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Transcript
Mechanical Signaling Through Connective Tissue: A Mechanism for the
Therapeutic Effect of Acupuncture
One explanation of how manual therapy works is provided by Donald E. Ingber MD,
PhD, at Harvard Medical School (2008) who argues for the “concept of cellular
mechanotransduction, the process by which cells sense mechanical forces and transduce
them into changes in intracellular biochemisty and gene expression.” Based on a prolific,
federally funded research program over a number of years, Dr. Ingber has been studying
cells on the nanometer scale. He views “the cytoskeleton as an architectural structure that
actively generates tensile forces and distributes them to other components inside the
cell”. Ingber (2006) suggests that in the living body “the process of cellular
mechanotranduction might be more a phenomena of structural hierarchies and biological
architecture than the action of any single mechanotransduction molecule”. This has
significant implications for the field of manual therapy. Ingber (2006) states that to “seek
out and study individual biological parts in isolation without considering contributions of
multiscale architecture and invisible internal forces means we will never be able to fully
understand how physical forces influence biological form and function.”
The cellular/tensegrity research of Ingeber (2008), connective tissue research of Langevin
et al. (2001 and 2002), and the fascial research of Schleip (2003) are critical in our
understanding of connective tissue and its applications in the manual therapies.
Wyke’s mechanoreceptor research (1980) has been instrumental in understanding the
effects of the manual therapies and in particular joint mobilization/manipulation. Schleip
(2003) explains the importance of fascial mechanoreceptors, and with manual
manipulation changes can occur in the viscosity of the ground substance and a lowering
of sympathetic tonus. Schleip (2003) has also found smooth muscle cells in fascia that
appear to be involved in active fascial contractility and have only been reported in large
fascial sheets. Pacinian corpuscles are also found in the peritoneum (Stilwell in Schleip
2003 page 15) and can be influenced by manual therapy (Schleip 2003}.
Mechanoreceptors have been found in the visceral ligaments (Schleip, 2003). The “belly
(enteric) brain” (Gershon in Schleip 2003 p. 17) contains more than 100 million neurons.
Many of these sensory neurons function as mechanoreceptors.
Ingber, D.E. (2008) Tensegrity-Based Mechanosensing from Macro to Micro. Progress
Biophysics Molecular Biology 97(2-3) pages 163-179
Langevin, H., Churchill, D. Cipolla, M (2001) Mechanical Signaling Through
Connective Tissue: A Mechanism for the Therapeutic Effect of Acupuncture. Federation
of American Societies for Experimental Biology volume 15 , 2275-2281
Langevin, H., Yandow, J., (2002) Relationship of Acupuncture Points and Meridians to
Connective Tissue Planes. The Anatomical Record, 269(6) pages 257-265
Wyke, BD. (1980) Articular Neurology and Manipulative Therapy. In Aspects of
Manipulative Therapy. Ed. Idezak, R.M. Lincoln Institute of Health Sciences.
Ingber, D.E. (2008) Tensegrity-Based Mechanosensing from Macro to Micro. Progress
Biophysics Molecular Biology 97(2-3) pages 163-179