Fascia is a connective tissue in the body that has been historically disregarded as insignificant; however, more recent popularity has brought this tissue back to life. Fascia’s role in the body is fundamental, acting as a three-dimensional continuum of connective tissue to adhere your other systems together. You may think such an integral part of the body is intrinsically complex in order to hold everything together, although you may be surprised at how simple this system is. In this review, you will gain an understanding of what comprises fascia as well as the various roles it plays in the body. Gaining a complete understanding of the roles the fascial network performs will give you more insight into how and why your body moves and feels the way it does. This network of communication can be simple when the body flows in clear coordination; however, the lack of transmission will create immobility and pain.
A consistent theme to define fascia should be established for consistency within resources; albeit, the English version of Henry Gray’s historical anatomy text will be used for the definition. Fascia is a connective tissue formed of collagen fibers that are irregularly arranged, unlike in other connective tissues like tendons. This irregular arrangement of fibers provides a universal resistance to tensional forces and has a role in packing tissue. Therefore, fascia, with its irregular weaves of collagenous fibers, is designed to withstand stress in multiple planes of direction.
The fascial system is classified into a generalized system consisting of four fundamental types layered throughout the body. The most superficial layer is termed the pannicular fascia, which surrounds the body; this layer is subdivided into three parts, including two adipose layers with a fascial layer between them. Deep to the superficial fascia is the investing fascia, which surrounds the musculoskeletal system. It is subdivided into appendicular fascia (surrounding the extremities) and axial fascia (surrounding the muscles of the trunk or torso) depending on location. This layer is denser and thicker than its superficial relative and is devoid of adipose. The third type is the meningeal fascia, which integrates into the central nervous system. The fourth is visceral or splanchnic fascia, investing the body cavities and the organs contained within.
After gaining a conceptual understanding of how fascia is formed and the subtypes of the tissue, we can start to unravel more facets of its function. The functional importance of fascia can be broken into four overarching categories: shape, movement, supply, and communication. Additionally, recent research reveals a new understanding of how fascia is an active organ that is crucial for proprioception and its link to mental health (Fascial Fitness book). As we explore each category in more depth, the true complexity of fascia becomes clearer, demonstrating how this connective tissue influences not just structure, but also perception, performance, and overall well-being.
The shape of fascia is integral for encasing and providing support to structures; it is a continuous, tension-bearing network transmitting force and storing elastic energy. The fiber orientation, layered architecture, and connectedness determine the mechanical efficiency of movement. When this network becomes altered in alignment due to injury, chronic tension, or inflammation, fascia loses efficiency in its ability to transfer tension, which can lead to pain, stiffness, and altered movement. Within fascial tissues, collagen is aligned with the primary force vectors of adjacent muscles, enabling efficient load resistance and tension distribution during motion (Yahia et al., 1993). Fascia layers itself, each with a distinct fiber orientation, allowing accommodation of multidirectional strain and interlayer sliding. This three-dimensional layering supports complex joint and muscle dynamics and mechanical continuity between muscle compartments and across joints (Benjamin, 2009; Huijing, 2012). This geometric configuration allows tissues to glide smoothly, enhances proprioceptive feedback, and coordinates muscle synergy, all of which are essential for postural stability and fluid movement (Stecco et al., 2018). Fascial shape can be compromised through fibrosis, disorganization, or dehydration; therefore, movement efficiency and load transfer decline significantly. Thus, fascial shape is integral to its function.
The transfer of tension plays into the second functional role of fascia, which relates to movement. The importance goes far beyond wrapping the muscles; it acts as an integrative system coordinating mechanical forces, sensory input, and stabilizing processes throughout the body. Research shows that fascial tissue transmits and distributes forces between muscles and joints, enabling efficient load sharing and coordinated motion across kinetic chains (Huijing, 2009; Krause et al., 2016; Wilke et al., 2018). Its elastic collagen structure stores and releases energy, enhancing propulsion while reducing muscular effort during dynamic movements. Additionally, fascia is richly innervated with mechanoreceptors, so it serves a role in proprioception, providing the nervous system with constant feedback on body position, movement, and tension (Kopeinig et al., 2015; Langevin, 2021). Impairment of fascia leads to stiffness, poor coordination, and pain, and this lack of mobility is restricted by inflammation, injury, or fibrosis (accumulated fibrous connective tissue). Thus, the mobility of fascia plays a vital role in biomechanical efficiency and neurosensory regulation and whole-body stability (Stecco et al., 2011).
