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fascial adhesions & proprioceptive dysfunction as the common cause of disease?

“Connective tissue is something of an orphan child in medicine: although it is an integral part of the musculoskeletal system, connective tissue is basically absent from orthopedic textbooks, which deal principally with bones, cartilage, and muscles. Nonspecialized connective tissues, which form what’s known as the fasciae and envelop all muscles, nerves, bones, and blood vessels, are typically allotted a short paragraph in current textbooks, if mentioned at all. 

And despite increasing evidence of its role in chronic pain and other diseases, connective tissue is not very well studied.  In contrast to the general neglect of connective tissue in the conventional medical and scientific fields, “alternative-medicine”  researchers, and especially clinical practitioners, have for many years recognized the potential importance of connective tissue in health and disease. 

Indeed, a variety of alternative manual and movement-based therapies work under the collective assumption that connective-tissue pathology lies at the source of musculoskeletal pain, and that this can be ameliorated with manual treatments.” Some cherry-picked sentences from Dr. Helene Langevin’s article, The Science of the Stretch from the May 2013 issue of The Scientist journal

Although I do not believe that there is any such thing as “one cause, one cure” for all human sickness and disease; it would behoove you to pay attention to brand new research floating around the academic portion of the medical community. This research concerns something that mankind has been searching for practically since the beginning of time —- medicine’s ‘Holy Grail’ if you will —- the “Common Cause”. 

Is this search for a Universal Cause of all sickness and disease a pipe dream, or could we be closer to finding a solution to human suffering than anyone might have imagined just a short decade or two ago?

There are four types of tissue in the body.  Epithelial Tissue, Muscle Tissue, Nerve Tissue, and Connective Tissue.  The Connective Tissues that I primarily deal with in my clinic are BONE, FASCIA, LIGAMENTS, and TENDONS (by the way, I frequently categorize MUSCLES as a Connective Tissue even though this is not technically accurate). 

Once you start to understand a little bit about the way the body functions, it is not a reach to grasp how big a part FASCIAL ADHESIONS play not only in the development of numerous and sundry CHRONIC PAIN SYNDROMES, but in the development of various disease processes as well. 

In the quest to find a “Common Cause” of all disease, men have believed a wide variety of different treatments to be the solution.  These ranged from things as radical as suicide, to holes drilled through the head, and virtually everything in between.  This is because over the centuries, this ‘Common Cause’ has been thought to be things as diverse as karma, harmful vapors, GERMS, BAD GENES, and even evil spirits. 

Well over 100 years ago, two pioneers in the field of Natural Medicine, B.J. PALMER (Chiropractic) and A.T. STILL (Osteopathy) developed healing philosophies and systems based on their belief that there was a common cause of all disease.  And although they did not agree on what this common cause was, they may have both been closer to the truth than anyone could have possibly known at the time. 

The former thought that this “Common Cause” was nerve interference caused by misaligned or malfunctioning vertebrate (HERE), while the later believed that disease was largely the result of restrictions or ADHESIONS OF THE FASCIA.  It seems that medical research may be proving both of them correct.  Enter Drs. Donald Ingber and Helene Langevin.

DRS. DONALD INGBER & HELENE LANGEVIN DISCUSS FASCIA’S ROLE IN DISEASE — ALL DISEASE

After earning her MD degree in 1978, Dr. Helene Langevin did post-doctoral work in Neurochemistry at Cambridge in England before doing her residency in Internal Medicine and fellowship in Endocrinology and Metabolism, both at Johns Hopkins.  She is not only a Professor of Medicine at Harvard, but a professor of neurology, orthopedics, and physicial rehabilitation at the University of Vermont’s medical school.  She also happens to be the Director of Integrative Medicine at Harvard Medical School and Brigham and Women’s Hospital. 

Some of her chief areas of study include the relationship of LOW BACK PAIN TO FASCIA, and acupuncture to fascia, as well as being part of the astounding study that actually imaged adhesed fascia in motion (HERE are the two 10 second videos side by side).

Dr. Ingber is a cell biologist.  But he is not your ordinary, average, every-day cell biologist.  He also happens to be a medical doctor with advanced degrees in molecular biophysics and cellular biochemistry (all from Yale).  He was part of the Vascular Biology Program in the Department of Surgery and Pathology, at Children’s Hospital of Harvard Medical School, where he was a researcher and pathologist, until 2008, when he was named a professor of bio-engineering at the Harvard School of Engineering and Applied Sciences. 

Ingber has published nearly 300 research papers in peer-reviewed scientific / medical journals, and a recent bio stated that, “Ingber’s insights have helped create the fields of mechanobiology, angiogenesis, tissue engineering, nanobiotechnology, and biomimetics“.   In other words, Dr. Ingber is probably smarter than you, I, and everyone we know combined. 

