Although fascia’s relationship to the immune system is the focus of this post, we will cover much more than that. We will delve into brand new research on its relationship to the neuro-endocrine system and mechano-transductive systems as well; touching on several other little-understood functions of fascia along the way, particularly the way it handles various forms of stress.
On January 1 of this year, a team of Italian researchers from Guglielmo Marconi University in Rome published a heavily-bibbed literature review (over 200 sources) in the journal, Frontiers in Biosciences Elite, titled Impact of Stress, Immunity, and Signals from Endocrine and Nervous System on Fascia. Here is the meat of the abstract…..
The stress response, by virtue of release of glucocorticoids 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….
So, FASCIA, the cellophane-like membranous organ found throughout the body (yep, it’s now considered an organ), in response to the body’s various physiological / emotional responses to stress, not only impacts but can massively impact FIBROBLASTS — the cells that manufacture the COLLAGEN MATRIX, which is the building block of all connective tissues; of which fascia is the most abundant.
I’ve already shown you how physical stresses (mechanical stresses), whether via INJURY or therapy, can have HUGE EFFECTS ON FIBROBLASTIC ACTIVITY. It’s why, if these mechanical stresses can be harnessed and precisely directed, the therapeutic potential is endless. It also happens to be why the scar tissue remodeling I do in my clinic is so effective (PATIENT TESTIMONIALS).
But before we move into this study, there are a couple of things you must both understand and watch for as you read. The first is that inflammation — your body’s chemical response to tissue damage (FEW PEOPLE REALLY UNDERSTAND IT) — is an immune system response. Unfortunately, because so many of us live in a perpetually-inflamed state we cannot be surprised that modern humanity is being ravaged by its effects, body and mind (THESE POST TITLES ON THE TOPIC WILL MAKE YOUR HEAD EXPLODE!).
Secondly, if you really want to grasp the concept of “stress” you need to explore my posts on the topic of SYMPATHETIC NERVOUS SYSTEM DOMINANCE and its relation to something known as HEART RATE VARIABILITY (HRV). Why? For decades, the medical and scientific community’s gold-standard for measuring and tracking the body’s stress response has been HRV — the microscopic amount of “variability” in timing between the peak of one heart beat to the peak of the next using EKG.
Take a look at the two links above because they not only critical for those of you who have chronic pain / chronic conditions, they are significant in understanding why a stressed-out public is increasingly latching on to Wim Hof’s SEEMINGLY INSANE RELATIONSHIP WITH COLD.
The authors began by introducing the HPA AXIS (hypothalamus, pituitary, adrenal). If you have been following my site you already know that chronic stress (emotional, physical, mental, dietary, etc) amps up the adrenal glands, leading to adrenal fatigue, which is heavily related to both FIBROMYALGIA & CHRONIC FATIGUE. The authors went on to discuss at length the way that chronic stress also has the ability to affect both the pituitary (which is responsible for manufacturing 9 major hormones, including HGH) and the HYPOTHALAMUS, which makes 6.
The HPA Axis is, or at least should, operate as a finely tuned machine. What happens to fascia when it is not? For starters, “The HPA axis can heavily influence the immune system [and] the stress response can affect the body structure.” While I simply do not have the time nor the will to cover it here, suffice it to say that the authors go into some complex detail about the HPA Axis and the ways it can adversely affect body structure. Pay attention — not just function but structure (not surprising considering the old cliché, “form follows function”).
Without going into their definitions of fascia (if you are curious, HERE is a great and very simplified starting point), the authors make this statement about its function. “The fascia integrates the functions of several systems (e.g., the nervous, immune, and cardiovascular systems) and can transmit mechanical, chemical, and electrical information.” We already know that fascia ACTS AS A SECOND NERVOUS SYSTEM via its ability to convert mechanical impulses into electrical impulses by a mechanism known as TRANSDUCTION. These impulses actually travel much faster than nerve impulses — the speed of sound in water (over four times faster than the speed of sound in air!).