The vascular supply in fascial tissue plays several functional roles in movement, physiology, healing, and homeostasis, supporting the understanding that fascia is not merely a passive connective tissue. It contains an intricate network of arterioles, venules, and capillaries that deliver oxygen and nutrients to fibroblasts, myofibroblasts, and extracellular components, allowing metabolic homeostasis and tissue adaptability throughout movement (Benjamin, 2009; Stecco et al., 2023). Alongside the vascularization runs the lymphatic system; thus, fascia supports lymphatic drainage, facilitating interstitial fluid regulation and sustaining hydrated extracellular matrix conditions for effective sliding and elasticity (Bordoni & Bordoni, 2020). Additionally, as a result of the vast network of arterio-venous anastomoses, fascia contributes to thermoregulation; however, this appears to have a more localized presence affecting site-specific mechanical performance and tissue compliance (Galli et al., 2023). The vascular system is accompanied by autonomic and sensory nerve fibers forming neurovascular bundles that integrate metabolic signaling with proprioceptive and nociceptive feedback (Bordoni et al., 2018). The integrated circulatory system plays a pivotal role in delivering nutrients; adequate perfusion supports fascial repair following microtrauma by ensuring the supply of growth factors and immune cells required for collagen remodeling (Stecco et al., 2018). Conversely, hypoperfusion or compromised vascularity may lead to fibrosis, reduced gliding efficiency, and impaired force transmission. This reduction in flow compromises movement coordination and postural control globally (Bordoni & Varacallo, 2023). Therefore, the supply chain in fascia is not merely supportive but functionally fundamental to its dynamic role as a metabolically active tissue supporting movement and systemic health.
A common theme throughout the previous topics is how the different systems interact and work together through communication. Fascial communication refers to the complex interplay of mechanical, biochemical, neural, and cellular signaling that enables fascia to function. Through mechanotransduction, fibroblasts and myofibroblasts embedded in the extracellular matrix sense tension, compression, and shear; these mechanical stimuli are translated into biochemical responses that regulate collagen synthesis, matrix remodeling, and tissue stiffness (Langevin & Huijing, 2009; Schleip et al., 2019). This transduction process ensures fascia adapts to dynamic loading changes, aiding in the maintenance of mechanical continuity throughout the body. Alongside mechanotransduction, communication also occurs through intercellular junctions—gap junctions composed of connexin-43 (Cx43) proteins and adherens junctions involving N-cadherin—which permit ionic and molecular exchanges between fibroblasts during inflammation, wound repair, and remodeling (Loparic et al., 2023). These communication modalities allow long-range mechanical signaling, meaning localized strain is transmitted through collagen and elastin fibers to distant sites, coordinating tension and movement across muscular chains (Huijing, 2012; Wilke et al., 2018). This network extends and integrates into the neurofascial interface, where sensory afferents and autonomic fibers embedded within the fascia transmit proprioceptive, nociceptive, and viscerosensory input into the central nervous system (Stecco et al., 2018). Communication occurs at the biochemical level as well; fascial cells secrete cytokines, growth factors, and extracellular matrix proteins that act in a paracrine fashion, orchestrating tissue repair, angiogenesis, and immune modulation (Bordoni & Bordoni, 2020). Lastly, integration of mechanical and biochemical signaling creates a mechanobiological hub in the fascia. This hub acts as a reservoir of progenitor and stem cells that is influenced by local mechanical and biochemical signaling, supporting site-specific regeneration and remodeling following injury (Bordoni et al., 2023). Collectively, these communication methods overlap and synergize, allowing fascia to regulate itself and cross-talk with other systems, linking structure, function, and healing across the entire body.
To help with the understanding of fascia, it is important to acknowledge the biological and biochemical underpinnings. In this section, we will dive into the cellular components and extracellular matrix within and surrounding fascial tissue. The primary cellular components include fibroblasts, myofibroblasts, and fasciacytes, as well as pericytes, adipocytes, and immune cells. Fibroblasts synthesize and maintain the extracellular matrix. Myofibroblasts contribute to contractile behavior in fascia, helping regulate basal tension. Fasciacytes, more recently identified, produce hyaluronic acid, supporting the gliding properties of fascial layers. Pericytes wrap around blood vessels, maintaining flow; adipocytes store energy and provide insulation; immune cells regulate inflammatory responses.
