As I covered in my Crohn’s Protocol, and The Science Behind the Crohn’s Protocol, the big elephant in the room in Crohn’s is that biomechanical dysfunction from joint misalignments is probably the missing ingredient in Crohn’s that no one is paying attention to.
You’re right and treatment/exercise can and should be highly specific not only to personal weak links (within the tensegrity system) but to the specific anatomy of the immune system. For example, the gastrosplenic ligament and splenorenal ligament, gerota fascia and zuckergandl fascia as it relates to spinal and rib position etc. etc. the vast majority of practitioners lack the assessment, treatment and analytical exercise tools to maximize effectiveness.
Could you elaborate on how practitioners can learn more? Or how patients can discern whether a practitioner may be able to have this expertise? Asking for a friend :-)
It’s a tricky thing because the standard at the university level is low so that practitioners need to stumble upon better information to gain their skills through continuing education. I did an 8 year + program with many PT’s and chiros.
The above is the 4 year continuing education program that a professional can take. It’s my no means the only one out there. The critical pieces are understanding biotensegrity and relational anatomy and having complex assessment and treatments tools.
Regarding immune health there are two categories of skills a practitioner needs - 1- to know the physiology/anatomy of the immune system and how to test and work with it. -2- to know how the other systems relate to the immune system structurally and functionally. So for example, the liver, brain and GI tract may be relevant.
You can ask a practitioner questions as it’s relevant to you. So for example, if you had a TBI 10 years ago and still have some autonomic dysregulation you’d want to ask “how does this relate to my immune health?” “What are the structures that you would want to assess?” The person should know about the ALL, spinal and sacral ganglion, vagus nerve, diaphragm, dura mater, etc. and have an understanding of how to work with it.
Regardless, you’ll want a practitioner with understanding of the fascial connections between the spine, skull, rib cage and the thymus, spleen, lymph nodes and a bare minimum.
There’s a lot of lymphatic drainage practitioners and fascial manual therapists that can help you with the low hanging fruit of your immune health through a structural lens.
But I thought it could be a good moment to mention that antibodies are awful for small things present in big quantity (virus, or small free floating antigens) and rightfully the body usually mange to avoid producing too many antibodies for theses, and way better for bigger things with bigger surface like bacteria that have embed antigens.
anti-virals and anti-bacterials have different tuned drugs, and likewise for the natural body
One of the big reasons is that otherwise for free-floating antigens or small virus the antibody "Y" can form strings of antigens antibodies -> produce clots - sub-clinically clots are ball moving, hitting & producing erosion on the walls of the blood vessels.
Antibodies + Antigens string/clots are known as Precipitins - but no one mention them - too obvious of an issue against all virus vaccine ....
The man that has lots of straightforward explanations on that is Joe Lee, worth a quick read.
This might be a little out there but... what about belts? I wonder whether wearing them too tight or maybe wearing them at all could be a factor to some extent.
We started Myoactivation therapy, which focuses on breaking down scar tissue and releasing muscles, a kind of intense acupuncture. It has helped pain levels miraculously, but no change in our food and chemical sensitivities yet. We may need to give it time.
What about the Midwestern Doc who is always on about flow. I can't recall the term right now, but the MWD talk a lot about stagnant flow and the impact on health. I think it was the zeta potential?
Yes Midwestern Doc mentioned liquid crystalline water/zeta potential as helping move fluid through the body. He mentioned potassium compounds like potassium citrate as helping zeta potential. And aluminum as being bad for zeta potential. He also mentioned trampolining as being a particularly good exercise for moving fluid. And he suggested that DMSO helps fluid movement.
Chiropractors have been seeing improved immune function since 1895. I’m not talking about manipulation that’s been around for centuries…cause pushing the wrong spot can also harm the body if you think about it. The founder of chiro taught to find one place in the spine for maximum benefit. Anyways. You mention physical therapists but please don’t forget Chiropractic (after decades of scrutiny and misunderstanding- some credit from society would be nice)
I cited a chiropractic article in the Crohn’s article. I think chiropractors are generally more correct in their holistic view of the integration of skeletal and non-skeletal health, but are usually too focused on the spine.
I would not discount osteopathic providers as well, specifically those that continue to practice through their philosophy and osteopathic manipulation approach, rather than simply jumping ship to conventional medicine.
