Today we learned via Dr. Russell SCHIERLING‘s blog that “Superficial fascia, the adipose layer at the hypo-dermal level is a whole body endocrine organ, a whole body lymphoid organ, a sensory system, and a metabolic regulator.” Dr. Gil Hedley
“Since connective tissue plays an intimate role in the function of all other tissues, a complex connective tissue network system integrating whole body mechanical forces may coherently influence the function of all other physiological systems. Connective tissue bioelectrical, cellular and tissue plasticity responses, as well as their interactions with other tissues, may be key to understanding how pathological changes in one part of the body may cause a cascade of ‘remote’ effects in seemingly unrelated areas and organ systems. Connective tissue may be a key missing link needed to improve cross-system integration in both biomedical science and medicine.” Connective Tissue: A Body-Wide Signalling Network? Medical Hypotheses, June 2006
When it comes to the body, nothing is as simple it seems on the surface — it’s always far more complex. A prime example of this is fascia. Not only have I talked at length about the Endocrine system, but I have shown that body fat, as well as the bacteria that live in and on your body, act as secondary endocrine systems as well. Today I want to talk about connective tissue and particularly Fascia, as another endocrine system. Before we begin, let’s answer a simple question: What is the endocrine system and why is it important?
The endocrine system consists of hormones, the parts of your brain that originate the signals to create said hormones, as well as the actual glands where they are manufactured. Fascia and other connective tissues (bone, ligaments, tendons, and even though it’s not considered a connective tissue – muscles) are far more than simple structural entities. Furthermore, when it comes to scarred or fibrotic Fascia (there are many ways this can happen).
Think about why this is a big deal for a moment. Given that fascia is the most abundant connective tissue in the body, ask yourself how fascia could be the cause of all disease and pain if it were not intimately related to the endocrine system? Speaking of the endocrine system, let’s talk for a moment about the neuroendocrine system. If we cruise over to PubMed and search the term “neuroendocrine,” we come up with over 140,000 studies, not a misprint. But we shouldn’t be surprised once we begin to grasp the intimate relationship between neurology and endocrinology. The best example of this is to look at the HPA-Axis.
With the HPA-AXIS, the hypothalamus (brain) sends out hormones that act on the pituitary gland (brain), which in turn releases hormones that travel all over the body to effector sites. In other words, you can’t really understand neurology and brain function without understanding endocrinology, and you can’t really understand endocrinology without having a handle on neurology. They cannot be separated. And while this is nothing new, neither is the fact that these hormones have effects on connective tissues such as ligaments, tendons, and fascia.
For instance, an article from a 1921 issue of the Journal of the American Medical Association was talking about treating cancer by radiating it with x-ray and exposing the body to toxic chemicals that could stunt it or even kill it, went on to talk about a scientist who, “demonstrated the special relationship between the thymus and connective tissues. He even included connective tissues in the endocrine system. Its close connections to this system is apparent in its dependence on the different phases of development of the thyroid…..” Rather vague, but I find it amazing that a century ago there was an ongoing discussion concerning this relationship. Fast forward into the 21st century and what do we see? Some pretty amazing stuff.
Bruno Chikly is a French psychologist and licensed massage therapist. He also happens to be an MD as well as a DO (osteopath). For quite some time he has been one of the foremost experts on the lymphatic system and lymphedema, authoring the book that’s widely considered to be the definitive text on the subject (Silent Waves: Theory and Practice of Lymph Drainage Therapy: With Applications for Lymphedema, Chronic Pain, and Inflammation). Last year, his team of three researchers published a well-bibbed study (76 sources) in the Journal of the American Osteopathic Association called Primo Vascular System: A Unique Biological System Shifting a Medical Paradigm. Here is the abstract….
“The primo vascular system has a specific anatomical and immunohistochemical signature that sets it apart from the arteriovenous and lymphatic systems. With immune and endocrine functions, the primo vascular system has been found to play a large role in biological processes, including tissue regeneration, inflammation, and cancer metastases. Although scientifically confirmed in 2002, the original discovery was made in the early 1960s by Bong-Han Kim, a North Korean scientist. It would take nearly 40 years after that discovery for scientists to revisit Kim’s research to confirm the early findings. The presence of primo vessels in and around blood and lymph vessels, nerves, viscera, and fascia, as well as in the brain and spinal cord, reveals a common link that could potentially open novel possibilities of integration with cranial, lymphatic, visceral, and fascial approaches in manual medicine.”
