Comment inverser la sclérose en plaques naturellement
Multiple sclerosis (MS) is an autoimmune disease that affects the nervous system. In MS, the immune system attacks myelin, a fatty coating around nerves that protects them and allows them to transmit messages.
Lorsque les globules blancs attaquent la myéline, des substances chimiques inflammatoires commencent à détruire la gaine de myéline autour de certains nerfs. Il en résulte que les messages du système nerveux ne peuvent pas circuler aussi bien, voire pas du tout, à travers les nerfs affectés. Les symptômes de la sclérose en plaques dépendent entièrement des nerfs touchés. Ainsi, certaines personnes atteintes de SEP peuvent ressentir des picotements ou des engourdissements dans certaines parties de leur corps, tandis que d'autres peuvent se sentir faibles ou incapables de marcher, et d'autres encore peuvent avoir des difficultés d'équilibre.
La sclérose en plaques peut entrer en rémission pendant certaines périodes, lorsque l'inflammation diminue et que la remyélinisation se produit. Mais de nombreuses personnes connaissent un déclin progressif, les fibres nerveuses étant endommagées de façon permanente. Cependant, le système nerveux possède une incroyable capacité à s'auto-guérir, à générer de nouvelles cellules nerveuses et à créer de nouvelles voies neuronales ; ces processus sont appelés neuroplasticité. Plus tôt dans le processus de la maladie, un patient atteint de MS peut stabiliser sa progression, plus il sera en mesure d'éviter des dommages permanents à son système nerveux et, éventuellement, d'inverser le cours de la maladie.
Multiple sclerosis is becoming more common. Worldwide, the number of people with MS increased by 50% between 2013 and 2020. The increase was highest in North and South America, which saw an 87% increase in the rate of MS during this time frame.
Earlier diagnosis and longer survival rate both contribute to the rate of increase, but lifestyle and environment are factors as well. Rates of autoimmune disease are increasing across the board, and research suggests that this increase is related to worsening diet, increasing rates of obesity, higher stress levels, worsening air pollution, more exposure to toxic chemicals, and increasing rates of infection.
Dr. George Jelinek, an expert on multiple sclerosis, provides detailed advice on addressing the most common lifestyle and environmental risk factors for MS in his book Overcoming Multiple Sclerosis. He discusses lack of sun exposure, low levels of vitamin D, omega-3 deficiency, a diet high in saturated fat, lack of exercise, high stress, and smoking.
In her book Healing Multiple Sclerosis, Ann Boroch focuses on the relationship between diet and gut health and MS. She has found a strong connection between processed food, intestinal permeability (leaky gut), and overgrowth of the Candida fungus, which all tend to be present in MS.
Dans cet article, j'explique comment les facteurs suivants augmentent le risque de développer une SEP, et comment des personnes peuvent inverser naturellement leur SEP en contrôlant ces facteurs :
- La génétique
- Exposition au soleil et taux de vitamine D
- Alimentation et santé intestinale
- Croissance fongique
- Infection virale et bactérienne
- Exposition aux toxines
- Le manque d'exercice
- stress
Palmer Kippola, author of Beat Autoimmune, describes “the total body burden.” This is the cumulative load of inflammatory stressors that our body is subjected to. These include any and all of the factors listed above, and each of us is subjected to a unique combination of these stressors. When our total body burden becomes too much for our natural detoxification system to handle, our immune system becomes impaired, and the result is typically an autoimmune disease.
Le rôle de la génétique dans le développement de la sclérose en plaques
Experts agree that having a genetic predisposition to multiple sclerosis is likely necessary in order to develop the disease. This genetic predisposition is the result of many inherited genes working together; probably more than 100 genes, each with a small effect. Research shows that genetics do not play a role in how the disease progresses—it simply is a factor in whether or not the disease develops in the first place.
Approximately 2.2% of the general population has this genetic predisposition to MS. Since we get half our DNA from our mothers and half from our fathers, each may contribute some genetic susceptibility. Most people who have the genetic predisposition to MS never actually develop the disease, so most people are unaware that they have the susceptibility in themselves or their family.
If you do have a first-degree relative with multiple sclerosis, your risk of developing the disease is 20 to 40 times greater than the general population. Identical twins have 300 times the risk of the general population; if one identical twin has MS, the other twin has a 24% chance of developing the disease. While 2.2% of the general population has the genetic predisposition for MS, only .03% of the worldwide population is diagnosed with the disease.
