This guide will help you understand what collagen and tissue repair. You’ll learn what collagen is and its role in human movement. We’ll also cover what happens when things go wrong and how to fix them.
Understanding Collagen
Collagen is a protein that is found throughout the human body and is a major component of connective tissue, including fascia, tendons, and ligaments. It is the most abundant protein in the body, making up about 25% to 35% of the total protein content. So, collagen and tissue repair are connected.
Collagen fibers are long, thin strands that are arranged in a parallel fashion and are responsible for the strength and structure of connective tissue.
Types of Collagen
There are hundreds of different types of collagen fibers, but ~95% are made up by type I, type II, type III, and type IV. Each type has a specific role and is found in different parts of the body.
Type I collagen is the most abundant type of collagen and is found in tendons, ligaments, skin, and bone. It is known for its strength and is responsible for the structural integrity of these tissues.
Type II collagen is found in cartilage and is responsible for its elasticity and resilience. It helps to cushion and protect joints and allows for smooth movement.
Type III collagen is found in skin, blood vessels, and other tissues and is known for its elastic properties. It helps to provide support and structure to these tissues.
Type IV collagen is found in the basement membrane, which is a thin layer of connective tissue that underlies the epithelial tissues of the body. It helps to provide structural support and serves as a barrier between tissues.
In addition to its role in providing strength and structure to connective tissue, collagen also plays a role in tissue repair and regeneration. When tissues are damaged, collagen fibers are produced to help repair and rebuild the tissue. This process helps to maintain the health and function of the tissue.
Fascia and Connective Tissue
In fascia and connective tissue, collagen fibers are arranged in a network-like structure that gives the tissue its strength and support.
Ffascia and connective tissue also contain other components. Water is a major component. And hydration plays a major role in tissue quality.
Proteoglycans (molecules that help to retain water and maintain the structure of the tissue), and
Cells such as fibroblasts (cells that produce collagen and other proteins). These components work together to form a complex network that provides support and structure to the tissue.
Collagen and Tissue Repair Affect Movement
The content and alignment of collagen fibers within the fascia can affect movement and range of motion in a number of ways.
Collagen fibers provide strength and structure to the fascia, and their alignment affects the tissue’s ability to stretch and move.
When collagen fibers are aligned in a parallel fashion, the tissue is able to stretch and move more easily. It allows a greater range of motion. However, when collagen fibers are misaligned or densified , the tissue may become more rigid and less flexible. This limits the range of motion and causes movement restrictions.
In addition to their alignment, the content of collagen within the fascia can also affect movement and range of motion. An excess of collagen fibers can lead to the formation of scar tissue. Scar tissue is characterized by a high concentration of collagen fibers. It is typically less flexible and less elastic than normal tissue, and can restrict overall movement.
Overall, the content and alignment of collagen fibers within the fascia play a critical role in the tissue quality. It’s ability to stretch and move, and can affect movement and range of motion. When the collagen fibers are properly aligned, it allows for a greater range of motion.
However, when collagen fibers are misaligned or there is an excess of collagen in the tissue, it can lead to movement restrictions and limited range of motion.
Scar Tissue versus Densification
Fibrosis and densification are two different processes that can affect the structure and function of the fascia and other connective tissue.
Scar Tissue
Scar tissue os a term that get thrown around a lot, but not always properly. To be specific, scar tissue from trauma involves fibrosis.
Fibrosis is a process where the body produces excess collagen fibers in response to injury or inflammation. This can lead to the formation of scar tissue. It is characterized by a high concentration of collagen fibers with a disorganized alignment.
In fibrosis the underlying structure of the collagen is changed. This means once the healing process and scar formation are complete, opportunity to improve the structure is limited.
This in part is why the right, early tissue interventions are important while recovering from injury.
Scar tissue is typically less flexible and less elastic than normal tissue, which can also lead to movement restrictions and limited range of motion.
Densification
In densification, the collagen fibers become more densely packed, which can make the tissue more rigid and less flexible. They may also have additional cross-linking that strengthens them and limits movement.
However, unlike scar tissue (fibrosis) the underlying structure is not altered. This means densified fascia can more easily be improved compared to scar tissue.
There are several mechanisms that may contribute to the densification of scar tissue, including:
- Inflammation: Inflammation is a natural response to injury or tissue damage and is characterized by swelling, redness, and pain. It can lead to the production of collagen fibers, which can contribute to the formation of scar tissue. Excess inflammation can also lead to the densification of collagen fibers within the tissue, which can make the tissue more rigid and less flexible.
- Repetitive strain: Repetitive strain, or the repeated use of a joint or muscle, can lead to the formation of scar tissue and the densification of collagen fibers. This can occur due to overuse injuries or the accumulation of small micro-traumas over time.
- Impaired circulation: Poor circulation can contribute to the densification of collagen fibers within the tissue. When blood flow is impaired, it can lead to reduced delivery of oxygen and nutrients to the tissue, which can affect the health and function of the tissue.
Both densification and fibrosis can contribute to movement restrictions and limited range of motion by altering the structure and alignment of the collagen fibers within the tissue.
