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
Mechanical stimulation of human dermal fibroblasts regulates pro-inflammatory cytokines: potential insight into soft tissue manual therapies
Aric Anloague, Aaron Mahoney, Oladipupo Ogunbekun, Taylor A Hiland, William R Thompson, Bryan Larsen, M Terry Loghmani,…This lab study investigated how mechanical forces, similar to those in manual therapy, affect human skin cells. Researchers first applied a repetitive strain to cultured dermal fibroblasts to simulate an overuse injury,…
inflammationMyofascial releaseManual Therapyphysical therapyphysiotherapy - A+++2020
The Cranial Bowl in the New Millennium and Sutherland's Legacy for Osteopathic Medicine: Part 2
Bruno Bordoni, Stevan Walkowski, Bruno Ducoux, Filippo TobbiThis narrative review, the second in a series, discusses how modern scientific research challenges some of the original concepts of cranial osteopathy. The authors examine the mechanical characteristics of cranial struc…
fasciaManual TherapyOsteopathiccraniocraniosacral - A2019
Improving the New Definition of Fascial System
Bruno BordoniThis narrative review proposes expanding the definition of the fascial system to include bone tissue. The author argues that bone, a specialized form of connective tissue, shares the same embryological origins as other…
fasciaChiropracticosteopathyManual Therapyfascial system - A2018
A New Concept of Biotensegrity Incorporating Liquid Tissues: Blood and Lymph
Bruno Bordoni, Fabiola Marelli, Bruno Morabito, Roberto CastagnaThis conceptual article proposes an update to the biotensegrity model, which traditionally focuses on the solid structures of the fascial system. The authors argue that "liquid tissues" like blood and lymph should also…
fasciaChiropracticManual TherapyMyofascialOsteopathic - 1A+2018
Equine Manual Therapies in Sport Horse Practice
Kevin K HausslerManual therapies can provide diagnostic and therapeutic approaches for assessing and managing neuromuscular coordination and strength in sport horses. This review describes various techniques, including active and passi…
osteopathyManual Therapyproprioceptionmassage therapyNeuromuscular control - 1A+++2018
Emission of Biophotons and Adjustable Sounds by the Fascial System: Review and Reflections for Manual Therapy
Bruno Bordoni, F Marelli, B Morabito, B SacconiIn this narrative review, the authors explore how fascia, the web of connective tissue enveloping everything in the body, might communicate. They discuss research suggesting the fascial system may emit faint light parti…
fasciaMuscleManual TherapyMyofascialOsteopathic - 1A+2018
Effect of Stretching on Thoracolumbar Fascia Injury and Movement Restriction in a Porcine Model
H M Langevin, J Bishop, R Maple, G J Badger, J R FoxIn this animal study on pigs, researchers investigated the effect of stretching on the thoracolumbar fascia after injury and movement restriction. An injury combined with restricted movement led to reduced fascial mobil…
fasciaConnective tissueStretchingManual TherapyMovement Therapy - A2018
A fundamental critique of the fascial distortion model and its application in clinical practice
Christoph ThalhamerThis narrative review critiques the Fascial Distortion Model (FDM), a manual therapy approach based on the idea that all musculoskeletal complaints stem from distortions of fascia. The author investigated the scientific…
Manual Therapyfasciaefascial distortion modelreductionismtypaldos - A2018
Meaning of the Solid and Liquid Fascia to Reconsider the Model of Biotensegrity
Bruno Bordoni, David Lintonbon, Bruno MorabitoThis theoretical article proposes a reconsideration of the traditional biotensegrity model. The authors argue that fascia should be viewed as a system with both solid and liquid components, where blood and lymph constit…
fasciaChiropracticManual TherapyMyofascialOsteopathic - 1A+2017
Emotions in Motion: Myofascial Interoception
B Bordoni, F MarelliIn this perspective piece, the authors argue that the myofascial system is closely linked to our emotional state. They suggest that manual treatment not only affects the body physically but also activates the interocept…
fasciaManual TherapyMyofascialOsteopathicInteroception - A2017
The indeterminable resilience of the fascial system
Bruno Bordoni, Fabiola Marelli, Bruno Morabito, Beatrice SacconiThis commentary proposes a model of fascia not as layers, but as a network of polyhedral microvacuoles of connective tissue. These structures connect the body's systems and can change shape in response to tension, allow…
fasciafibroblastManual TherapyOsteopathicfascial continuum - A++2017
Biological effects of direct and indirect manipulation of the fascial system. Narrative review
Giovanni Parravicini, Andrea BergnaThis narrative review explores the biological effects of manual fascial therapies. While osteopathic manipulative treatment (OMT) is clinically effective, its underlying mechanisms are not fully understood. The authors…
fasciaMyofascial releaseManual TherapyMyofascial manipulation - A+++2016
Manual evaluation of the diaphragm muscle
Bruno Bordoni, F Marelli, B Morabito, B SacconiThe diaphragm is a vital muscle for breathing, but it also plays a key role in posture, organ function, and even emotional states. Despite its importance, there is little scientific literature on how to manually assess…
ChiropracticManual Therapydiaphragmphysiotherapyosteopathic evaluation - A+2015