As the saying goes, “Genes load the gun, the environment pulls the trigger.” Experts agree that genetics are likely necessary to set the stage for developing MS, but lifestyle and environment are responsible for turning on the genes that trigger the disease process to begin. Approximately 25% of the risk of developing MS is genetic, while 75% is the result of lifestyle and environment.
Le rôle de la carence en Vitamin D et du manque d'exposition au soleil dans le développement de la sclérose en plaques
Due to over-avoidance of the sun, the western world is suffering from widespread vitamin D deficiency. Researchers state that this public health issue has grown to the level of a pandemic. Lack of vitamin D and sun exposure are both strongly linked to increased risk of developing multiple sclerosis.
Sadly, the general population suffers more health issues due to lack of sun exposure than from getting too much sun. It’s estimated that in 2004, vitamin D deficiency cost the US $40-56 billion, while the cost of excess UV exposure was just $6-7 billion.
L'exposition aux rayons UV du soleil est le moyen le plus efficace pour l'homme d'obtenir suffisamment de vitamine D pour rester en bonne santé. Peu d'aliments contiennent de la vitamine D, et les aliments enrichis en vitamine D ne couvrent généralement pas nos besoins quotidiens. La carence en vitamine D est associée à un large éventail de problèmes de santé, notamment le cancer, les maladies auto-immunes, l'hypertension, les maladies infectieuses, le rachitisme, l'ostéopénie, l'ostéoporose et les fractures osseuses.
The rate of multiple sclerosis increases with each degree of latitude traveled farther from the equator, except in areas with high fish consumption. For example, the Japanese population gets a lot of vitamin D from fish, which makes up for their high latitude. The farther we get from the equator, the lower the UV index, and the less vitamin D is produced from sun exposure.
A significant body of research has demonstrated the relationship between vitamin D deficiency and increased risk of multiple sclerosis. One study of 332 children with a genetic predisposition for MS found that their risk of developing MS correlated directly with their levels of vitamin D. Likewise, higher levels of vitamin D are associated with a reduced risk for developing MS, as well as with fewer relapses and reduced disease activity in MS patients.
However, getting adequate sun exposure provides more health benefits than simply triggering our body to produce vitamin D. A 2012 study of over 2000 people showed that people with the lowest amount of sun exposure had 2.2 times the risk (more than double) of developing MS than those who had the highest amount of sun exposure. The study found that the people with low vitamin D levels had 1.4 times the risk of developing MS than people with adequate vitamin D levels. The study authors suggest that UV radiation may have a protective effect against developing MS beyond simply the benefits of producing vitamin D.
Other large studies also show that adequate sun exposure, independent of vitamin D levels, is preventative for MS and helps to halt progression of the disease. Research shows that lack of sun exposure and frequent sunscreen use in childhood and adolescence increases the risk of developing MS.
It has been suggested that there may be five possible ways in which UV radiation protects against multiple sclerosis:
- Diminution de certaines cellules immunitaires dans la peau
- Une réduction de certaines protéines nécessaires à l'activation des cellules immunitaires
- Une production accrue d'interleukine10, une cytokine anti-inflammatoire
- Une réduction de l'interleukine12, une cytokine pro-inflammatoire
- La production de vitamine D3 interfère avec la fonction de certaines cellules immunitaires.
Le Dr. Jelinek recommande aux personnes atteintes de MS qui ont un faible taux de vitamine D de prendre une mégadose de vitamine D lorsqu'elles commencent à prendre des suppléments. Une mégadose peut contribuer à augmenter rapidement le taux de vitamine D. Si l'on commence simplement à se supplémenter avec des doses quotidiennes standard, il faut parfois des mois pour que la vitamine D atteigne un niveau sain. La forme correcte de vitamine D à prendre est la D3, ou cholécalciférol. Après la mégadose, il faut suivre une supplémentation régulière et s'exposer au soleil. Toute personne envisageant de prendre une mégadose de vitamine D doit le faire sous la direction de son médecin.
You can reference this chart as a general guide for how much sun exposure is ideal for your skin type based on the UV index. Many weather apps on smartphones show the current UV index of your location. When UV index is lower, longer sun exposure is necessary. It’s important to expose as much of your skin as possible, as each area of skin can produce a fixed amount vitamin D at a time. The darkest-skinned people need up to ten times more sun exposure than the fairest-skinned people, since darker skin absorbs fewer UV rays.