Improving Restricted Tissue
Fibrosis and densification are two different processes that can affect the structure and function of the fascia and other connective tissue. Treatment approaches may vary depending on the specific condition and the underlying cause.
Treatment approaches for fibrosis may include physical therapy, exercise, and needling therapies such as dry needling or acupuncture. These treatments may help to improve the flexibility and function of the tissue and reduce pain.
Treatment approaches for densification may include massage therapy, stretching, heat therapy, exercise, and myofascial release. These treatments may help to break up densified collagen fibers and improve the flexibility of the tissue.
Overall, different treatment approaches may be needed for fibrosis and densification, depending on the specific condition and the underlying cause. It is always important to consult with a healthcare professional to determine the most appropriate treatment approach.
Exercise
Exercise has the potential to affect collagen and tissue repair in a number of ways.
It can stimulate the production of collagen and other proteins within the tissue. When the fascia is subjected to mechanical stress, it may stimulate the activity of fibroblasts. Subsequently, that can help to promote the production of collagen and other proteins within the tissue. This may lead to an increase in collagen content within the fascia and may improve its strength and structure.
In addition, exercise may also affect the alignment of collagen fibers within the fascia. The mechanical stress produced during exercise may also help to break up crosslinks between fibers. It also improves the flow of fluids within the tissue. Together, these may lead to improved flexibility and function of the fascia.
A study published in the Journal of Orthopaedic & Sports Physical Therapy looked at individuals with plantar fasciitis.
It found that exercise was effective in increasing collagen production. It also improved the strength and structure of the plantar fascia (the connective tissue in the foot. (https://www.jospt.org/doi/10.2519/jospt.2015.5506)
Overall, exercise has the potential to affect collagen and tissue repair. It stimulates the production of collagen and other proteins. Additionally, it improves the alignment of collagen fibers within the tissue.
Red Light Therapy
Red light therapy, also known as low-level laser therapy (LLLT) or photobiomodulation, is a treatment that involves the use of low-level lasers or LEDs to deliver red or near-infrared light to the skin. It is thought to stimulate the production of collagen and other proteins within the tissue, which may have a range of therapeutic effects.
There is some evidence to suggest that red light therapy may be effective in improving the structure and function of connective tissue, including fascia. A study published in the Journal of Orthopaedic & Sports Physical Therapy found that red light therapy was effective in improving the flexibility and function of the plantar fascia (the connective tissue in the foot) in individuals with plantar fasciitis (pain in the heel and arch of the foot). (https://www.jospt.org/doi/10.2519/jospt.2015.5506)
Another study published in the Journal of Physical Therapy Science found that red light therapy was effective in improving the flexibility and function of the Achilles tendon (a type of connective tissue in the leg) in individuals with Achilles tendinitis (pain and inflammation in the tendon). (https://www.jstage.jst.go.jp/article/jpts/28/3/28_18-00246/_article/-char/en)
Myofascial Decompression Therapy
Cupping, otherwise known as Myofascial decompression therapy, is a type of physical therapy that involves the use of suction cups to apply pressure to the skin and underlying fascia. It is thought to improve the flexibility and function of the fascia by breaking up adhesions and promoting the flow of fluids within the tissue.
There is some evidence to suggest that myofascial decompression therapy may affect collagen in the fascia. A study published in the Journal of Bodywork and Movement Therapies found that myofascial decompression therapy was effective in improving the flexibility and function of the fascia and reducing pain. (https://www.sciencedirect.com/science/article/pii/S1360859212002442)
Another study published in the Journal of Physical Therapy Science found that myofascial decompression therapy was effective in reducing muscle stiffness and improving range of motion in individuals with upper back pain. (https://www.jstage.jst.go.jp/article/jpts/28/3/28_18-00246/_article/-char/en)
It is thought that the suction created by the cups during myofascial decompression therapy may help to break up adhesions within the fascia and improve the flow of fluids within the tissue. This may lead to improved flexibility and function of the fascia.
Manual Therapy Affects Collagen and Tissue Repair
Manual therapy involves the application of tension and pressure to the soft tissues of the body. These include; myofascial release, deep tissue work, and IASTM. This affects the extracellular matrix and cellular activity. Specifically, the production of collagen, fibroblasts activity, and collagen alignment.
The Extracellular Matrix
The extracellular matrix (ECM) is the non-cellular component of fascia. it is made up of a variety of proteins including; collagen and elastin, as well as glycosaminoglycans (GAGs) and proteoglycans. The ECM provides structural support to the tissue and plays a role in maintaining its function.
Manual therapy techniques may stimulate the production of proteins within the ECM. These proteins include collagen and elastin, as well as GAGs and proteoglycans. This may contribute to the strength and structure of the tissue and improve its function.
A study published in the Journal of Orthopaedic & Sports Physical Therapy looked at manual therapy techniques. It found they were effective in improving the strength and structure of the plantar fascia (the connective tissue in the foot) in individuals with plantar fasciitis (pain in the heel and arch of the foot). (https://www.jospt.org/doi/10.2519/jospt.2015.5506)
Manual therapy techniques can stimulate the production of collagen and other proteins within the tissue. This may lead to an increase in collagen content within the tissue and may improve its strength and structure.
