The Influence of Hormones on the Fascia of Aging Clients

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Promotional graphic for a FiTOUR® “Ask the Expert” blog by Dolly Stokes titled “The Influence of Hormones on the Fascia of Aging Clients,” featuring two adults jogging outdoors with a soft gradient overlay and a headshot of Dolly Stokes in the upper left

Written by Dolly Stokes, FiTOUR®

When trainers think about mobility, stiffness, or recurring tightness, the focus is usually on stretching, strength, or movement patterns. But there is another powerful factor at play: hormones.

Myofascia (hereinafter fascia) is not just structural. It is biologically active and highly responsive to hormonal changes.

What is Fascia?

Fascia is a 3-D web of continuous tissue that connects the muscles and joints throughout the musculoskeletal system.

Fascia plays a key role in force transmission, movement efficiency, proprioception, and injury prevention.

How Hormonal Changes Affect Fascia

Hormones influence fascia by altering its pliability (how stretchy it is), its hydration (how well the fascia tissues glide over one another), the ability of collagen to repair altered fascia and to provide strength to fascia, and pain sensitivity.

Changes in hormones can alter collagen production, elasticity, and hydration of the fascia. In addition, hormonal imbalance can cause chronic inflammation, which can lead to a decrease in the lubrication of the fascia. Lubrication, through compression and rolling, is what allows the fascia tissue to easily glide during movement.

With the onset of menopause, women can begin experiencing sarcopenia (loss of muscle), and many women may experience what is known as “Musculoskeletal Syndrome of Menopause.” This can result in unexplained musculoskeletal pain, often manifested with gluteal tendinopathy, frozen shoulder, or rapidly progressing osteoarthritis. Estrogen stimulates collagen synthesis. When estrogen levels begin to decline, lower collagen production can result in lower hydration levels throughout the fascia. This can cause increased stiffness and reduced flexibility, resulting in joint pain.

As men age, they experience andropause, which occurs when testosterone levels begin to decline. Just as with menopause in women, andropause can result in changes in the fascia. Just as estrogen has an impact on collagen production in women, lower testosterone has an impact on collagen production in men. As testosterone levels decline, collagen begins to degrade, which can cause fascia to become excessively stiff. Due to higher testosterone levels, men genetically have stiffer and thicker fascia than women.

During andropause, men will begin to experience more rigid fascia tissue, which can result in stiffness and low flexibility. As testosterone levels decrease, the integrity of joints may be affected, resulting in joint instability, and, just as women, men can experience sarcopenia. In addition, these hormonal changes can affect pain receptors and can contribute to chronic myofascial pain and discomfort. This effect on pain receptors occurs in both men and women.

As hormonal changes occur, the myofascial tissues begin to lose their strength and elastic properties. Just as the effects of hormonal changes can be seen in the skin through wrinkling and crepiness, the same changes occur in the soft tissues we cannot see under the skin.

In addition to producing collagen, estrogen and testosterone function as a shield against inflammation. With the lowering levels of these hormones, women and men can begin to experience stiffer and firmer fascia, creating a lack of pliability. This low pliability in the fascia can result in feeling as if you are wearing a “tight suit.”

Performing regular myofascial release through rolling and stretching can hydrate and lubricate the fascia, reducing the density of the fascia brought on by hormonal changes with natural aging.

Bottom Line: When It Comes to Hormones and Fascia

When training clients who are experiencing hormonal changes, be sensitive to the unseen tissue changes taking place under the skin within the fascia network. Address the reality that natural aging results in lower estrogen and testosterone levels and can impact the fascia. Older clients may experience more pain and stiffness than their younger counterparts.

Include regular resistance training with progressive overload to combat age-related muscle loss, along with adequate recovery through myofascial release to hydrate the fascia tissue using foam rollers, small balls, PNF stretching, and/or dynamic stretching.

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