To learn more about how moderate sun exposure improves health, I recommend reading The Healing Power of the Sun by Dr. Richard Hobday. Dr. Jelinek also discusses this topic in detail in his book Overcoming Multiple Sclerosis.
Le rôle de l'alimentation et de la santé intestinale dans le développement de la sclérose en plaques
L'alimentation est un élément important pour toute personne souffrant d'une maladie auto-immune, car environ 70% à 80% de notre système immunitaire se trouve dans notre intestin. Ce que nous mangeons affecte directement notre microbiome intestinal et peut entraîner une perméabilité intestinale (leaky gut), qui permet à des aliments non digérés et à d'autres toxines de pénétrer dans la circulation sanguine, ce qui entraîne des problèmes de santé majeurs.
There is some debate about what is the best diet for people with multiple sclerosis. Essentially, the debate is whether a plant-based diet (like the Swank diet and the OMS diet) or a paleo diet (like the Wahl’s protocol) is more beneficial.
La recherche confirme que tous ces régimes sont bénéfiques pour la SEP, ce qui suggère que les facteurs les plus importants pourraient être l'élimination des aliments transformés et des graisses malsaines. Les produits laitiers sont également éliminés dans deux de ces trois régimes populaires.
Le régime alimentaire occidental typique, riche en aliments transformés, en glucides raffinés et en graisses saturées, et pauvre en fibres et en micronutriments, a des effets négatifs sur le microbiome intestinal. Ce type d'alimentation réduit la diversité globale de nos bactéries intestinales et provoque la prolifération de certaines "mauvaises" bactéries, ce qui est associé à une augmentation de l'inflammation dans tout le corps.
Research shows that people with multiple sclerosis have gut dysbiosis, which is an imbalance of the microorganisms in the gut. MS symptoms can be reduced by intentionally improving the gut microbiome, through diet change, taking probiotics, and fecal microbial transplantation. Researchers suggest that adjustment of the gut microbiome may be a future direction of treatment for MS.
Intestinal permeability, commonly referred to as leaky gut, occurs when the protective mucosal lining in the gut becomes inflamed and porous. This can result from an imbalance in gut bacteria, maldigestion, and malabsorption, all of which are directly related to diet. When our gut lining is porous, undigested food particles and other toxins can travel into the bloodstream. These substances overload the immune system, leading to autoimmune conditions.
The term autoimmune means that the immune system is attacking its own body. Molecular mimicry is one reason why this happens. This term describes a phenomenon in which molecules of one organism are identical or very similar to those of another organism. In autoimmune disease, the immune system learns to attack a foreign molecule, and if that foreign molecule is similar in structure to a molecule of the person’s own body (such as myelin), that molecule will also be attacked.
Dairy protein is similar to myelin in structure. When dairy protein travels through the walls of a leaky gut into the bloodstream, the adaptive immune system learns to attack it. Since myelin is similar in structure to dairy protein, the immune system is tricked into attacking the nerves’ myelin sheath.
Likewise, gluten is similar in structure to myelin, and has been shown to trigger neurological antibodies that cause demyelination. Gluten consumption is now linked to autoimmune conditions including multiple sclerosis, as well as neurodegenerative conditions including Parkinson’s disease and Alzheimer’s disease. While gluten sensitivity is typically associated with digestive symptoms, it can manifest solely as neurological dysfunction. Gluten intolerance is also linked to Candida overgrowth, which is a risk factor for MS, and is discussed in the next section.
Both Palmer Kippola, author of Beat Autoimmune, and Dr. Terry Wahls found that eliminating gluten was a key factor in allowing them to recover from multiple sclerosis. Since people who are gluten-sensitive are often sensitive to all lectins (anti-nutrient proteins found in most grains), it can be beneficial for these people to eliminate all grains from the diet.
We literally are what we eat; the building blocks of our cells are made up of what we consume. For people with MS, this is especially important when it comes to the types of fat they eat. The myelin sheath is made of fat and protein, and the brain is about 60% fat. When people change the types of fat they eat, it affects the makeup of these fat cell membranes. Consuming saturated fat leads to cells that are less flexible, while consuming unsaturated fats leads to more flexible cells that are less susceptible to degeneration.