In a 2003 article published in the Annals of Medicine titled Mechanobiology and Diseases of Mechanotransduction, Dr. Ingber shed some new light on an old topic —- the search for the “Common Cause” of sickness and disease.  Although Dr. Ingber himself would never tout his research as a quest to find the elusive “Universal Cause,” he certainly believes that the basis of the largest percentage of today’s diseases is directly related to dysfunctional mechanoreception / proprioception of Connective Tissues.  O.K.  We already know what Connective Tissues are, but what in the world is proprioception / mechanoreception, and how does it relate to health?

The word proprioception’ (aka mechanoreception) comes from two words. First is the Latin word ‘proprius,’ meaning one’s own“.  The second is the word perception’, meaning the process by which one translates sensory input into a coherent and unified picture of one’s environment.  Thus, proprioception is the sense or “perception” of the relative position of various parts of the body in relationship to their environment. 

In other words, proprioception is your body’s ability to unconsciously know where its various body parts are in space as well as how they are moving in relationship to each other at all times and in all circumstances.  Where are the heaviest density of mechanoreceptors found? FASCIA, OF COURSE!

It is this internal sense of PROPRIOCEPTION that indicates whether the body (or a part of the body — i.e. a limb) is moving, how fast it is moving, what direction its moving, and how much energy is being expended to move it; as well as where the various parts of the body are located in space —– in relation to every other part of the body. 

Incredible proprioceptive ability is one of the things that makes a great athlete a great athlete (sometime watch some old highlights of JOHNNY MANZIEL, DARREN SPROLES, or BARRY SANDERS).  As you start to grasp how complex and vital proprioception is, you can begin to understand why it has been said that it is more important than the inner ear for balance!

When proprioceptive nerve endings (mechanoreceptors) are stimulated via stretch, movement, or pressure, the nerve input is fed to the brain via the spinal cord and nerve system.  Once in the brain (cerebellum), these impulses are decoded, translated and integrated into something the body can understand.  Messages are then created and sent out to the various parts of your body.  There is a continual feedback loop, with the whole process taking microseconds to accomplish.  When it all works perfectly, it’s literally poetry in motion (see videos above). 

However, when this system begins to break down, all sorts of problems can arise — many of them ugly, severe, and as you’ll soon see; not well understood by the average doctor.  What are the most common ways that this system goes haywire?

  • FIRSTLY:   ABNORMAL BIOMECHANICS ultimately leads to both INFLAMMATION and fouled up mechanoreception, which both cause DEGENERATION of the affected joint.  This is a well known fact that can be found in any PATHOLOGY TEXTBOOK or from any doctor you care to talk to. Everyone has heard the old adage ‘use it or lose it’. Although it is an oversimplified cliché, there is a tremendous amount of truth in these five words. A quick review of the scientific literature on the subject tells us that loss of normal joint motion creates a loss of proprioception that subsequently causes degeneration of the affected joint.  Furthermore, it tells us that degeneration of the joint causes abnormal joint motion and a subsequent loss of proprioception.  Ladies and Gentlemen; start your cycles — your vicious cycles!  A causes B, and B causes A.  Abnormal joint function causes degeneration, but degeneration turns right around and causes abnormal joint function, with the whole thing churning out a steady stream of inflammation (HERE).  Not good if you happen to have an injured or dysfunctioning HIP, KNEE, SPINAL DISC, etc.
  • SECONDLY:  Using this model, let’s think about what loss of joint motion and the subsequent loss of proprioceptive input could theoretically do to the various organs and organ systems in the body.  Because the brain ultimately controls every function of the body via the spinal cord and nerve system, a loss of range of motion and proprioception has actually been shown to diminish organic (organ) function.  SOUND CRAZY?  Not to B.J. Palmer.  Not to A.T. Still.  And certainly not to Doctor Ingber.  Allow me to me explain.

It is a simple physiological fact that loss of spinal range of motion due either to Vertebral Subluxation and / or Fascial Adhesion, causes diminished nerve system (proprioceptive) function.  Amazingly enough, this loss of mechanoreception turns around and causes a loss of motor nerve function.   The real stunner though, is that recent scientific research has shown us exactly how this occurs!  

In a lecture I attended nearly two decades ago by the venerable Dan Murphy, he showed then-current research saying that in healthy people; for every proprioceptive impulse (sensory – afferent) that is fired up to the brain; there are approximately 30 return nerve impulses (motor – efferent) coming back down in response.  

