Why this body-wide story keeps growing in Anatomy & Physiology
Fascia is having a moment.
Actually, it's been having a pretty long moment.
Research into fascia has expanded greatly in recent decades, along with interest among anatomists, physiologists, physical therapists, massage therapists, movement specialists, pain researchers, surgeons, and others.
What was once too easily dismissed as the stuff you cut through—or remove—to get to the "real" anatomy is increasingly being studied as an important participant in the structure and function of the body.
Which means fascia deserves appropriate attention in an undergraduate A&P course.
We've thought that for quite a while.
Base image: Henry Vandyke Carter - Henry Gray (1918) Anatomy of the Human Body. Bartleby.com: Gray's Anatomy, Plate 384, Public Domain, https://commons.wikimedia.org/w/index.php?curid=561537
We've been going deep with fascia
Deep. Get it?
Okay, moving on.
Our coverage of fascia in Anatomy & Physiology didn't suddenly appear in the 12th edition. We've been giving fascia significant attention since the early 1990s, and nearly every edition since then has reflected our expanding understanding of what fascia is and what it does.
Even then, we were asking students to think beyond individual muscles and isolated structures. We pointed out structural and functional relationships among the cytoskeleton inside cells, the extracellular matrix outside cells, and the myofascial structures of the body.
In other words, the little pieces fit into bigger pieces—and those bigger pieces remain connected.
By the 2010 edition, released in 2009, we had also incorporated Thomas Myers's Anatomy Trains concept. Myers developed this model during the 1990s as a way of teaching "connected anatomy." It proposes that muscles and fascia form myofascial continuities, or functional "trains," that can help us think about whole-body posture and movement.
Later anatomical research has found support for several of the proposed myofascial continuities, although not all of them. Their functional significance and the amount of force that may be transmitted along them remain active areas of investigation.
That's an important distinction.
We don't include an interesting model because it settles the science. We include it when it can help students think about the science—including the parts we're still figuring out.
Wait. Is there really a "fascial system"?
You'll notice that in the new edition we sometimes use the term fascial system.
Not everyone likes that term.
And I don't mean that somebody complained about it on social media. There's a genuine scientific and anatomical terminology debate going on.
The Fascia Nomenclature Committee of the Fascia Research Society developed two related definitions. A fascia refers more narrowly to a dissectible sheet, sheath, or aggregation of connective tissue. The fascial system is a broader concept describing a three-dimensional continuum of collagen-containing connective tissues that permeates the body. The broader term is particularly useful when considering the functional relationships among these tissues rather than viewing each named fascia in isolation.
Some researchers want to go further. A 2025 paper in the Journal of Anatomy formally proposed that fasciae and their interstitial components constitute an anatomical system—a body-wide, multiscale network with superficial, musculoskeletal, visceral, and neural components.
Case closed?
Of course not.
A 2026 paper in Clinical Anatomy argues specifically that fascia should not be classified as an anatomical system, particularly within the framework of fbormal international anatomical terminology.
So why did we use fascial system in the textbook?
Because we find it to be a useful functional and teaching concept.
We're not announcing the discovery of an additional organ system or claiming that fascial system has become universally accepted anatomical terminology. We're using a term found in the scientific literature that helps students recognize something important: these connective tissues have extensive relationships throughout the body, and many of those relationships make more sense when we don't consider each bit of fascia in isolation.
As the science and the terminology evolve, our usage may evolve, too.
That's what textbooks are supposed to do.
Why should A&P students care?
Because our understanding of fascia has moved far beyond its old reputation as passive wrapping material.
Research is investigating fascia's roles in mechanical force transmission, movement, proprioception, nociception, tissue remodeling, fluid relationships, and pathological processes.
Consider innervation. A systematic review found that fasciae are well innervated, with different types and densities of nerve endings in different fascial tissues. Those include proprioceptive and nociceptive endings, with some evidence of increased innervation in pathological fascia.
That's pretty important information for somebody learning how the body senses itself, moves, and experiences pain.
It's increasingly important clinically, too.
Students heading into physical therapy, massage therapy, athletic training, rehabilitation, sports medicine, and other health professions are likely to encounter fascia again. Some forms of manual therapy and rehabilitation explicitly target fascial tissues or use fascial models to help explain assessment and treatment.
That doesn't mean every proposed fascial mechanism—or every treatment marketed as "fascial"—has been established.
Far from it.
The evidence varies, and research continues.
To me, that's another argument for teaching the basic science appropriately.
Our students need enough anatomy and physiology to understand—and eventually evaluate—the clinical claims they'll encounter.
Fascia is becoming an A&P teaching issue, too
This isn't only a conversation among fascia researchers and clinicians.
It's increasingly a conversation among anatomy and physiology educators.
Rebecca Pratt made an especially useful argument about this several years ago. How do we squeeze an increasingly complex understanding of fascia into an already packed health-sciences curriculum?
Her answer was essentially: put it where it belongs. Everywhere.
Because fascia itself is found throughout the body, Pratt argued that it can be integrated throughout an existing curriculum rather than requiring another isolated block of material. Her article puts it nicely: fascia can fit anywhere in the curriculum because it is found everywhere.
That sounds awfully familiar.