One study found that cell membranes of people with MS contained fewer polyunsaturated fatty acids and more saturated fatty acids than healthy controls. Other studies have found similar deficiencies in omega-3 fatty acids in the cell membranes of people with MS. Research has also found that worse lipid profiles are associated with higher levels of disability in MS and worse disease progression.
In Overcoming Multiple Sclerosis, Dr. Jelinek goes into detail about how the types of fat we consume directly relate to risk of MS and disease progression. He also explains his recommendations for fat intake, which include consuming sources of healthy fats like fish and flaxseed oil, limiting saturated fat, and avoiding hydrogenated and trans-fat completely.
Ultimately, each person has to figure out which foods cause inflammation for them. Each of us has a unique gut microbiome and a uniquely adapted immune system. An elimination diet, like the Whole30 diet, can be extremely helpful in determining which foods are inflammatory for you.
I also recommend reading Beat Autoimmune, The Autoimmune Solution, and The Wahls Protocol for advice on making dietary changes to reverse your autoimmune condition.
Le rôle de l'infection fongique dans le développement de la sclérose en plaques
Fungal infection, particularly with Candida albicans, is associated with an increased risk of multiple sclerosis. Candida albicans is a harmless yeast that resides in everyone’s bodies. However, if it overgrows, it can become pathogenic. Ann Boroch goes into detail about the relationship between Candida and multiple sclerosis in her book Healing Multiple Sclerosis.
There are many risk factors for developing Candida overgrowth, including antibiotics, corticosteroids, hormonal therapies, chemotherapy, radiation, heavy metal exposure, recreational drugs, and stress. Candida thrives on a diet of processed foods, sugar, refined carbohydrates, dairy products, and alcohol.
Candida produces many toxic by-products which can cause major health problems. One type of these by-products is mycotoxins, which are neurotoxins that can damage and destroy neurons, disrupt RNA and DNA synthesis, disrupt immune system function, and contribute to cancer growth.
Another toxic substance produced by Candida is acetaldehyde. This toxin is produced in the digestive tract when Candida feeds on carbohydrates or alcohol. An excess of acetaldehyde affects nervous system function, leading to nerve cell death, depression, anxiety, slowed reflexes, brain fog, lethargy, impaired memory and concentration, and deficiency of vitamins that are crucial for nervous system function.
Candida can attack any tissue or organ, but most commonly attacks the muscles and nerves. When Candida and its by-products accumulate in the nervous system, they can attack and create lesions on the myelin sheath.
One small 2008 study found serum antibodies against Candida to be present in seven out of eight MS patients, while no antibodies were present in 10 healthy controls. A larger 2010 study found that Candida and its antibodies were present at a significantly higher rate in MS patients compared to healthy controls.
More recent research from 2022 shows a distinct difference in the mycobiome (the fungal microbiome) of MS patients as compared to healthy controls. Multiple sclerosis patients have increased abundance of fungus, including Candida, and an overall increased fungal to bacterial ratio.
Ann Boroch feels strongly that fungal infection is present in nearly all cases of multiple sclerosis. She describes in detail how to treat fungal infection in her book Healing Multiple Sclerosis. She provides a great deal of information about various anti-fungals, both pharmaceutical and herbal, as well as the diet that allows Candida and other fungus to die off. If you have multiple sclerosis, it is worth considering whether you have any of the symptoms or risk factors (listed at the beginning of this section) for fungal infection, and if so, consider appropriate testing and treatment.
Le rôle des infections virales et bactériennes dans le développement de la sclérose en plaques
Certaines infections virales et bactériennes sont plus fréquentes chez les personnes atteintes de sclérose en plaques que dans la population générale. Ces virus peuvent augmenter le risque de développer la SEP, ou être présents parce que les personnes atteintes de SEP sont immunodéprimées et incapables de combattre les infections, ou les deux.
A 2022 study showed definitively for the first time the way in which the Epstein-Barr virus (EBV; responsible for mononucleosis) triggers multiple sclerosis. It occurs through molecular mimicry, which I discussed above in the diet section. When a person is infected with EBV, the immune system learns to attack a protein from the virus called EBNA1. This protein mimics a protein called GlialCAM, which is found in myelin. So as the immune system attacks the virus, it is also tricked into attacking its own myelin. While this study found that 20% to 25% of MS patients have antibodies to EBNA1 in their bloodstream, another large study of MS patients found that EBV infection was present in virtually all patients at time of disease onset.