A unifying neuro-fasciagenic model of somatic dysfunction - Underlying mechanisms and treatment - Part II
Paolo TozziThis review paper proposes a new, unifying "neuro-fasciagenic" model for understanding somatic dysfunction. The author argues for a shift in perspective, moving from a purely neurological explanation to one where fascia…
fasciaManual Therapysomatic dysfunctionfascial dysfunctionfascial mechanisms - A2015
The fascial system and exercise intolerance in patients with chronic heart failure: hypothesis of osteopathic treatment
Bruno Bordoni, F MarelliThis hypothesis paper proposes a connection between the fascial system and exercise intolerance in people with chronic heart failure. The authors note that heart failure is a complex disease affecting the entire body, l…
fasciaManual TherapyOsteopathicfatiguechronic heart failure - A2015
Modeled Osteopathic Manipulative Treatments: A Review of Their in Vitro Effects on Fibroblast Tissue Preparations
Manal Zein-Hammoud, Paul R StandleyThis narrative review summarizes lab-based (in vitro) studies investigating how simulated osteopathic treatments, like myofascial release, affect fibroblasts. The authors found that applying mechanical strain to these c…
fasciaFibroblastsManual TherapyOsteopathic - A2014
Treatment of Medial Tibial Stress Syndrome according to the Fascial Distortion Model: A Prospective Case Control Study
Christoph Schulze, Susanne Finze, Rainer Bader, Andreas LisonThis prospective case-control study investigated the Fascial Distortion Model (FDM) for treating medial tibial stress syndrome (MTSS), or shin splints. Researchers applied targeted manual techniques to the lower leg fas…
Manual Therapyfasciaefascial distortion model - A2014
Deformations Experienced in the Human Skin, Adipose Tissue, and Fascia in Osteopathic Manipulative Medicine
Hans Chaudhry, Bruce Bukiet, Zhiming Ji, Antonio Stecco, Thomas W FindleyThis study used a mathematical model to investigate how forces from manual therapy affect the skin, adipose tissue, and fascia. The researchers aimed to understand how much each layer deforms under compression and shear…
fasciaosteopathyManual Therapy - A++2013
Mathematical Analysis of the Flow of Hyaluronic Acid Around Fascia During Manual Therapy Motions
Max Roman, Hans Chaudhry, Bruce Bukiet, Antonio Stecco,Thomas FindleyThis study used a mathematical model to simulate how different manual therapy techniques affect the flow of hyaluronic acid (HA) within fascia. The researchers compared constant sliding, perpendicular vibration, and tan…
hyaluronanfasciaManual Therapyfluid flowvibration - 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 - B2012
Fascia: a morphological description and classification system based on a literature review
Myroslava Kumka, Jason BonarIn this literature review, the authors address the historical problem of ambiguous and inconsistent terminology for fascia. Based on a review of existing research, they propose a new system for classifying fascia accord…
fasciaConnective tissueManual TherapyterminologyAnatomy - 1A+2012
Stretching of the Back Improves Gait, Mechanical Sensitivity and Connective Tissue Inflammation in a Rodent Model
S M Corey, M A Vizzard, N A Bouffard, G J Badger, H M LangevinIn this rodent study, researchers investigated how stretching affects inflammation in the connective tissue of the low back. They first induced local inflammation, which resulted in altered gait, increased mechanical se…
fasciaConnective tissueStretchingManual TherapyMovement Therapy - 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 - 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 - A2009
Fascia: A missing link in our understanding of the pathology of fibromyalgia
Ginevra L LiptanThis 2009 paper proposes that inflammation in the fascia, the body's connective tissue, could be a key source of the persistent pain signals that lead to central sensitization in fibromyalgia. While muscle tissue itself…
inflammationfasciaConnective tissueMyofascial releaseManual Therapy - A2009
The treatment of Chronic Low Back Pain following the principles of the Fascial Distortion Modell (FDM)
Rainer EngelThis small study investigated the effect of two Fascial Distortion Model (FDM) treatments on 22 people with chronic low back pain. Researchers measured pain, function, flexibility (finger-floor distance), and use of pai…
Manual Therapyfasciaefascial distortion modelreductionismtypaldos - 1A+2008
Tissue Stretch Decreases Soluble TGF-β1 and Type-1 Procollagen in Mouse Subcutaneous Connective Tissue: Evidence From Ex Vivo and In Vivo Models
N A Bouffard, K R Cutroneo, G J Badger, S L White, T R Buttolph, H P Ehrlich, D Stevens-Tuttle, H M LangevinThis study on mice investigated how brief, static stretching affects connective tissue healing after an injury. Researchers used two models: tissue samples cultured outside the body (ex vivo) and live mice with minor su…
fasciaConnective tissueStretchingManual TherapyMovement Therapy - A2008
Three-Dimensional Mathematical Model for Deformation of Human Fasciae in Manual Therapy
Hans Chaudhry, Robert Schleip, Zhiming Ji, Bruce Bukiet, Miriam Maney, Thomas FindleyResearchers developed a mathematical model to calculate the force required to deform human fascia during manual therapy. The model showed that very large forces, beyond the normal physiological range of a therapist, are…
fasciaManual Therapyplantar fasciachiropractic manipulationsoft tissue motion - 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