It is the body’s motor impulses that tell it what to do and how to function.  It is motor function of the nerve system that not only tells my fingers how to type, but also tells my heart to beat, my intestines to work, my body temp to stay at 98.6, and my immune system TO ATTACKOR NOT ATTACK, depending on the threat.  Oh; I may have forgotten to mention, it but fascia is the single biggest proprioceptive organ in your body (HERE).

THE VICEROSOMATIC LESION AS RELATED TO FASCIA

Every time a proprioceptive nerve ending is not being stimulated like it should be (usually due to restricted range of motion of a particular joint), 30 returning motor responses from the brain to the body are being inhibited.  In other words, loss of spinal range of motion causes a corresponding loss of proprioception affecting motor nerves at an astounding 1 to 30 ratio. 

This then affects not only the way that muscles and joints function, but the way that organs function as well. Whoa!  Sounds like both Dr. Still and Dr. Palmer may have been way ahead of their time!  And although these men (particularly BJ Palmer) were frequently labeled by the mainstream medical community as quacks, this concept of the “Vicerosomatic Lesion” has been in the scientific medical literature since the 1960’s. 

Although it’s a three dollar doctor word, “vicerosomatic” simply means that dysfunctioning areas of the spine or body (the soma) can present with palpable, localized, and sensitive symptoms directly related to corresponding visceral (organ) dysfunction.  And the interesting thing is that the dysfunction cuts both ways.  Problems in the viscera can cause problems in the soma, or problems in the soma can cause problems in the viscera. It’s a two-way street — an open phone line of communication, if you will. Or at least it should be.

If not sooner than later, loss of joint motion will result in pain. The beauty of CHIROPRACTIC ADJUSTMENTS coupled with SCAR TISSUE REMODELING is that they not only help relieve pain while restoring range of motion, they actually allow the nerve system and the various functions controlled by the nerve system (basically everything in the body, including organs!) to function closer to the way they were designed and created to function in the first place (see “Sound Crazy?” link from a couple paragraphs ago). Doubly cool is that once you start addressing the “TETHERING EFFECTS” of the SCAR TISSUE and FIBROSIS, you won’t feel like you constantly need to be adjusted (HERE).

BACK TO DR. INGBER
Dr. Ingber believes that modern medicine is far too wrapped up in trying to pin all our health problems on genetics (see earlier link), while mostly ignoring what he believes to be the greatest underlying causes of disease. What are these underlying causes of disease he speaks of?  His research in biophysics and pathology have led him to the conclusion that many, if not most of the problems people seek medical care for, are the result of abnormal structure and function of the body’s Connective Tissues (bones, ligaments, tendons, fascia, etc). 

Furthermore, he believes that you cannot truly understand any disease process without first understanding biomechanics and CELL BIOLOGY —- the relationship between the way the body functions mechanically, and proper cellular function.

Remember his article, Mechanobiology and Diseases of Mechanotransduction that we mentioned earlier?   “MECHANOTRANSDUCTION” is defined by Dr. Ingber as the method by which cells both sense and respond to mechanical stresses.   In a subtle slap in the face to his own profession, while inadvertently validating what Chiropractors have been saying for well over a century, he notes that numerous diseases from across the entire spectrum of medical practice share a “Common Cause”. 

In his article, Dr. Ingber states this about sickness and disease; “their etiology [cause] or clinical presentation [symptoms] results from abnormal mechanotransduction“.  In other words, a brilliant medical doctor from Harvard is saying that sickness and disease are being largely caused by loss of proprioception, and the subsequent abnormal activation patterns of the nerve system that follow. 

Here are some of the points (quotes) from Dr. Ingber in his ground-breaking paper — a paper that was published long enough ago that more professionals should be aware of its paradigm-exploding implications.

  • Mechanical forces are critical regulators of cellular biochemistry.
  • There is a huge disconnect between ‘genome-age’ technologies and the reality of how diseases manifest themselves. From the time the first human looked, listened and felt for what is wrong with a sick friend, caregivers have recognized the undeniable physical basis of disease.
  • In the current genome euphoria, there appears to be no place for ‘physicality’. This is especially worrisome given that abnormal cell and tissue responses to mechanical stress contribute to the etiology and clinical presentation of many important diseases, including asthma, osteoporosis, atherosclerosis, diabetes, stroke and heart failure.
  • There is strong mechanical basis for many generalized medical disabilities, such as lower back pain and irritable bowel syndrome, which are responsible for a major share of healthcare costs world-wide.
  • In biology and medicine, we tend to focus on the importance of genes and chemical factors for control of tissue physiology and the development of disease, whereas we commonly ignore physical factors. This is interesting because it was common knowledge at the turn of the last century that mechanical forces are critical regulators in biology.
  • These new insights into mechanobiology suggest that many ostensibly unrelated diseases may share a common dependence on abnormal mechanotransduction for their development or clinical presentation.
  • Understanding of the relation between structure and function in living tissues and of fundamental mechanisms of cellular mechanotransduction may therefore lead to entirely new modes of therapeutic intervention.
  • And although some level of medical prejudice is likely what prevented him from adding the words “Chiropractic” or “Chiropractic Adjustments” to the following list, he essentially validates the profession by stating, The therapeutic value of PHYSICAL THERAPY, massage, and muscle stimulation is also well known.