Evidence has also been found for infections of varicella-zoster virus, human herpes virus 6, and Chlamydia pneumoniae being associated with increased risk of MS. Some studies show that these infections are more easily detected by lab tests during relapses than during periods of remission. It is possible that addressing infections with specific antiviral or antibiotic medications may help to reduce symptoms; this an area of current and future research.
Le rôle des toxines environnementales dans le développement de la sclérose en plaques
Les substances toxiques, telles que les métaux lourds, les pesticides et d'autres produits chimiques, s'accumulent dans notre corps et surchargent le système immunitaire. Nombre de ces substances sont des neurotoxines et peuvent déclencher la sclérose en plaques. En outre, ils surchargent et affaiblissent le système immunitaire au point qu'il ne peut plus lutter contre les infections ou se défendre contre d'autres causes de la SEP.
A 2021 meta-analysis found that MS patients had significantly higher levels of arsenic and cadmium than healthy control subjects. Both arsenic and cadmium are neurotoxins, capable of damaging the nervous system, and may play a role in MS by producing oxidative stress. Mercury and lead, both also highly toxic to the nervous system, may increase the risk of MS, though research is mixed. A case study of an MS patient with high levels of aluminum, lead, and mercury found that chelation therapy successfully brought his heavy metal levels into normal range while also reducing his MS symptoms.
Multiple sclerosis occurs at higher rates in areas that have a high use of chemicals such as pesticides and mothballs. Farm workers who are exposed to high levels of pesticides have an increased risk of MS as well. And people who do industrial work that uses chemicals, such as in the shoe and leather industries, show a higher risk of developing MS.
Living in areas that are highly polluted is also associated with higher rates of MS incidence and relapse. Researchers suggest that inhaling particulate matter may allow toxic chemicals to travel into the bloodstream, triggering inflammation that affects the nervous system. Nitrogen oxides (gasses that contribute to air pollution) cause neuroinflammation and protein misfolding, and potentially contribute to neurodegeneration and MS.
If you suspect that environmental toxicity may be contributing to your disease, you should talk to your doctor about getting tested for heavy metals and other toxins. Ann Boroch discusses the detoxification process in her book Healing Multiple Sclerosis, as do Palmer Kippola, Dr. Amy Myers, and Dr. Terry Walhs in their books on reversing autoimmune disease.
Le rôle de l'exercice physique dans l'inversion de la sclérose en plaques
A great deal of research has shown the benefits of different types of exercise for people with multiple sclerosis. Aerobic training has been found to improve aerobic fitness and respiratory function and reduce fatigue. Resistance training improves muscle strength and walking and reduces fatigue. Flexibility exercises can reduce muscle spasticity and prevent painful muscle contractions. MS patients also benefit from balance exercises which improve walking and prevent falls. Various types of physical exercise have been shown to improve cognition, reduce depression, and improve quality of life for people with MS.
It’s clear that exercise improves quality of life and many other symptoms of multiple sclerosis, but an important question to ask is whether or not exercise actually slows the progression of the disease. Funding for long-term studies on this topic is hard to come by, but the studies that have been done are promising. A 2012 review found significant evidence in the animal model of MS, as well as in some human studies, to suggest that regular exercise can slow the disease process. In animal models, the animals who exercised experienced a delayed onset of the disease and their symptoms were less severe than the animals who did not exercise. In humans, regular exercise appears to slow disease progression, reduce symptoms, improve cognitive function, and improve walking. Likewise, a five-year study of 611 MS patients found that higher exercise levels were associated with reduced symptoms and functional limitations and improved quality of life over the course of five years.
There are at least two reasons why exercise helps to slow the disease process. Physical exercise increases production of neural growth factors, two of which are brain-derived neurotrophic factor (BDNF) and nerve growth factor (NGF). These proteins help to repair damaged nerve cells in people with MS, as well as prevent ongoing damage to nerves.
Exercise also has an anti-inflammatory effect and strengthens the immune system. Regular exercise has been shown to reduce the autoimmune responses present in MS. This occurs because exercise curbs the hyperactivation of immune cells, restricts peripheral immune cells from moving into the central nervous system, and shifts the balance of the immune response from a pro-inflammatory to an anti-inflammatory state.