In addition, manual therapy may stimulate the activity of fibroblasts, which can help to promote the production of collagen and other proteins within the tissue.
Manual therapy techniques that involve the application of tension and pressure to the soft tissues may also affect the alignment of collagen fibers within the tissue. The gentle pressure applied during these techniques may help to break up adhesions within the tissue and improve the flow of fluids within the tissue. This may lead to improved flexibility and function of the tissue.
Cellular Activity
Manual therapy techniques affect fibroblast or fasciacyte activity.
Fibroblasts are cells that are found in connective tissue, including fascia, and are responsible for producing collagen and other proteins that are important for the structure and function of the tissue.
Fasciacytes are a type of cell that is found in fascia and produce hyaluronan for the ground substance. Found near the sliding layers between the different fascial layers and in the endomysium.
Overall, manual therapy techniques that involve the application of tension and pressure to the soft tissues are being shown to affect collagen production, fibroblasts, and collagen alignment, although more research is needed to fully understand the mechanisms behind these.
Myofascial Release & Deep Tissue
Myofascial release involves applying pressure to the fascia to help improve its flexibility and reduce pain.
Deep tissue tissue therapy is a type of physical therapy that involves the use of hands-on techniques to manipulate the soft tissues of the body, including the fascia and connective tissue.
They are thought to work by breaking up fiber crosslinks and promoting the flow of fluids within the tissue, which may lead to improved flexibility and function of the fascia.
There is some evidence to suggest that myofascial release may change collagen in the fascia. A review published in the Journal of Bodywork and Movement Therapies found that myofascial release was effective in improving the flexibility and function of the fascia and reducing pain. (https://www.sciencedirect.com/science/article/pii/S1360859212002442)
It is thought that the pressure and tension applied during myofascial release and deep tissue work may help to break up adhesions within the fascia and improve the flow of fluids within the tissue. This may lead to improved flexibility and function of the fascia.
This may lead to improved flexibility and function of the tissue.
IASTM
Instrument-assisted soft tissue mobilization (IASTM) is a type of manual therapy that involves the use of instruments to manipulate the soft tissues of the body, including the fascia and connective tissue. It is thought to work by breaking up adhesions and promoting the flow of fluids within the tissue, which may lead to improved flexibility and function of the fascia and connective tissue.
There is some evidence to suggest that IASTM may affect collagen content and alignment in the fascia and connective tissue. A review published in the Journal of Orthopaedic & Sports Physical Therapy found that IASTM was effective in improving the flexibility and function of the fascia and reducing pain. (https://www.jospt.org/doi/10.2519/jospt.2015.5506)
It is thought that applying tension and targeted pressure with tools during during IASTM may help to break up adhesions within the fascia and connective tissue and improve the flow of fluids within the tissue. This may lead to improved flexibility and function of the tissue.
Nutritional Collagen Support
There is some evidence to suggest that collagen peptide supplements may affect collagen in tendons and fascia.
Collagen peptides are smaller fragments of collagen that are produced through a process called hydrolysis. They are thought to be more easily absorbed by the body than whole collagen molecules.
Collagen peptide supplements are often marketed as a way to support the health and function of the skin, hair, and nails, as well as to support joint health. Some research suggests that collagen peptide supplements may also affect collagen in tendons and fascia.
A study published in the journal Clinical Interventions in Aging found that collagen peptide supplements were effective in improving the strength and structure of the plantar fascia (the connective tissue in the foot) in individuals with plantar fasciitis (pain in the heel and arch of the foot). (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5568273/)
Another study published in the journal Nutrients found that collagen peptide supplements were effective in improving the strength and structure of the tendons in individuals with tendonitis (inflammation of the tendons). (https://www.mdpi.com/2072-6643/11/9/2293)
Overall, it is likely that collagen peptide supplements may affect collagen in tendons and fascia, although more research is needed to fully understand the mechanisms behind this effect.
Momentous Collagen Peptides is a formula that combines bovine collagen, vitamin C, and FORTIGEL®. FORTIGEL® contains a hydrolyzed form of collagen broken down into smaller peptides, which helps increase absorption by the body and maximizes stimulation of the human cell types involved in biosynthesis.
Summary
Overall, collagen is an important protein in the human body and plays a critical role in the structure and function of connective tissue, including fascia. Its presence is necessary for the proper functioning of the body, and its repair and regeneration capabilities help to maintain the health and integrity of connective tissue.
Collagen content and alignment can become dysfunctional from injury, overuse, and lifestyle. This can occur through densification or fibrosis, but there are treatments that can help.
- Exercise helps change cellular activity and collagen structure
- Manual tissue therapy will affect the collagen in the extracellular matrix of fascia and in tendons
- Red light therapy helps trigger positive adaptations to collagen and tissue repair
- Myofascial decompression theray (dry cupping) can be used to stimulate changes in collagen and tissue function
- Collagen peptides shown promise in supporting the healing process and can be an adjunct to other therapies
In the end collagen and tissue repair are interlinked, and key to better movement and quality of life for you.