Transitioning outside the cells, the extracellular matrix includes fibrous proteins, ground substances, and linking proteins and enzymes. Collagen types I and III provide tensile strength and structural integrity. Elastic fibers composed of elastin and fibrillin provide elasticity and resilience. Fibronectin, laminins, and glycoproteins contribute to adhesion, cell binding, and matrix organization. The ground substance is gel-like, composed of glycosaminoglycans, hyaluronic acid, and proteoglycans; these attract water, giving the matrix its hydrated, viscous characteristics and enabling fascial layers to glide. Linking molecules include fibronectin, which aids in scaffolding and binds cells via integrins, and lysyl oxidase, which catalyzes cross-linking of collagen and elastin, influencing tissue stiffness. Water is vital for mechanical behavior, influencing the ground substances that mediate sliding and viscoelastic responses.
Knowledge of the makeup of fascia is not sufficient for understanding why fascia functions the way it does. There are underlying mechanisms and stability factors that give fascia the properties that make this system fascinating. The structural properties—collagen and elastin—provide elasticity and strength, enabling fascia to stretch and recoil after deformation. Hydrated ground substances reduce friction and support efficient movement between layers. Maintaining healthy cell types is essential for remodeling and maintaining the extracellular matrix in response to mechanical stress. This remodeling allows fascia to adapt over time; however, each component must be cared for so that no process becomes rate-limiting.
The fascial system is highly innervated by the nervous system; it is a sensory-rich organ constantly communicating mechanically and chemically with neurons. Fascia supports proprioception, motor control, nociception, and systemic regulation. Studies of fascial histology and immunohistochemistry show multiple mechanoreceptor types embedded in fascia as well as abundant free nerve endings that mediate low-threshold mechanical sensation and nociception. There are differences in receptor densities between layers; for example, the thoracolumbar fascia is especially enriched and implicated in low back proprioceptive and nociceptive signaling (Suárez-Rodríguez et al., 2022; Fede et al., 2022; Mense, 2019). Receptors transduce signaling from tissue stretch, shear, and pressure into afferent firing, which projects into dorsal horn neurons and ascends to somatosensory cortices and integrative centers that shape body schema and motor planning (Langevin, 2021; Slater et al., 2024).
Diving further into neural pathways, receptor firing enters afferent neurons mediated by different pathways—A-beta for low-threshold mechanosensation and A-delta and C fibers for nociception and polymodal signals. These fibers have different levels of myelination, determining conduction velocity. Signals travel to the dorsal horn laminae in the spine, which can be sensitized by nociceptive input from the fascia; in short, the more you feel pain, the easier it is to continue feeling pain. Signals then travel to the brain—somatosensory cortex, insula, anterior cingulate, thalamus, and motor cortices—shaping unconscious representations of position, posture, spatial properties, interoception, and motor programs. Clinical work links altered fascial input with changes in neural networks in chronic pain (Langevin, 2021; Slater et al., 2024). Fascia also houses sympathetic fibers and neuropeptide-containing afferents, including CGRP and substance P, enabling neurovascular and neuroimmune communication. Neural activity can change local blood flow, immune cell recruitment, and extracellular matrix remodeling (Mense, 2019; Slater et al., 2024). Mechanically induced signaling from fascia drives mechanotransduction in fibroblasts and myofibroblasts, altering extracellular matrix composition and modifying sensory input over time. This feed-forward loop links tissue mechanics to altered proprioception and, under chronic perturbation, to central sensitization and persistent pain (Pirri et al., 2023; Langevin, 2021). Because fascial afferent input contributes to the CNS’s representation of body position and tension, changes in fascial state—densification, fibrosis, adhesions, or altered hydration—can degrade proprioceptive accuracy and motor control, leading to biased descending modulation and reweighted sensorimotor maps. These have implications for motor learning, balance, chronic pain syndromes, and rehabilitation strategies (Suárez-Rodríguez et al., 2022; Fede et al., 2022; Slater et al., 2024). Fascia communicates through a dense array of mechanosensitive and nociceptive pathways plus autonomic links, forming an integrated neuro-mechanical organ that informs and is shaped by the CNS.
Fascia responds differently to training than muscles or cardiovascular tissue because of slow remodeling processes and adaptation to mechanical tension based on variability. Training fascia improves glide, elasticity, hydration, proprioception, and collagen organization. To enhance fascia health, hydration and hyaluronan health must be restored; movement, heat, and slow compression shear this gel-like substance, reducing viscosity and restoring lubrication. This can be trained through slow dynamic stretching, mobility sequences, heat with movement, and hydration with electrolytes. Mechanical loading is needed to remodel collagen, transitioning stiffness into elasticity; collagen realigns in response to tensile loading, not heavy reps, because fibroblasts sense stretch and remodel the extracellular matrix over weeks to months. Training methods include long, slow loaded stretching, eccentric training, and isometrics at long muscle lengths. Multi-planar movement is essential because fascia adapts to varied vectors; training includes rotational patterns, lateral movements, diagonal slings, loaded carries, and flow-based movement.
