Stress Stiffens Our Fascia [Connective Tissues] and Impacts on Pain and Mobility

How Adrenaline, Cortisol, and Other Chemicals, Affect the Structure of the Body

“Since psychosocial stress can induce fascial alterations and alter immunity responses, a therapy that ignores stress management might never resolve fascial alterations. The organic effects of stress can be countered through pharmacological, surgical, or other interventions; however, this would not address the initial cause – stress – putting the person at risk of developing other pathologies. Indeed, as long as it detects a threat to its integrity, the organism can ceaselessly continue to elicit the stress response. This reasoning holds for all health conditions and can make us better comprehend what occurs inside, why sometimes nothing seems to relieve [the] pain or condition.”

The above quote is from “Impact of stress, immunity, and signals from endocrine and nervous system on fascia”, one of the articles that we will be considering here, but reading this in the article gave me a dopamine hit, because this so neatly and powerfully summarizes everything that

Lilian Sjøberg

and I have been telling for years.

Introduction

For background on fascia, what it is, and why it matters. see:

Book Review: "Fascia: What it is and Why it Matters" 2nd Edition

I have stated in previous articles on the topic that stress tends to stiffen, and dehydrate, our fascia, or connective tissue, causing movement restrictions, postural issues, and pain. In turn, chronic stress can cause holding patterns and fascia structures to become permanently problematic.

Recently, I found a couple of important articles which describe the mechanisms by which stress stiffens up the fascia. Indeed, this seems to occur through both adrenaline and cortisol release, but these two articles also mention that lots of other hormones and neurotransmitters can impact the fascia.

Here, I am sharing my abridged notes on these two articles, in case anyone else finds them useful. I will also be incorporating this material into our online course for better health and wellbeing, “Emotional Trauma, Fascia, and Breathing”.

Effects of Adrenaline and Cortisol

A New Scientist article “Fascia: The long-overlooked tissue that shapes your health” confirms that stress chemicals can temporarily stiffen the fascia, and chronic stress can create areas of permanently stiffened connective tissue.

“Injury and inflammation aside, there are many other reasons why fascia may become stiff. Schleip’s research hints that activation of the sympathetic nervous system, which is involved in the body’s fight-or-flight response, causes the fascia to contract by prompting the fibroblasts [a type of biological cell that synthesizes the fascia matrix and collagen] within it to transform into myofibroblasts, cells that are part of the inflammatory response to injury, often seen in joint-related problems such as frozen shoulder.“

“The details of how exactly fight-or-flight stress leads to stiffness are still being worked out, but Schleip says that adrenaline seems to increase the expression of an inflammatory substance called TGF-beta. This is then stored in the loose fascia in preparation for the next time the body is stressed. When this happens, fibroblasts ‘drink [TGF-beta] and they become myofibroblasts in a few hours… and then they are four times as strong as before… they are contraction machines So, adrenaline can make fascia stiffer.”

This chemical signature stored in the fascia may therefore be one of the physical mechanisms by which body memories of stressful episodes get written into the body.

Body Memories and Trauma

The more technical article “Impact of stress, immunity, and signals from endocrine and nervous system on fascia” also indicates that cortisol has a detrimental effect on fascia structure.

“The stress response, by virtue of release of glucocorticoids [cortisol] and catecholamines and by modifying the endocrine, neural, and immune responses, can impact the function of the fibroblasts and myofibroblasts that reside throughout the body and more specifically in the fascia, a ubiquitous and multi-functional connective tissue that supports the body”.

Effects of Other Hormones and Neurotransmitters

The hydration or fluidity, stiffness or elasticity, and structure of the fascia is both short term and long term affected by many other hormones, peptides, neurotransmitters, signalling molecules, pH, and immune markers.

For example, there is lore, but it is hard to find the originating source of this information, that dopamine fluidizes the fascia, while serotonin dehydrates it. The dopamine response would certainly match the experiences of folks with a diagnosis of Parkinson’s, dopamine responsive dystonia, Ehlers Danlos syndromes, fibromyalgia etc, that, upon supplementing with dopamine precursors, their stiffness, pain, and rigidity temporarily melts away, only to return once the dose wears off.

Dopamine Deficiency and Ehlers-Danlos Syndrome

Fibromyalgia as a Dopamine Deficiency Condition

The New Scientist article cited above also mentions Oestrogen having a large impact.

“In fact, the list of things that affect fascial stiffness is getting longer all the time…. Oestrogen is able to create a fascia that is more elastic… the fascia is a very dynamic tissue that is able to answer to hormonal input, chemical input and mechanical input. Altogether, that defines if our fascia is elastic or rigid.”

This matches anecdotal evidence that women encounter more fascia related issues, such as frozen shoulder, at the onset of menopause.

More generally, the article on the impacts of stress cited above says it is a two-way feedback:

“… stress response and the consequent nervous, endocrine, and immune activations can modify body structure – myofascial system and bones – and… body structure (e.g., the mechanical characteristics of [fascia]) can influence those same activations”.

Stiffening Under Applied Force or Touch

Fascia also stiffens due to physical stress, blunt force impacts, touch, and strains on the body.

“In-depth knowledge of the connective tissue can also assist in selecting the most appropriate physical loads and forces to be applied to restore the correct collagen structure after a [problem]: different loads induce the production of different types of collagen. Similarly, knowing the mechanisms by which wound healing is affected by health, stress response, inflammation, and manual therapies can be useful for therapists to comprehend which procedures could obtain the best outcome.”

To visualize how quickly the fascia can harden, and even armour the body, recall that fascia behaves in part like a viscoelastic material. Below is a video which demonstrates the hardening of such materials when sudden force is applied.

Below is a fun video showing how vibrations and frequencies effect materials like fascia very strangely.

Stress and Fascia

We will conclude with another great quote from the impacts of stress article.

“Knowing the relationship between stress, immunity, and fascia helps to understand that the outcome of medical and manual therapies can be boosted or curtailed by the person’s experiences: any beneficial effects of medical and manual treatments can be nullified by psychosocial adversities and lifestyle (e.g., physical inactivity, high glycemic index, and load nutrition) that trigger high inflammation.”

“Notwithstanding that manual therapies can have systemic effects – they can reduce cortisol, SNS [sympathetic nervous system] activation, and inflammation, increase oxytocin secretion and vagal tone and remodel collagen – they remain an isolated event in everyday life that must be integrated with other interventions such as patient education, physical exercise, lifestyle changes, and psychological therapies (as shown by the recommendation in the case of low back pain)”.