Historically, the founder of chiropractic medicine is reportedly to have received mentorship / training from, or at least visited with, early osteopathic physicians, before publishing on his own approach. Their initial philosophies were very similar.
Chiropractic historians have learned more about DD palmer, the founder of Chiropractic, in the past 5 years. Many osteopathic students who became chiropractors and studied under DD made it clear in their testimony that Chiropractic adjusting is "Very different" than Osteopathic manipulation. It's likely the other way around actually: Chiropractic inspired osteopathy to expand their manual medicine techniques, not the other way around. Lets not forget the major premise of each: Osteopathy was focused on blood circulation, Chiropractic was focused on nerve impingement.
I wouldn't discount them, but I feel like their manipulation is very cervical spine oriented and more limited even than a chiropractors, except for NUCCA chiropractor, and I think we need to be looking at the whole body.
To focus on f.x. cervical spine misalignment is not just about the cervical spine, because cervical spine misalignment will cause compensating patterns throughout the whole body including joint misalignement in other parts of the body, and vice versa. It's not always easy to find the root cause(s) of misaligments, if any.
If I understand your comment to be directed at osteopathic physicians, that's not my experience at all. My experience is that osteopathic physicians have a more comprehensive modality "toolkit" and understanding of the body, including the cranium, pelvic girdle, and the limbs then chiropractors. Overall, though, it's *very* provider dependent across all of what I would call "manual medicine" (to include physical therapists, chiropractors, osteopaths, massage therapists, craniosacral therapists, etc) - how much experience they have, how much they "buy" their own philosophy and are open to truth from other perspectives, and how much continuous learning they have sought after graduation.
Thanks, I don't have a large enough sample size to make a representative conclusion. Unfortunately all of it seems much more practitioner-dependent than credential-dependent though there are some broad generalizations that can be made.
As a physical therapist, I appreciate the idea about mechanical forces being a major factor in Crohn's, and I am not at all surprised to hear that there is a sweet spot of mechanical tension that maximally stimulates the immune system. The problem I see is that there is a massive amount of debate in the field about what constitutes "optimal" movement patterns and joint alignment, and a lot of skepticism that such things actually exist. For example, you'll find very experienced and competent practitioners who are convinced that any amount of lumbar flexion under load is terrible for you and inevitably working toward disc herniation, and then there are equally competent therapists who are big proponents of purposefully loading spinal flexion for therapeutic purposes.
I honestly think that most of the time, an annual "checkup" with a PT ends up just pathologizing things that aren't necessarily wrong or harmful. The healthiest and fittest person in the world could get on my treatment table and I can probably find some things biomechanically "wrong" with their movement patterns, but I don't think anyone can say for sure that they would actually be any kind of problem or cause any issues. People with so-called "perfect alignment" have plenty of pain, and people with "terrible" biomechanics can feel great and have zero issues, at least within the lens and context in which I work with them.
Like I could absolutely believe there are optimal ways to align joints and soft tissues to minimize risk of Crohn's and totally amp up our T cells, but who's to say what that looks like? Is there any research on joint alignment and immune function beyond the single chiropractic study? The field of PT and chiropractic is rife with pseudoscientific BS because getting your patient out of pain doesn't necessarily mean you "fixed" their biomechanics or got them moving "optimally," so it's very hard to take anecdotal accounts seriously unless there is some really compelling underlying data to support them.
What you highlight is that the issue needs to be studied. What I highlight is that the issue is being totally ignored and is probably massively important. These two ideas are completely compatible.
In the meantime, the average person has horrible problems in biomechanics and would benefit from optimizing them, even if there are major gray areas and dispute. The average person is crooked as heck from doing nothing but sitting.
The path forward is to do serious study.
The individual left in the mix would benefit from being proactive and staying ahead of the evidence basis, because the evidence basis moves slow and the people in charge of moving it are way behind the curve.
I agree, and I'm certainly not saying that people should do nothing until evidence shows the precisely right way to optimize movement. I just think that right now we can't rightfully say anyone is able to teach "optimal" biomechanics because we don't know what they truly look like and what works best.
I feel most people would be better served by going to a decent personal trainer who emphasizes taking all the joints through a full range of motion through appropriately dosed resistance training than going to a PT annually for a checkup, in all honesty.