Dr. Ingber went as far as saying,

Moreover, most of the clinical problems that bring a patient to the doctor’s office result from changes in tissue structure and mechanics.  Although these physical alterations have been commonly viewed as the end-result of the disease process, recent advances in mechanobiology suggest that abnormal cell and tissue responses to mechanical stress may actively contribute to the development of many diseases and ailments. Thus, it might be wise to search for a physical cause when chemical or molecular forms of investigation do not suffice.” 

Listen up people.  If you do not grasp how big that this concept being promoted by Dr. Ingber really is, re-read the quote until you do —- especially those of you who have been through every conceivable medical test under the sun in a fruitless quest to figure out what is wrong with you!

Although Fascia is a structural tissue, it is the tissue where the vascular system, the nerve system, and the musculoskeletal system all converge into one grand continuum.  Yes, this makes fascia the most potentially pain-sensitive tissue in the body, but it also helps it transmit electrical messages.  Changing the shape and tension on the fascia creates a weak electric current that actually travels along the tissue itself.  

And as Dr. Ingber has shown, various cells and tissues throughout the body respond to these electrical impulses either positively or negatively depending on many factors.  In fact, the current travels along fascia at 720 mph compared to 160 mph for the nervous system (HERE).

WHAT DOES IT ALL MEAN?
In the famous words of Arnold’s Schwarzenegger’s character (‘Dutch’) from 1987’s hit movie Predator, “If it bleeds, we can kill it.”  The first part of starting to solve these sorts of problems is figuring out what the heck might be causing them in the first place.  Sorry, but doing nothing else besides covering symptoms is no longer an option (I actually wrote an article for you on what it takes to RESTORE PROPRIOCEPTIVE INTEGRITY IN FASCIA). 

It also means that while their model was far from factually accurate (hard bones pinching soft nerves), chiropractors, in many respects, have been light years ahead of STANDARD DRUG THERAPY for well over a century, simply because they understood the end result of their adjustments.  Thus, chiropractors are no longer the lone voice crying out in the wilderness.

The type of advanced research being done by people like Drs. Ingber and Langevin is certain to attract a whole host of brilliant doctors, scientists, engineers, and scholars interested in finding that elusive “Common Cause”.  And while the Osteopathic profession has largely given up on this concept in order to become R.D.’s (“Real Doctors”), the Chiropractic Profession still largely embraces “THE BIG IDEA” as espoused in its various forms by men like Palmer, Still, Ingber, Langevin, and others. 

Unfortunately, when you are bucking “THE SYSTEM,” the process can be a long, slow, uphill battle.  No; the word “battle” was not a mistake.  In fact, I probably should have used the word “war” (clicking the previous link just to browse hundreds of article titles proves this).

It was the famed inventor, Thomas A. Edison, who stated around the turn of the century that, “The doctor of the future will give no medicine, but will interest his patients in the care of the human frame, in diet, and in the cause and prevention of disease.”  Talk about a man who was ahead of his time!  But much of the medical establishment and and certainly BIG PHARMA hate this sort of visionary thinking.  It lessens (and in some cases completely negates) the need for DRUGS

Drugs equal profits, and this is the sort of information that will bring out the Pharmaceutical Industry’s inner pit bull.  Believe me when I tell you they will not go down without a fight.   This is the very reason that today’s so-called “EVIDENCE-BASED MEDICINE” is frequently anything but.

Founding Father and signer of our nation’s Constitution, Dr. Benjamin Rush, saw this battle looming just below the horizon 250 years ago, when he made the uncanny prediction,  “Unless we put medical freedom into the Constitution, the time will come when medicine will organize itself into an undercover dictatorship.” 

Face it.  Standard Medical Healthcare is a dictatorship here in America —- and a not very “undercover” one at that.  But the truth is, your health as well as your healthcare decisions are still up to you.  The question now is what are you going to do with them?  You can either take the bull by the horns and take back responsibility for your own health —- or you can sit and wait for the next study touting the benefits of this pill or that surgery. 

HERE is a good starting point for those of you struggling with Chronic Pain or Chronic Illness. One last thing; if you have family or friends who are in this boat, be sure and forward this information to them or better yet, get it in front of them via FACEBOOK — still a great way to reach those you love and care about most.

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