Exploring the Connection Between Hormones and Fascia: What You Need to Know

Fascia is a fluid-filled connective tissue matrix that envelops blood vessels, nerves, muscles, and organs, situated within the lymphatic system. It is vital for transmitting force, aiding movement, providing stability, enhancing proprioception (your body's sense of position), and allowing smooth sliding to reduce friction during movement. Fascia is widely recognized for its active role in tissue maintenance and regeneration, being rich in nerves, proprioceptive receptors, blood vessels, and lymphatic vessels. Essentially, it serves as a crucial part of your body's drainage system and sensory network.

Healthy fascia is crucial for proper joint mobility, movement, and muscle performance. Like hair, skin, and nails, fascia is living tissue and is replaced every two years. Unhealthy fascia can lead to stiffness, myofascial pain syndromes, disease, and chronic debilitation. In the past, there has been limited research on the role of fascia and its impact on health and disease. A few years ago, scientists claimed to have discovered it and named it the "interstitium". We realized they were referring to fascia. Historically, most research was conducted on males, so the connection with hormones was not studied until recently. The health of fascia is influenced by various factors, including estrogen levels.

Within the fascia at the cellular level are fibroblasts and fasciacytes. Fibroblasts have estrogen receptors, and when estrogen levels are elevated, they produce type III collagen, known for its elasticity and extensibility. Conversely, when estrogen levels are low, fibroblasts generate an excess of type I collagen, which forms the dense, stiff fascia that bridges a wound (similar to scar tissue). Additionally, fasciacytes produce hyaluron, a substance that aids in the sliding and gliding of fibers. When stimulated, fasciacytes increase hyaluron production to enhance the hydration of fascial tissues. In summary, estrogen provides a protective effect on fascia.

Twice a month, during their childbearing years, menstruating women experience peaks in estrogen levels. The first peak occurs around days 10-14 during ovulation, and the second happens around days 20-24 just before menstruation. At these times, increased flexibility and joint hypermobility can occur, raising the risk of injury or exceeding the normal joint range of motion. Women are particularly susceptible to ligament tears, such as the ACL in the knee, during these periods. Therefore, it is advisable to avoid end-range movements and lifting heavier weights, as this is not the ideal time to aim for a personal record (PR) or repetition maximum (RM). Additionally, stiffness and myofascial pain may develop just before menstruation when the fascia becomes less flexible. Conversely, as estrogen levels decline starting in a woman's 40s, fascia stiffens, affecting flexibility, mobility, and muscle strength, which is common during perimenopause and menopause (defined as the absence of menstruation for over a year). This contributes to common musculoskeletal symptoms of menopause like frozen shoulder, plantar fasciitis, knee pain, thumb pain, pelvic pain and other ailments. Men typically face this issue throughout most of their lives due to naturally low estrogen levels.

How can fascial stiffness be managed? Recent studies indicate that fascia rolling can help the body adjust to hormonal changes by promoting hyaluron production to improve tissue glide and increasing type III collagen to enhance tissue flexibility. Fascial release is especially beneficial for chronic issues like back pain, hip pain, pelvic pain, and general stiffness. In our clinic, we utilize our hands and various tools, such as soft, pliable balls, and we will teach you how to do the same to ensure the long-term health of your fascia, enhancing joint mobility, muscle flexibility, and overall strength. Contact us at (330)528-0034 to speak with one of our expert physical therapists and begin your journey to lifelong healthy fascia.

Sources:

Stecco, C, Fede, C; Macchi, V et al. The Fasciacytes: A New Cell Devoted to Fascial Gliding Regulation. Clinical Anatomy. 2018.

Miller, Jill. The Roll Model: A Step-by-Step Guide to Erase Pain, Improve Mobility, and Live Better in Your Body. Victory Belt Publishing Inc.; 2014.

written by Janine Laughlin - August 2024