More recently, my colleague and former student Dr. Kate Oland has become something of a fascia advocate among A&P teachers, encouraging us to give fascia the emphasis it deserves in our courses.
Kate and I explored many of these ideas in Episode 152 of The A&P Professor podcast, Fascinating Fascia: Kate Oland Unravels the Ties That Bind. We talked about the traditional tendency to rip fascia out of the way during dissection, the increasingly connected view of fascia, clinical applications, and why fascia deserves more attention in undergraduate A&P.
Then, at the 2026 HAPS Annual Conference, fascia showed up prominently on the program.
Dr. Alan Detton presented an Update Seminar, Fascia, What Is It and Why Should I Care? HAPS described his presentation as addressing the meaning of the anatomical term fascia and its significance in A&P.
And Kate presented a workshop with a title that gets right to the issue: The Fascial System: A Missing Link in A&P Education.
Two fascia presentations at one HAPS conference?
I'd say the conversation has arrived.
Peggie keeps us connected
Which brings me back to the 12th edition of Anatomy & Physiologyb.
Author Peggie Williamson took the lead in implementing and coordinating much of our fascia-related work for this revision.
Peggie is our Patton Team fascia expert. Besides being an experienced A&P educator, she's a doctor of physical therapy who has worked directly with patients and now serves on the faculty of a Doctor of Physical Therapy program, helping prepare the next generation of physical therapists. Her clinical background includes myofascial release and other approaches to soft-tissue treatment.
That gives her a particularly valuable perspective for this topic. She understands what beginning A&P students need, but she also knows where those basic concepts may eventually lead in clinical education and practice.
So when Peggie tells the rest of us that we need to take another look at something involving fascia, we take another look.
More fascia in the 12th edition
What did that mean for this edition of Anatomy & Physiology?
In Chapter 9, Tissue Types, we added a completely new Connect It! article, Fascia: The Body's Not-So-Hidden Network.
I like that title because fascia really isn't hidden.
It's everywhere.
As anyone who has spent much time in a traditional dissection lab knows, however, fascia is often dissected away so that muscles, nerves, vessels, and organs can be seen more clearly.
That's understandable.
But it can also leave students with the unintended impression that fascia is something obscuring the anatomy rather than something that is part of the anatomy.
In Chapter 10, Skin, we've added an explicit connection between the hypodermis and the fascial system.
And in Chapter 15, Axial Muscles, we've added further explanation of fascia to an illustration, along with clarification of related connective-tissue structures.
Those may sound like relatively modest changes when they're listed one at a time.
But they're additions to fascia coverage that was already distributed through several parts of the book.
That's intentional.
Why isn't there a fascia chapter?
If fascia is increasingly important, why don't we simply put it all together in one chapter?
Maybe someday we will.
We've done that sort of thing before.
Over the long history of Anatomy & Physiology, topics that were once scattered through several chapters have sometimes developed enough—and become important enough—that we've brought them together into a more unified story. Homeostasis, stress, and the lymphatic system have all evolved substantially in our book over the years.
Most recently, we gathered much of our distributed coverage of the human microbiome into the new Chapter 49.
Could fascia eventually get similar treatment?
Maybe.
But fascia presents an interesting teaching problem.
Its connections to other structures are part of the story.
When students are learning connective tissues, fascia belongs there.
When they're learning about the hypodermis, fascia belongs there.
When they're studying skeletal muscles, muscle compartments, and movement, fascia belongs there.
And when we're asking students to connect what happens inside cells with the extracellular matrix outside them—and then follow those relationships into tissues and larger body structures—we're building another part of the same story.
That's why, at least for now, we think its reappearance at pivotal points is one of the clearest ways to teach fascia.
Besides, repeated encounters let students keep adding to their mental model.
They don't learn "fascia" once and put it away.
It keeps coming back.
Sort of like fascia.
Ahead of the curve?
I'd like to think we've been a bit ahead of the curve.
Not because we've somehow known in advance where fascia research would lead.
We haven't.
Some ideas about fascia have changed. Others remain unsettled. Some claims will undoubtedly be revised or discarded as the evidence improves.
What I think we got right fairly early was taking fascia seriously.
We didn't treat it simply as disposable packing material surrounding the structures that really matter. We emphasized relationships among cells, extracellular matrix, fascia, and muscle. We introduced students to body-wide myofascial relationships. And as the science expanded, we kept revisiting the story.
Now we're seeing researchers working toward broader models of fascia, clinicians applying fascial concepts in practice, and A&P educators asking whether fascia has been getting enough attention in our courses.
So we're not scrambling to insert an unfamiliar topic into the textbook.
We're continuing a story we've been telling—and revising—for decades.
One chapter someday?
Maybe fascia eventually deserves a chapter of its own.
Or maybe not.
There is something pedagogically satisfying about meeting fascia again and again as we work our way through tissues, skin, muscles, movement, and other parts of the A&P story.
After all, its repeated appearance is part of the point.
The structures and functions of the human body don't operate in isolation.
Fascia keeps reminding us of that.
And we'll keep watching the research—and listening to instructors, students, clinicians, and researchers—to see where this story takes us next.
What?! You don't have a free examination copy to review? Please request a free instructor review copy of the new 12th Edition of Anatomy & Physiology.
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