However, fascia’s ability to convey information does not stop there as it can likewise act as an ENDOCRINE ORGAN , not only transmitting hormonal (chemical) messages throughout the body, but also actually creating at least some of these messages (see link). How interconnected is all this, and why is it important that clinicians look at the body as a whole organism — an organism that is far greater than the sum of its individual parts? Take a look at the one sentence example they provided.
The systemic influences of every organ – e.g., the vicious cycle connecting dysbiosis, arthritis, low back pain, and Parkinson’s Disease.
Wow! It’s a rare day indeed when we see mainstream medicine thinking / talking / writing like this! Let me break it down for you. DYSBIOSIS — the fouling of GUT HEALTH, which causes “THE LEAKIES” (loss of the integrity of the body’s various cellular barriers, especially in the BRAIN & GUT) — largely due to ANTIBIOTICS or in many cases, NON-ANTIBIOTIC MEDICATIONS — causes rampant inflammation (see earlier links), which is spoken of by the medical community in terms of its Latin name (itis), and is heavily related (causally related) to almost any chronic condition you care to mention, including, but not limited to ARTHRITIS. BTW, this is even true of many of the diseases that are considered to be “GENETIC“.
To reiterate, the process above is strongly linked to any number of health problems, but since 80% of your immune system lives in the Gut (HERE), one of the biggies will always be AUTOIMMUNITY — the condition whereby your immune system starts attacking self. In this case the authors are specifically discussing the intimate relationship of these processes (which could more actually be described as a viscous cycle) to PARKINSON’S DISEASE.
Understand this and you’ll understand why simply taking another of the “BIG FIVE” DRUGS or even any number of the drugs specifically made for specific diseases (remember that when it comes to autoimmunity, the #1 form of treatment is IMMUNE SYSTEM SUPPRESSION) never provides the total ‘solution’.
While there is no dishonor is using pharmaceutical means to help manage chronic conditions, if this is the only thing you are doing you will not deal with the underlying causes of the cycle, although you may temporarily improve your symptoms. The authors said it this way: “Clinicians should cure disease, but also preserve and promote health.” Curing disease is a very misunderstood concept in today’s PHARMA-DRIVEN culture.
Although these authors went over each and every hormone produced by the HPA Axis in detail (there are a bunch!), right now I only want to touch on one, CRH. I am not singling out CRH (corticotrophin-releasing hormone) because it’s the most important of the lot but simply because it was first on their list. I want you to see how complex these hormonal relationships are and the fact that fascia is an integral part of the “vicious cycle” mentioned a moment ago. Also realize that the quote below has a bib — you can go back and check the peer-reviewed sources if you want.
CRH is correlated with anxiety and motor hyperactivity. CRH can inhibit the activity of other hypothalamic hormones, i.e., thyroid-releasing hormone, increasing hypothyroidism risk; gonadotropin-releasing hormone, facilitating reproductive disorders; and growth hormone-releasing hormone, promoting growth problems in children living under high stress. CRH is also produced by immune cells and the autonomic nervous system. CRH has an inflammatory effect, stimulating mast cells in many tissues and organs such as the gut, brain, respiratory mucosa, prostate, vagina, uterus, heart, and even fascia…
After intimately discussing the THREE PARTS OF THE IMMUNE SYSTEM, along with the GUT MICROBIOTA (they specifically mentioned how it protects against loose “epithelial barriers” — see previous link on “The Leakies”), they gave several examples of why, “under chronic stress, the situation is far more complex.” In other words, we must all deal with stressful events. However, living your day-to-day life under that sort of stress is far more complicated, i.e. far worse. They then went on to discuss immune system implications on the Extra-Cellular Matrix (ECM) as related to this sort of stress.
Since every fiber has different characteristics, the collagen composition of the ECM changes according to the stress, especially mechanical, it undergoes. Mechanical stress enables the differentiation of connective tissue at any age, and different combinations of compressive and tensional forces induce the formation of different collagen fibers so that connective tissue can better adapt to everyday mechanical stimuli. Therefore, physicians, physical therapists, and manual therapists like osteopaths and chiropractors should comprehend the biomechanical role and function of every collagenic structure, so as to properly choose the optimal kind of force to elicit a good structural and functional recovery.