Dr. George Jelinek offers detailed advice on how to start exercising in his book Overcoming Multiple Sclerosis. He recommends starting slowly and increasing the duration and intensity of your workouts very gradually. He suggests starting with a duration and intensity of workout that is less than what you are capable of, so as to not overdo it. Dr. Jelinek also recommends seeking out a trainer or therapist who works with people who have MS, as they will have the knowledge and experience to modify exercises and create a personalized training plan.
Le rôle du stress dans le développement de la sclérose en plaques
A growing body of research shows the relationship between chronic stress, stressful events, and worsening of MS symptoms. A number of studies have found that stressful life events are associated with relapses, worsening of existing brain lesions, and development of new brain lesions in patients with MS.
Researchers propose that this may occur because stress activates mast cells, a type of immune cell, and chronic stress leads to glucocorticoid resistance in immune cells. Also, disruption in the communication between the immune system and the natural stress response systems appears to occur in MS, leading to an increase in inflammation, neurodegeneration, and disability.
Researchers have studied the effects of a stressful work schedule, specifically shift work, on the risk of developing MS. One study found a 30% to 60% increased risk of developing MS in people who had done shift work done at a young age. Sleep restriction and disruption of the circadian rhythm, which affects stress hormone levels and melatonin secretion, are associated with the increase in inflammation that results from shift work. In addition, shift workers are prone to vitamin D deficiency due to lack of sun exposure, and low vitamin D levels are directly associated with increased risk of MS.
Le Dr Jelinek et Ann Boroch fournissent tous deux des conseils précieux sur la manière de gérer le stress et d'aborder les croyances limitantes, les émotions fondées sur la peur et la perte d'espoir dans leurs livres. Le Dr Jelinek estime que la responsabilisation est d'une importance capitale dans la guérison de la sclérose en plaques ou de toute autre maladie chronique. La recherche montre que les personnes qui se sentent capables de prendre leur santé en main et qui sont proactives dans leur processus de rétablissement obtiennent de meilleurs résultats en matière de santé, notamment une meilleure qualité de vie et un meilleur état fonctionnel, moins de visites médicales et une diminution des symptômes dépressifs.
Réduire votre niveau de stress et votre réaction aux événements stressants peut sembler décourageant ou impossible. Il peut être utile d'entamer une thérapie par la parole avec un professionnel expérimenté dans le conseil aux personnes atteintes d'une maladie chronique. De nombreuses pratiques physiques sont également très efficaces pour réduire le stress, notamment l'exercice physique, un sommeil suffisant, les bains de soleil et un régime alimentaire pauvre en caféine, en sucre et en alcool. En outre, vous devriez trouver un médecin qui vous soutienne dans votre parcours de guérison.
Aller de l'avant dans votre processus de guérison
If you have multiple sclerosis, I highly recommend reading both Ann Boroch’s book Healing Multiple Sclerosis and Dr. George Jelinek’s book Overcoming Multiple Sclerosis. Both authors were diagnosed with multiple sclerosis, and committed to a healing process that allowed them to become symptom-free.
If you have multiple sclerosis or any other autoimmune condition, I also recommend reading Palmer Kippola’s book Beat Autoimmune and Dr. Terry Wahls book The Wahls Protocol. Both of these authors were also diagnosed with multiple sclerosis, and put their disease into remission by addressing the lifestyle and environmental factors that were contributing.
Ann Boroch propose ces sages paroles :
"Avant que vous ne sachiez que vous étiez atteint de la SEP, il s'est écoulé au moins dix à quinze ans. Le système nerveux central est le système le plus lent à guérir dans l'organisme, c'est pourquoi il faut faire preuve de patience et de ténacité. La recherche d'une solution miracle ne conduira qu'à la déception et à un déclin plus important. La meilleure approche pour guérir la SEP est de s'informer, d'appliquer les protocoles qui vous conviennent et de s'engager à changer votre mode de vie pour le meilleur."
Lecture recommandée:
The Pain Relief Secret: How to Retrain Your Nervous System, Heal Your Body, and Overcome Chronic Pain by Sarah Warren, CSE
Somatics: Reawakening the Mind’s Control of Movement, Flexibility and Health by Thomas Hanna