Why is this important to know? A couple of reasons; firstly, how often are scientists or anatomists able to find a new body system today? It’s kind of like exploring. In the days of Christopher Columbus, Ferdinand Magellan, and Lewis & Clark, everything was being “discovered” because it was all new and unexplored. Discoveries of this magnitude do not occur today because everything was discovered long ago. The same thing is true in anatomy.
Secondly, it provides yet another potential endocrine avenue. “Endocrine Functions: Neurotransmitter Pathway. The PVS has also been described as an endocrine organ that transports hormones. Catecholamines (eg, adrenalin, noradrenalin) have been identified in the primo fluid in vessels on the organ surfaces. Primo vessels are ubiquitous channels for transporting fluid with immune and endocrine functions. The PVS could reasonably link tissue functions across systems. If the anatomy and pathophysiology of the PVS, in particular their roles in inflammation, endocrinology, and oncology, are confirmed, our understanding of human body systems and of medicine in general will shift.” Although some might say this is wishful thinking (or at least a great leap), it seems to me that the evidence from study after study continues to mount, pointing to the fact that even though we might not completely understand what’s going on when it comes to bodywork or chiropractic, there is often a much bigger effect than we could have imagined, or comprehend.
Thus, when we see a tissue like fascia that has obvious neurological, proprioceptive, and lymphatic properties, it certainly begins to make more sense that there are increasing numbers of brilliant physicians and researchers who either believe fascia is the chief factor in all sickness, pain, and disease, or at the very least, is a significant contributing factor. Enter Dr. Helene Langevin, an endocrinologist / neurologist at Harvard and the University of Vermont; who discovered that in 80% of the cases, acupuncture points correspond to fascial planes. A fact later verified by the STECCOS (Italian MD’s) and Tom Meyers with his ANATOMY TRAINS AS MYOFASCIAL MERIDIANS studies. This means that there is evidence pointing to the fact that fascia has the ability to act not only as a separate neurological system, but quite possibly as a separate endocrine system as well.
Back in 2003, Dr. Robert Schleip was already talking about this a study that was published in the Journal of Bodywork and Movement Therapies (Fascial Plasticity–A New Neurobiological Explanation). Dr. Schleip stated, “These hidden neurons are much smaller in diameter and are now commonly called interstitial muscle receptors. A better name would be interstitial myofascial tissue receptors since they also exist abundantly in fascia. According to the model of hypothalamic tuning states by Ernst Gellhorn, an increase in vagal tone does not only trigger changes in the autonomic nervous system and related inner organs, but also tends to activate the anterior lobe of the hypothalamus. Such a ‘trophotropic tuning’ of the hypothalamus then induces lower overall muscle tone, more quiet emotional activity, and an increase in synchronous cortical activity. This results in global neuromuscular, emotional, cortical and endocrinal changes that are associated with deep and healthy relaxation.” Interesting, considering what we know about the hypertonic quality of trigger points, as well as how dry needling has been shown to unwind these tissues. But the effect is deeper than that.
A group of a dozen Chinese physicians and researchers published a similar study in a 2010 issue of the Journal of Acupuncture and Meridian Studies called Possible Applications for Fascial Anatomy and Fasciaology in Traditional Chinese Medicine in which they stated, “Research using medical imaging instruments such as computed tomography and magnetic resonance imaging has led to the proposal that the fascial network distributed over the human body is the anatomical basis for the acupoints and meridians of traditional Chinese medicine. Stimulated stem cells in the supporting-storing system differentiate to functional cells in the functional system, and therefore, provide a cell supplement for this system. This may be one of the mechanisms for traditional Chinese medicine therapy. The result is a mobilization of the body’s reserves of stem cells and a regulation of the endocrine system.” So, even though this does not show direct endocrine system control, it does show that fascia is helping to regulate that system.