I'm interested to see where the research goes and I appreciate that you are highlighting this concept that is not being talked about enough. It's definitely a conversation worth having and worth serious consideration.
I see a lot of ways that people can stay ahead of the evidence basis in health, but how would one stay ahead of it in this case, if we don't know what optimal movement looks like? Or if nobody can really agree on what it looks like? I'm not trying to be argumentative, I'm genuinely curious how one would stay ahead of it when it doesn't seem like there is very much to go by right now. I'm all for it if I can find the right direction to stay ahead of the evidence, but the PT world is full of so many opposing theories, conflicting evidence, and complex body system interactions, so I find it hard to navigate outside of established research with any kind of certainty (but I still try my best).
I think you are so well versed in this area that your attention is focused on the controversy and leaving behind a lot that can be agreed on.
The typical person is all kinds of misaligned from sitting too much, working on a laptop, looking down at their phone all day, and so on. There are a lot of things the average person could get that aren't very controversial.
As to what to do about the points that aren't agreed on: find something that resonates and see if it is beneficial. Hopefully more people doing this and sharing what they find drives scientific research forward.
Suppose someone's pelvis is twisted and their right iliac bone is off by an inch and putting pressure on their ileocecal valve.
Do we need to settle all of the controversies over how much glute activation you need during walking to do some manual therapy and get it back into position?
That's a perfect example of what I'm talking about. In this hypothetical situation, how do you know the person's pelvis is twisted? Visual assessment and manual palpation of pelvic landmarks is notoriously unreliable. Your pelvis could be in fine alignment but have one ASIS higher than the other, just because of anatomical variability, and PTs love to palpate those things and declare that you have a rotated innominate when that might not be the case at all. How do we know it is putting pressure on the ileocecal valve? What if they developed that asymmetry because there was pressure on the valve in their previous posture, and they compensated by twisting their pelvis?
Beyond that, some asymmetry is completely normal. If someone has obvious deformity or severe asymmetry I'll totally work on it, but if someone comes to me with mild asymmetry and no symptoms or pain and asks me to make them "optimal," I would necessarily recommend any interventions because it's likely nothing abnormal or necessary to adjust.
What I mean is, the controversy isn't "should we do it this way or that way" so much as "is this actually pathological and does it need addressing?" People can and should totally go to a PT and work on things if they are having pain, issues, symptoms, etc.BUT if they're feeling fine and go to a PT for a checkup to "optimize," then chances are they're going to be told that some very normal or at least benign structural and/or biomechanical factors are "dysfunctional" and need "realignment" or "fixing" when that likely isn't the case. And believe it or not, sometimes that can actually cause people to become fearful of moving in completely natural ways, and they can even develop pain just from the nocebic effect of being told something about them is physically wrong.
I am 100% for people seeing a skilled PT because their ileocecal valve has mechanical pressure on it and they are having resulting issues, if it can be legitimately confirmed that is the case, and if the resulting treatment can improve symptoms. I am wary of telling healthy people without symptoms or issues to get annual PT checkups because I think that can actually do more harm than good. I'd rather them just start a good exercise program with a decent personal trainer, or even under the guidance of a PT, but more from the "movement is good for you" perspective than the "you need to optimize your movement." I hope that makes sense.
Look at The Gokhale Method (Esther Gokhale) that shows you how to take each of your bones home. This methodology is based on biophysics and evidence-based biomechanics.
How S-shaped Spine is compressed spine. We are more closer to J-Spine(pain free) that we see in ancestral populations, non industrialised cultures and young children world over.
Give these a read if you will. I'm pretty much seeing the same pattern in a lot of places and your article put it together. BUT you're missing a major piece of the puzzle, the TMJ joint and it's connection to the spine and how all these structures are closely related to neural structures.
It makes a strong case for things like Taichuchuan, Baguazhang, etc. Thanks Chris.
You’re right and treatment/exercise can and should be highly specific not only to personal weak links (within the tensegrity system) but to the specific anatomy of the immune system. For example, the gastrosplenic ligament and splenorenal ligament, gerota fascia and zuckergandl fascia as it relates to spinal and rib position etc. etc. the vast majority of practitioners lack the assessment, treatment and analytical exercise tools to maximize effectiveness.