Elastic recoil training should integrate the fascial spring system through low-amplitude rhythmic bouncing drills, slow-to-moderate plyometrics, fascial elasticity work, and movements like skipping or jump rope. Neuromyofascial proprioceptive training enhances coordination, spinal modulation, and reflexive stability with balance work, unstable surfaces, precision control drills, and slow mindful transitions. Because fascia interacts with the autonomic nervous system, regulating the ANS reduces pain perception, restores pliability, and enhances recovery. For recovery, shear and glide restoration through manual or self-myofascial techniques affects fibroblast shape, reducing fascial stiffness; pressure temporarily breaks down cross-links, improving glide. Tools include foam rollers (1–2 minutes per region), skin rolling, cupping, and other myofascial release techniques. These interventions restore sliding surfaces, reduce neural tension, interrupt nociceptive signaling, and calm the nervous system.
If there is one thing this deep dive can make crystal clear, it is that fascia is not just some wrapping around the muscle. It is a living, intelligent, shape-shifting network that holds your entire body together on every level, with that being structural, chemical, and neurological. Understanding fascia will allow you to understand the human body in a completely different way. This tissue responds to pressure, load, movement, temperature, and even hydration habits. Its collagen fibers, elastin, hyaluronan, fibroblasts, and fasciacytes are constantly remodeling based on how you move and how you take care of your body. When you move well, fascia glides. When you do not, it gums up, stiffens, and starts sending louder warning signals.
Here is the part most people never hear about: fascia does not simply support movement; rather, it actually communicates with your nervous system. It is packed with mechanoreceptors, proprioceptors, and nociceptors that create an ongoing conversation with your brain about tension, body position, risk, and safety. When fascia becomes irritated or restricted, those nociceptive signals can sensitize the dorsal horn in the spinal cord. That means your nervous system becomes easier to trigger and more reactive. Pain becomes easier to feel, and if this continues long enough, the body starts operating in what feels like a “pain memory state.” This is why chronic pain is so persistent: it is literally reinforced by the communication loops built into the fascial and neural networks.
The good news is that fascia is highly trainable. In fact, the constantly remodeling nature of fascia makes it thrive on the right type of stimulus. Movement, loading, stretching, shear-based mobilization, breathwork, and hydration all help maintain fluid hyaluronan, aligned collagen, and responsive fibroblasts. When you train fascia intentionally, you do more than become flexible. You can reduce pain, improve proprioceptive awareness, support nervous system regulation, and help your muscles glide and contract more efficiently. Many people even feel and see changes in skin tone because healthy fascia supports hydration and tissue tension across the entire system.
The real takeaway is that fascia is the body’s hidden operating system. It connects everything. It communicates everything. It adapts to everything you do or do not do. Supporting fascial health is essential if you want a body that moves with power and precision. Continuous support to the tissue will help you feel better longer, aiding in aging gracefully. The more we understand fascia, the more we understand our movement, our pain, and our potential. Caring for fascia is not just about another fitness trend; fascial wellness is a foundational principle for real performance and long-term well-being.
