hartmut Metzger, Markus J Buehler, Peter FratzlResearchers investigated the role of water in tendon collagen using a combination of experiments and computer modeling. They found that water is a crucial part of the collagen molecule's structure. When water is removed…
collagenOsmotic pressurewater - A++2014
The role of collagen crosslinks in ageing and diabetes - the good, the bad, and the ugly
Jess G Snedeker, Alfonso GautieriThis narrative review explores how glucose in the body can bind to proteins like collagen, a process called glycation. This process creates crosslinks that can change the mechanical properties and function of connective…
collagenCrosslinksageingadvanced glycation endproductstendon mechanics - 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 - A+2012
The effect of menopause on the skin and other connective tissues
J Calleja-Agius, M BrincatThis narrative review examines how menopause and the resulting decline in estrogen affect the body's connective tissues, particularly the skin. Research suggests that skin collagen levels drop significantly following me…
collagenageingskin tissuemenopauseoestrogen - B2011
Fascia Research from a Clinician/Scientist’s Perspective
Thomas W FindleyIn this perspective piece, a clinician-scientist summarizes exciting areas in fascia research. The article describes the fascial network as a body-wide system that connects individual cells and shares loads with muscles…
fasciaTensegritycollagenfibroblastconference - A2011
Exercise training reduces fibrosis and matrix metalloproteinase dysregulation in the aging rat heart
Hyo-Bum Kwak, Jong-hee Kim, Kumar Joshi, Alvin Yeh, Daniel A Martinez, John M LawlerIn this animal study, researchers investigated how exercise affects age-related fibrosis (scarring) in the rat heart. They found that aging was associated with an increase in collagen and a dysregulation of enzymes call…
collagenRemodelingTIMP-1 - 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 - C2010
A new lock-step mechanism of matrix remodelling based on subcellular contractile events
Lysianne Follonier Castella, Lara Buscemi, Charles Godbout, Jean-Jacques Meister, Boris HinzMyofibroblasts are cells that contribute to tissue contracture in fibrotic conditions like scarring. This study investigated how these cells contract to remodel tissue. The researchers identified two separate contractio…
fibrosiscollagenMyofibroblastCalcium oscillationsRho kinase - A2010
3D reconstruction of the crural and thoracolumbar fasciae
L Benetazzo, A Bizzego, R De Caro, G Frigo, D Guidolin, Carla SteccoResearchers created detailed 3D computer models to visualize the structure of the crural fascia in the lower leg and the superficial layer of the thoracolumbar fascia in the lower back. They found the crural fascia is c…
Connective tissuecollagenThoracolumbar fasciacrural fascia3D models - B2010
Mechanical Strain Stabilizes Reconstituted Collagen Fibrils against Enzymatic Degradation by Mammalian Collagenase Matrix Metalloproteinase 8 (MMP-8)
Brendan P Flynn, Amit P Bhole, Nima Saeidi, Melody Liles, Charles A DiMarzio, Jeffrey W RubertiThis laboratory study investigated how mechanical tension affects collagen's resistance to breakdown. Researchers created small networks of type I collagen fibers, gently stretching some while leaving others unloaded. B…
collagenstrainCollagenase - A2009
Relevance of Collagen Piezoelectricity to “Wolff’s Law”: a Critical Review
Andrew C Ahn, Alan J GrodzinskyThis narrative review explores how bone adapts to mechanical stress, a principle known as Wolff's Law. For decades, scientists have investigated how bone cells sense this stress to trigger remodeling. An early theory pr…
fasciacollagenpiezoelectricwolff's law - A2008
Differential effects of hyaluronan and its fragments on fibroblasts: Relation to wound healing
Maha David-Raoudi, Frederic Tranchepain, Brigitte Deschrevel, Jean-Claude Vincent, Patrick Bogdanowicz, Karim Boumedien…This lab study investigated how hyaluronan (HA) of different molecular sizes affects human fibroblast cells, which are key to wound healing. Researchers exposed fibroblasts to native HA and two smaller fragments. All th…
hyaluronanfasciawound healingextracellular matrixfibrosis - 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 - 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 - C2002
Age-related Changes in the Collagen Network and Toughness of Bone
X Wang, X Shen, X Li, C Mauli AgrawalThis study investigated how the collagen network in bone tissue changes with age and how this affects bone toughness. Researchers analyzed 30 femurs from human cadavers, with donors ranging from 19 to 89 years of age. T…
collagenAgingBoneToughnessDenaturation - A2001
Mechanical signaling through connective tissue: a mechanism for the therapeutic effect of acupuncture
Helene M Langevin, David L Churchill, Marilyn J CipollaThis paper proposes a hypothesis for how acupuncture might work. The authors focus on the "de qi" sensation, which includes the acupuncturist feeling a "needle grasp" in the tissue. They suggest that when an acupuncture…
collagenmechanotransductionmeridian - C2001
Collagen accumulation in muscles of children with cerebral palsy and correlation with severity of spasticity
Booth, Cortina-Borja, TheologisThis study investigated the link between connective tissue and muscle function in children with cerebral palsy (CP). Researchers analyzed muscle samples from 26 children, comparing collagen content to clinical measures…
Cerebral palsycollagenspasticity - A1993
Angiogenic oligosaccharides of hyaluronan enhance the production of collagens by endothelial cells
P Rooney, M Wang, P Kumar, S KumarThis study investigated how small fragments of hyaluronan (HA) affect collagen production during the formation of new blood vessels, a process called angiogenesis. Researchers observed that applying these HA fragments t…
hyaluronancollagenAngiogenesis - A1979
THE INFLUENCE OF MECHANICAL FORCES ON THE GLYCOSAMINOGLYCAN CONTENT OF THE RABBIT FLEXOR DIGITORUM PROFUNDUS TENDON
GERALD C GILLARD, HELEN C REILLY, PAUL G BELL-BOOTH, MICHAEL H FLINTIn this animal study on rabbits, researchers surgically altered the mechanical forces on a deep finger flexor tendon to observe how the tissue adapted. They analyzed how the content of glycosaminoglycans (GAGs)—molecule…
collagenLoadingECMGAGdeep digital flexor tendon