Could you elaborate on how practitioners can learn more? Or how patients can discern whether a practitioner may be able to have this expertise? Asking for a friend :-)
It’s a tricky thing because the standard at the university level is low so that practitioners need to stumble upon better information to gain their skills through continuing education. I did an 8 year + program with many PT’s and chiros.
https://www.somavoyer.com/somatherapy/overview
The above is the 4 year continuing education program that a professional can take. It’s my no means the only one out there. The critical pieces are understanding biotensegrity and relational anatomy and having complex assessment and treatments tools.
Regarding immune health there are two categories of skills a practitioner needs - 1- to know the physiology/anatomy of the immune system and how to test and work with it. -2- to know how the other systems relate to the immune system structurally and functionally. So for example, the liver, brain and GI tract may be relevant.
You can ask a practitioner questions as it’s relevant to you. So for example, if you had a TBI 10 years ago and still have some autonomic dysregulation you’d want to ask “how does this relate to my immune health?” “What are the structures that you would want to assess?” The person should know about the ALL, spinal and sacral ganglion, vagus nerve, diaphragm, dura mater, etc. and have an understanding of how to work with it.
Regardless, you’ll want a practitioner with understanding of the fascial connections between the spine, skull, rib cage and the thymus, spleen, lymph nodes and a bare minimum.
There’s a lot of lymphatic drainage practitioners and fascial manual therapists that can help you with the low hanging fruit of your immune health through a structural lens.
Slightly related Slightly unrelated
But I thought it could be a good moment to mention that antibodies are awful for small things present in big quantity (virus, or small free floating antigens) and rightfully the body usually mange to avoid producing too many antibodies for theses, and way better for bigger things with bigger surface like bacteria that have embed antigens.
anti-virals and anti-bacterials have different tuned drugs, and likewise for the natural body
One of the big reasons is that otherwise for free-floating antigens or small virus the antibody "Y" can form strings of antigens antibodies -> produce clots - sub-clinically clots are ball moving, hitting & producing erosion on the walls of the blood vessels.
Antibodies + Antigens string/clots are known as Precipitins - but no one mention them - too obvious of an issue against all virus vaccine ....
The man that has lots of straightforward explanations on that is Joe Lee, worth a quick read.
https://josephyleemd.substack.com/p/vaccines-have-the-main-effect-of
https://josephyleemd.substack.com/p/the-middle-man-2-mechanism
https://josephyleemd.substack.com/p/to-nature-reviews-nephrology
https://josephyleemd.substack.com/p/teaching-aseem-what-the-cure-for
This might be a little out there but... what about belts? I wonder whether wearing them too tight or maybe wearing them at all could be a factor to some extent.
Another very cool article, thank you!
We started Myoactivation therapy, which focuses on breaking down scar tissue and releasing muscles, a kind of intense acupuncture. It has helped pain levels miraculously, but no change in our food and chemical sensitivities yet. We may need to give it time.
Very interesting article.
What about the Midwestern Doc who is always on about flow. I can't recall the term right now, but the MWD talk a lot about stagnant flow and the impact on health. I think it was the zeta potential?
Yes Midwestern Doc mentioned liquid crystalline water/zeta potential as helping move fluid through the body. He mentioned potassium compounds like potassium citrate as helping zeta potential. And aluminum as being bad for zeta potential. He also mentioned trampolining as being a particularly good exercise for moving fluid. And he suggested that DMSO helps fluid movement.
How do you get a mouse to do stretches??
Fascinating!
If you mention good flow than grounding should be advised
and i thought i heard it all
Chiropractors have been seeing improved immune function since 1895. I’m not talking about manipulation that’s been around for centuries…cause pushing the wrong spot can also harm the body if you think about it. The founder of chiro taught to find one place in the spine for maximum benefit. Anyways. You mention physical therapists but please don’t forget Chiropractic (after decades of scrutiny and misunderstanding- some credit from society would be nice)
I cited a chiropractic article in the Crohn’s article. I think chiropractors are generally more correct in their holistic view of the integration of skeletal and non-skeletal health, but are usually too focused on the spine.
I’ll peep that article Chris thank you, and I agree. Extremity adjusting (including the cranium) is a game changer.
Amen, brother! Chiropractic first!
I would not discount osteopathic providers as well, specifically those that continue to practice through their philosophy and osteopathic manipulation approach, rather than simply jumping ship to conventional medicine.