References
Benjamin, M. (2009). The fascia of the limbs and back: A review. Journal of Anatomy, 214(1), 1–18. https://doi.org/10.1111/j.1469-7580.2008.01011.x
Bordoni, B., & Bordoni, G. (2020). The fascial system and exercise intolerance in patients with chronic heart failure: Hypothesis of an anatomical continuity. Cureus, 12(5), e8118. https://doi.org/10.7759/cureus.8118
Bordoni, B., Varacallo, M. (2023). Anatomy, fascia. In StatPearls. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK532937/
Bordoni, B., Zanier, E., & Lintonbon, D. (2018). The continuity of the body: Hypothesis of a proprioceptive role for the fascial system. Cureus, 10(10), e3491. https://doi.org/10.7759/cureus.3491
Bordoni, B., Varacallo, M., & Lintonbon, D. (2023). Fascia as a mechanobiological hub: The emerging role of stem cells in fascial regeneration. International Journal of Molecular Sciences, 26(20), 10166. https://doi.org/10.3390/ijms262010166
Caldeira, P., Souza, R. R., Piratello, A. C., Biazon, T. M., Fonseca, M. C. R., & Filho, W. R. (2022). Fascia and movement: The role of myofascial force transmission and proprioception in human motion. Frontiers in Physiology, 13, 856142. https://doi.org/10.3389/fphys.2022.856142
Fede, C., Porzionato, A., Lia, A., Macchi, V., De Caro, R., & Stecco, C. (2022). Innervation of human superficial fascia: Anatomical, immunohistochemical and functional considerations. Frontiers in Neuroanatomy, 16, 981426. https://doi.org/10.3389/fnana.2022.981426
Galli, M., Panariello, U., & Stecco, C. (2023). Vascular and neural networks of the superficial fascia: Morphological and functional considerations. International Journal of Molecular Sciences, 26(3), 1289. https://doi.org/10.3390/ijms26031289
Huijing, P. A. (2012). Epimuscular myofascial force transmission: A historical review and implications for new research. Journal of Biomechanics, 45(1), 23–32. https://doi.org/10.1016/j.jbiomech.2011.09.027
Langevin, H. M. (2021). Fascia mobility, proprioception, and myofascial pain. Life, 11(7), 668. https://doi.org/10.3390/life11070668
Langevin, H. M., & Huijing, P. A. (2009). Communicating about fascia: History, pitfalls, and opportunities. Journal of Bodywork and Movement Therapies, 13(2), 144–146. https://doi.org/10.1016/j.jbmt.2008.10.003
Loparic, M., Lee, S., & Sinha, S. (2023). Gap-junction communication and collective fibroblast behavior during fascia repair. Burns & Trauma, 12(1), tkaf002. https://doi.org/10.1093/burnst/tkaf002
Mense, S. (2019). Innervation of the thoracolumbar fascia: A review. BioMed Research International, 2019, Article 6325954. https://doi.org/10.1155/2019/6325954
Pirri, C., Stecco, A., Raghavan, P., et al. (2023). Mechanobiological remodeling within deep fascia: Fibroblast responsiveness. Journal of Anatomy. Advance online publication. https://pubmed.ncbi.nlm.nih.gov/37895068/
Schleip, R., Findley, T. W., Chaitow, L., & Huijing, P. A. (Eds.). (2019). Fascia: The tensional network of the human body (2nd ed.). Elsevier.
Schleip, R., & Bayer, J. (2021). Fascial fitness: Practical exercises to stay flexible, active and pain free in just 20 minutes a week (2nd ed.). North Atlantic Books. https://doi.org/10.1623176747
Sinhorim, L., Torres, I. L., Santos, D. S., & Furlanetto, T. C. (2021). Potential nociceptive role of the thoracolumbar fascia: A scoping review. Pain & Rehabilitation Studies [Preprint]. https://doi.org/10.31219/osf.io
Slater, A. M., O’Connell, N. E., & Wand, B. M. (2024). Fascia as a regulatory system in health and disease: A comprehensive review. International Journal of Molecular Sciences, 25(3), Article 11346343. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11346343/
Stecco, C., Pirri, C., & Schleip, R. (2018). Fascial entrapment neuropathies: The role of fascia in soft tissue pain. Frontiers in Physiology, 9, 1008. https://doi.org/10.3389/fphys.2018.01008
Stecco, C., Schleip, R., Hill, R., & Pirri, C. (2021). Functional anatomy of the deep fascia and its role in musculoskeletal dynamics. Journal of Bodywork and Movement Therapies, 26, 233–242. https://doi.org/10.1016/j.jbmt.2020.10.017
Suárez-Rodríguez, V., Valera-Calero, J. A., & Fernández-de-Las-Peñas, C. (2022). Fascial innervation: A systematic review of the literature. International Journal of Molecular Sciences, 23(10), 5674. https://doi.org/10.3390/ijms23105674
Wilke, J., Krause, F., Vogt, L., & Banzer, W. (2018). What is evidence-based about myofascial chains? A systematic review. Archives of Physical Medicine and Rehabilitation, 99(1), 117–129. https://doi.org/10.1016/j.apmr.2017.06.032
Yahia, L. H., Rhalmi, S., Newman, N., & Isler, M. (1993). Viscoelastic properties of the human lumbodorsal fascia. Journal of Biomedical Engineering, 15(5), 425–429. https://doi.org/10.1016/0141-5425(93)90080-7