I have talked at length on my site about the mechanical difference between compressive forces (gravity and other forces that compact the body’s joints and tissues together) and the forces that actually pull tissues apart, requiring elasticity to resist damage via tearing (ESPECIALLY MICROSCOPIC TEARING). As I mentioned earlier, these forces can be therapeutically harnessed in context of both pain relief and regaining mechanical function — of which the later fuels the former. We will get into the crux of this particular topic in a moment.
Just before discussing the effects of FEVER, SLEEP, HYPOXIA, CYTOKINES, HORMONES and other factors on the ECM and fibroblasts, the authors revealed how it all works together. “All ECM components are equally important for a healthy connective tissue: given the role of the ECM at the structural, nutritive, and immune level, any disorder affecting one of its components can have serious consequences for the organism.” Fail to address any one of these components (structural, nutrition, immune / inflammation) means you are not treating the whole person. Implications?
Realize that when the body creates SCAR TISSUE (medical name, FIBROSIS), it involves normal physiology. In a perfect world, injured tissues would all heal with bioidentical tissue (bones are one tissue that actually do this). This is certainly not the case, as the body heals injuries to soft tissues (normally) with scaring, which is radically different than the original tissue in many ways (HERE).
The real problem is that due to factors that I have mentioned throughout this post (let’s just call them “EPIGENETIC FACTORS“), the normal process can go rogue, hijacking one’s physiology and turning it into A MONSTER — something that could only be described as pathological. For instance, due to excess RIGIDITY / TISSUE DENSIFICATION and muscles spasms…
Inflammation elicits severe mechanical stress. The greater the stress, the more severe the contraction brought about by myofibroblasts on the ECM, and the stiffer the ECM, the more intense the production of contractures by myofibroblasts. Therefore, fibrosis is determined by a vicious cycle. High inflammation can occur, become chronic and cause fibrosis: this results in wide and hypertrophic scarring of the tissues that lose their functionality. Examples of fibrosis are Dupuytren syndrome and scleroderma, besides the classical ones that affect the pulmonary, renal, cardiac, and hepatic organs.
In other words, what I have told my readers over and over again (I’m a broken record); inflammation always leads to fibrosis (HERE) — the microscopic scar tissue that is not only arguably the number one cause of pain and dysfunction, but has also been proven to be the SINGLE GREATEST CAUSE OF DEATH WORLD-WIDE.
This is why physicians, practitioners and therapists who fail to at least suggest in passing that their patients start addressing their inflammatory lifestyles, not simply by taking anti-inflammatory drugs, which are known to have MASSIVE SIDE-EFFECT PROFILES, are probably going to see that patient over and over again for the same problem(s). I could say a lot more here but today I will stay out of that rabbit hole.
What’s truly amazing for a mainstream, peer-reviewed medical study is that the authors mention by name some of the very DIY solutions that I mention over and over again on my site. These included, Gut Health, featuring A HEALTHY “ANTI-HYGENIC” MICROBIOME, capsaicin and other YELLOW / RED SPICES, a host of ANTI-OXIDANTS, including those that run the P-450 CYTOCHROME SYSTEM (SULFEROPHANE was one that was mentioned by name), LOW GLYCEMIC DIETS, EXERCISE (I included numerous links to posts on general wellness here also) as well as various forms of body work and mind-body therapies. Read this next quote in terms of its first three words, many studies showed…..
Many studies showed that manual and mind-body therapies can increase vagal tone, which regulates inflammation, and remodel fascia via mechano-transduction pathways, even in the case of adhesions, fascial fibrosis, and scleroderma.