Historically, the founder of chiropractic medicine is reportedly to have received mentorship / training from, or at least visited with, early osteopathic physicians, before publishing on his own approach. Their initial philosophies were very similar.
Chiropractic historians have learned more about DD palmer, the founder of Chiropractic, in the past 5 years. Many osteopathic students who became chiropractors and studied under DD made it clear in their testimony that Chiropractic adjusting is "Very different" than Osteopathic manipulation. It's likely the other way around actually: Chiropractic inspired osteopathy to expand their manual medicine techniques, not the other way around. Lets not forget the major premise of each: Osteopathy was focused on blood circulation, Chiropractic was focused on nerve impingement.
I wouldn't discount them, but I feel like their manipulation is very cervical spine oriented and more limited even than a chiropractors, except for NUCCA chiropractor, and I think we need to be looking at the whole body.
To focus on f.x. cervical spine misalignment is not just about the cervical spine, because cervical spine misalignment will cause compensating patterns throughout the whole body including joint misalignement in other parts of the body, and vice versa. It's not always easy to find the root cause(s) of misaligments, if any.
If I understand your comment to be directed at osteopathic physicians, that's not my experience at all. My experience is that osteopathic physicians have a more comprehensive modality "toolkit" and understanding of the body, including the cranium, pelvic girdle, and the limbs then chiropractors. Overall, though, it's *very* provider dependent across all of what I would call "manual medicine" (to include physical therapists, chiropractors, osteopaths, massage therapists, craniosacral therapists, etc) - how much experience they have, how much they "buy" their own philosophy and are open to truth from other perspectives, and how much continuous learning they have sought after graduation.
Thanks, I don't have a large enough sample size to make a representative conclusion. Unfortunately all of it seems much more practitioner-dependent than credential-dependent though there are some broad generalizations that can be made.
As a physical therapist, I appreciate the idea about mechanical forces being a major factor in Crohn's, and I am not at all surprised to hear that there is a sweet spot of mechanical tension that maximally stimulates the immune system. The problem I see is that there is a massive amount of debate in the field about what constitutes "optimal" movement patterns and joint alignment, and a lot of skepticism that such things actually exist. For example, you'll find very experienced and competent practitioners who are convinced that any amount of lumbar flexion under load is terrible for you and inevitably working toward disc herniation, and then there are equally competent therapists who are big proponents of purposefully loading spinal flexion for therapeutic purposes.
I honestly think that most of the time, an annual "checkup" with a PT ends up just pathologizing things that aren't necessarily wrong or harmful. The healthiest and fittest person in the world could get on my treatment table and I can probably find some things biomechanically "wrong" with their movement patterns, but I don't think anyone can say for sure that they would actually be any kind of problem or cause any issues. People with so-called "perfect alignment" have plenty of pain, and people with "terrible" biomechanics can feel great and have zero issues, at least within the lens and context in which I work with them.
Like I could absolutely believe there are optimal ways to align joints and soft tissues to minimize risk of Crohn's and totally amp up our T cells, but who's to say what that looks like? Is there any research on joint alignment and immune function beyond the single chiropractic study? The field of PT and chiropractic is rife with pseudoscientific BS because getting your patient out of pain doesn't necessarily mean you "fixed" their biomechanics or got them moving "optimally," so it's very hard to take anecdotal accounts seriously unless there is some really compelling underlying data to support them.
What you highlight is that the issue needs to be studied. What I highlight is that the issue is being totally ignored and is probably massively important. These two ideas are completely compatible.
In the meantime, the average person has horrible problems in biomechanics and would benefit from optimizing them, even if there are major gray areas and dispute. The average person is crooked as heck from doing nothing but sitting.
The path forward is to do serious study.
The individual left in the mix would benefit from being proactive and staying ahead of the evidence basis, because the evidence basis moves slow and the people in charge of moving it are way behind the curve.
I agree, and I'm certainly not saying that people should do nothing until evidence shows the precisely right way to optimize movement. I just think that right now we can't rightfully say anyone is able to teach "optimal" biomechanics because we don't know what they truly look like and what works best.
I feel most people would be better served by going to a decent personal trainer who emphasizes taking all the joints through a full range of motion through appropriately dosed resistance training than going to a PT annually for a checkup, in all honesty.