Holy smokes! Did you catch that? mechanotransduction — turning mechanical input such as MECHANOREPCETION into electrical impulses — has the ability to aid those struggling with FASCIAL ADHESIONS. It’s why I have so many posts on the DIY down-regulation of inflammation (including INCREASING VAGAL TONE, which promotes restfulness, digestion, SEXUAL HEALTH, and a myriad of others). Others include, SOLVE YOUR OWN BACK PAIN, SOLVING CHRONIC PAIN & CHRONIC DISEASE and CREATING YOUR OWN EXIT STRATEGY — making a customized blueprint, if you will, for taking your life back.
Cytokines and enzymes can fragment the ECM network, thus weakening the connective tissue. Prolapses and tissue permeability may emerge because the fibers become unable to bear the weight of organs and the epithelial barrier is damaged. The facilitation of microbial and neoplastic growth and tissue infiltration may be another undesired result; the excessive amount of ECM components excreted by the cells fills more and more space, replacing local tissue (epithelial, muscular, or nervous) with connective fibers and inducing fibrosis.
What more can inflammation (an immune system response) do to fascia? Realize that the authors discussed mechanisms whereby fascial adhesions caused things like LOW-TESTOSTERONE LEVELS, ESTROGEN DOMINANCE, OBESITY, CARDIOVASCULAR PROBLEMS OF ALL SORTS, TENDINOSIS (“in most cases, the so-called tendinitis is tendinosis with poor inflammatory infiltrate and highly degraded collagen“), leads to ANXIETY & DEPRESSION, ADDICTIONS, diminishes COGNITION, causes OSTEOPOROSIS, and makes the pancreas less sensitive to insulin, meaning a person will be more prone to T2D and the astounding number of sequalae associated with (AGE’s were mentioned by name, but the list is endless).
Oh; and let’s not forget (gulp) that there are known intimate relationships between fascia and cancer (FASCIA & CANCER) (or HERE) (SUGAR FEEDS CANCER) — and autoimmunity, which I provided links to earlier, but which these authors discussed on some level as well. Thank God, however, that there really is some light at the end of the tunnel.
The good news is that the immune and endocrine systems can be positively affected by addressing the body ‘mechanically’ (HERE and HERE are examples), including / STRETCHING / YOGA / BODY WORK / CHIROPRACTIC ADJUSTMENTS along with any number of others that I don’t have time to mention (HERE’S A DOWNRIGHT WEIRD ONE THAT I ABSOLUTELY LOVE!). The final quote below sums up the “paramount” nature of understanding some of these concepts if you are interested either in staying healthy or getting healthy!
All white cells are mechanosensitive…. Whenever fascia is under high tension (e.g., stiffness due to myofibroblasts contractures, fibrosis) [the resultant] stiffness facilitates macrophages attachment and spreading [of fibrosis]. Therefore, as with myofibroblasts, regulating inflammation and mechanical tension become paramount.
SIX NEURO-IMMUNE-ENDOCRINE IMPLICATIONS FOR FASCIA AS RELATED TO BODYWORK
We’ve discussed the importance of a mechanically sound body as far as the health and integrity of the whole person is concerned. What are some of the things these authors specifically mentioned throughout their paper concerning benefits of bodywork?
1.) STRESS IS A DESTROYER OF HEALTH AND LIFE — BODYWORK RELIEVES STRESS: This is a no-brainer considering that 80 years ago the brilliant scientist/physician, Hans Selye, was coming to the conclusion that 2/3 of all physical ailment is the direct result of stress. After reading these author’s conclusions and looking at the numerous destructive and pathological pathways they discussed in significant detail, the two thirds statistic might actually be low.
Bodywork, while certainly not a stand-alone therapy, can be a huge aid to diminishing the destructive and deadly effects of stress. There is so much proof of this that I’m not sure even those associated with SCIENCE-BASED MEDICINE would try to deny it (although it wouldn’t surprise me).
2.) ADDRESS INFLAMMATION: Name almost any disease or chronic health condition, and in a short amount of time I will find studies linking it to chronic inflammation — probably more studies than you could wade through in a lifetime. Fail to address this systemic inflammation at your own peril. And while bodywork can certainly cause LOCAL ACUTE INFLAMMATION, which is actually part of the normal healing process, research has shown it to be highly anti-inflammatory overall.
3.) EFFECTIVE TREATMENT IS ALWAYS SYSTEMIC: Unfortunately, Americans take too may pharmaceutical drugs — way too many pharmaceutical drugs (HERE). However, this is not the only way people cover symptoms without addressing their underlying causes. Realize that virtually anything, including ENDLESSLY REPEATED CHIROPRACTIC ADJUSTMENTS (or HERE or HERE), can likewise play that role; covering symptoms without ever actually addressing causality. This is true whether said problem is local or systemic. In other words, you never go wrong treating a local problem systemically, and in most cases will reap tremendous benefits to overall health regardless.
4.) GRASPING THE MATERIAL IN THIS POST COULD BENEFIT SURGICAL OUTCOMES: While I am not a proponent of jumping quickly into a surgery without trying conservative methods first, sometimes there is simply no other alternative. This is why I always suggest that if you are going under the knife for anything other than an emergency, which you typically have no real control of, endeavor to go into it as un-inflamed as is humanly possible (HERE).
5.) CHRONIC PAIN IS A BRAIN-BASED PHENOMENON: When chronic pain pathways are repetitively reinforced (learned) by over-and-over-and-over-again activation, they can become locked into the brain (CENTRAL SENSITIZATION). Realizing this, the authors stated, “manual therapists often treat the painful area or other body structures that are physically connected to it, but this can be noxious if there is no real lesion“. While true, this statement does not tell the whole story.
The dilemma for clinicians is simple — especially when one considers that these “lesions” cannot typically be seen with today’s most commonly-used advanced imaging techniques (HERE). How do you know whether your pain is “centralized” or not? The beauty of what I do clinically is that in most cases if it is going to help, you will know after one treatment (LOOK AT OUR VIDEO TESTIMONIALS) — realize that herniated discs are a bit different. I don’t know anyone anywhere making this kind of statement and then backing it up with results.
While THIS APPROACH might temporarily fire up the overworked neurological pathways in someone who’s pain truly is “centralized,” at this point in life, what have you really got to lose? Worst case scenario is that you hurt worse than typical for a day or two (HERE). For those whose every aspect of life has been compromised and affected by their pain, however, I have yet to meet a person not willing to take this kind of risk. To the best of my knowledge, no one has ever gotten truly “worse” with our tissue remodeling treatment.
6.) YOU ARE ULTIMATELY RESPONSIBLE FOR YOUR OWN HEALTH: I say this with hesitation and a huge dose of EMPATHY, realizing I will likely get some negative feedback over it. Once again the following quote, while 100% true, is not painting many people’s picture in its entirety. “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.” While some of these “experiences” can be completely and 100% controlled, there are others that you have absolutely no control of whatsoever. Some of you know exactly what I mean.
Many of you live in chronic pain through no fault of your own. Maybe a drunk hit you head-on at 100 mph — I treat a shattered PT who lives this brutal scenario every day of her life. Or maybe someone failed to put a warning sign out on the nuclear sub you were deployed on and you slipped and fell thru an open hatch, down some very steep steel stairs because the floor had been freshly mopped and left wet (GL, I love you man!). The scenarios are endless, and some days I feel the weight of having seen way too many of them.
Regardless of the cards you’ve been dealt, you must make good decisions concerning your health because if you don’t, things will only become more DEGENERATIVE and more painful — leading to the vicious cycle discussed at length in this post. And the harsh reality is that God love him/her, your doctor can only help you so much. Either step out of the box or it is unlikely that you will have any real chance of improving your life and diminishing your pain. The harsh reality that we all learn sooner or later is that life can sometimes be very unfair.
Be sure to go back and look at the links I included as far as solving your own problem is concerned. Also, if you know anyone living a nightmare, send them a lifeboat. A lifeboat? Send them a link to our site. Or maybe like, share, or follow on FACEBOOK as it’s one of the best ways I know to reach the people you love and care about most (family, friends, support group members, etc) with free information that has the potential to help them take control charge of their lives again!