I'm interested to see where the research goes and I appreciate that you are highlighting this concept that is not being talked about enough. It's definitely a conversation worth having and worth serious consideration.
I see a lot of ways that people can stay ahead of the evidence basis in health, but how would one stay ahead of it in this case, if we don't know what optimal movement looks like? Or if nobody can really agree on what it looks like? I'm not trying to be argumentative, I'm genuinely curious how one would stay ahead of it when it doesn't seem like there is very much to go by right now. I'm all for it if I can find the right direction to stay ahead of the evidence, but the PT world is full of so many opposing theories, conflicting evidence, and complex body system interactions, so I find it hard to navigate outside of established research with any kind of certainty (but I still try my best).
I think you are so well versed in this area that your attention is focused on the controversy and leaving behind a lot that can be agreed on.
The typical person is all kinds of misaligned from sitting too much, working on a laptop, looking down at their phone all day, and so on. There are a lot of things the average person could get that aren't very controversial.
As to what to do about the points that aren't agreed on: find something that resonates and see if it is beneficial. Hopefully more people doing this and sharing what they find drives scientific research forward.
I mean let's consider this at another angle.
Suppose someone's pelvis is twisted and their right iliac bone is off by an inch and putting pressure on their ileocecal valve.
Do we need to settle all of the controversies over how much glute activation you need during walking to do some manual therapy and get it back into position?
That's a perfect example of what I'm talking about. In this hypothetical situation, how do you know the person's pelvis is twisted? Visual assessment and manual palpation of pelvic landmarks is notoriously unreliable. Your pelvis could be in fine alignment but have one ASIS higher than the other, just because of anatomical variability, and PTs love to palpate those things and declare that you have a rotated innominate when that might not be the case at all. How do we know it is putting pressure on the ileocecal valve? What if they developed that asymmetry because there was pressure on the valve in their previous posture, and they compensated by twisting their pelvis?
Beyond that, some asymmetry is completely normal. If someone has obvious deformity or severe asymmetry I'll totally work on it, but if someone comes to me with mild asymmetry and no symptoms or pain and asks me to make them "optimal," I would necessarily recommend any interventions because it's likely nothing abnormal or necessary to adjust.
What I mean is, the controversy isn't "should we do it this way or that way" so much as "is this actually pathological and does it need addressing?" People can and should totally go to a PT and work on things if they are having pain, issues, symptoms, etc.BUT if they're feeling fine and go to a PT for a checkup to "optimize," then chances are they're going to be told that some very normal or at least benign structural and/or biomechanical factors are "dysfunctional" and need "realignment" or "fixing" when that likely isn't the case. And believe it or not, sometimes that can actually cause people to become fearful of moving in completely natural ways, and they can even develop pain just from the nocebic effect of being told something about them is physically wrong.
I am 100% for people seeing a skilled PT because their ileocecal valve has mechanical pressure on it and they are having resulting issues, if it can be legitimately confirmed that is the case, and if the resulting treatment can improve symptoms. I am wary of telling healthy people without symptoms or issues to get annual PT checkups because I think that can actually do more harm than good. I'd rather them just start a good exercise program with a decent personal trainer, or even under the guidance of a PT, but more from the "movement is good for you" perspective than the "you need to optimize your movement." I hope that makes sense.
Thank you for sharing your perspective.
Would it be possible to discuss peroxynitrites and best ways to reduce their effects on the body (for example, using antioxidants)?
Hi Chris,
Look at The Gokhale Method (Esther Gokhale) that shows you how to take each of your bones home. This methodology is based on biophysics and evidence-based biomechanics.
How S-shaped Spine is compressed spine. We are more closer to J-Spine(pain free) that we see in ancestral populations, non industrialised cultures and young children world over.
Yes I like her contribution.
https://reviv.substack.com/p/impact-of-biomechanics-on-the-immune
https://reviv.substack.com/p/my-thoughts-on-dr-young-jun-lee-the
https://enthesis.info/research/enthesis_and_immune_system.html
Give these a read if you will. I'm pretty much seeing the same pattern in a lot of places and your article put it together. BUT you're missing a major piece of the puzzle, the TMJ joint and it's connection to the spine and how all these structures are closely related to neural structures.
What exactly is a „misaligned joint“ ? I suppose you don’t mean dislocation
A joint in an alignment that is not optimal.