The Gut Microbiome’s Role in Musculoskeletal Health and Injury Recovery

Introduction: Why the Gut-Musculoskeletal Connection Matters

The gut microbiome — the complex community of bacteria, fungi, and other microorganisms living in the digestive tract — is increasingly recognized as a key player in musculoskeletal health. While it’s well known that muscles, bones, and connective tissues rely on proper nutrition and exercise, fewer people realize that gut microbes directly influence nutrient absorption, inflammation control, hormone regulation, and even tissue regeneration. These processes affect muscle strength, bone density, and the body’s ability to recover from injury.

Dr. Alexander Jimenez, DC, APRN, FNP-BC, a nurse practitioner and chiropractor based in El Paso, specializes in treating patients involved in work-related, sports, personal, and motor vehicle injuries. In his dual-scope clinical work, he often finds that individuals with poor gut health experience longer recovery times, more pain, and reduced mobility. His treatment protocols address both the structural and biochemical aspects of healing, recognizing that a patient’s microbiome can determine the speed and quality of musculoskeletal recovery.

(Harvard Medical School, 2024)

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Understanding the Gut Microbiome

The gut microbiome is made up of trillions of microorganisms, including bacteria, viruses, archaea, and fungi, that collectively influence digestion, immunity, and metabolism. These organisms help break down food, synthesize vitamins, and produce bioactive compounds that affect tissues far beyond the digestive tract. Advances in research now show that the microbiome interacts closely with the musculoskeletal system through multiple pathways, including immune signaling, hormonal modulation, and nutrient delivery.

Injury, illness, poor diet, stress, and certain medications can disrupt the microbiome’s balance, a condition known as dysbiosis. This imbalance can reduce the body’s ability to absorb the very nutrients muscles and bones need for repair, while increasing inflammation that slows healing. Understanding this relationship gives clinicians like Dr. Jimenez more tools to optimize recovery and long-term musculoskeletal health.

(Microbiome in Motion, 2025)

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Nutrient Absorption: Building Blocks for Healing

A healthy gut microbiome enhances nutrient absorption by breaking down complex carbohydrates, proteins, and fats into usable components. Certain gut bacteria produce short-chain fatty acids (SCFAs) such as butyrate, propionate, and acetate, which not only fuel colon cells but also improve intestinal lining integrity. This tight barrier prevents inflammation-causing toxins from leaking into the bloodstream and ensures that critical nutrients like calcium, magnesium, phosphorus, vitamin D, and vitamin K are efficiently absorbed.

These nutrients are the foundation for tissue repair:

• Calcium and phosphorus strengthen bones and aid in muscle contraction.
• Vitamin D supports calcium absorption and muscle function.
• Vitamin K plays a role in bone mineralization.
• Magnesium contributes to muscle relaxation and energy production.

In Dr. Jimenez’s clinic, patients with fractures, ligament tears, or muscle strains often undergo nutritional evaluations to ensure they’re getting these nutrients. He uses both dietary interventions and supplementation when necessary, always considering the gut’s ability to process and absorb these compounds effectively.

(Calcium: a pivotal mineral for bone growth, 2024)

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Inflammation Control: The Healing Accelerator

Inflammation is essential for repairing damaged tissues, but chronic or excessive inflammation can slow healing and worsen musculoskeletal pain. The gut microbiome helps regulate inflammation by producing SCFAs and other metabolites that influence immune cell function. Balanced gut bacteria promote a measured inflammatory response, ensuring that the body addresses injury without causing excessive tissue damage.

Diet plays a key role in maintaining this balance. High-fiber foods, fermented products, and polyphenol-rich fruits and vegetables feed beneficial bacteria, increasing SCFA production. On the other hand, diets high in processed foods and low in fiber promote the growth of pro-inflammatory microbes.

Dr. Jimenez has seen patients with joint injuries recover faster when they adopt anti-inflammatory dietary patterns alongside physical therapy and chiropractic adjustments. For example, a patient with chronic knee swelling after a sports injury experienced significant improvement within six weeks after adding probiotic-rich foods and reducing processed sugar intake.

(Digbi Health, 2024)

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Hormone Regulation: Microbes as Endocrine Partners

The gut microbiome influences the production and regulation of key hormones involved in musculoskeletal recovery, including:

• Insulin-like growth factor 1 (IGF-1) — promotes muscle protein synthesis and repair.
• Testosterone and estrogen — regulate bone density and muscle mass.
• Cortisol — a stress hormone that, in excess, can break down muscle and weaken bones.

Certain gut bacteria produce metabolites that signal the endocrine system to increase anabolic hormones and suppress excessive cortisol production. When dysbiosis occurs, these regulatory signals can be disrupted, leading to slower tissue repair and increased injury risk.

In his dual-scope practice, Dr. Jimenez often evaluates hormone levels in patients with unexplained muscle weakness or delayed healing. He then combines chiropractic rehabilitation with nutritional protocols to restore hormonal balance.

(IGI-Global, 2024)

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Microbiome and Muscle Growth

A healthy gut microbiome plays a direct role in muscle growth and repair. Research shows that microbial metabolites such as short-chain fatty acids (SCFAs) help regulate muscle metabolism by providing an additional energy source, enhancing mitochondrial function, and reducing oxidative stress. These metabolites can also boost the production of IGF-1, a hormone essential for muscle protein synthesis and regeneration (PMC9132697, 2022).

Dr. Jimenez has observed that patients recovering from muscle tears or post-surgical muscle atrophy progress more rapidly when their treatment plans include both resistance exercise and microbiome-supportive nutrition. For example, pairing progressive strength training with a diet rich in prebiotic fibers (like asparagus, onions, and oats) and fermented foods often leads to better muscle endurance and less soreness.

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Microbiome and Bone Density

The relationship between the gut microbiome and bone health is multifaceted. Beneficial gut bacteria improve the absorption of bone-building minerals such as calcium, magnesium, and phosphorus. They also produce SCFAs that promote osteoblast activity — the cells responsible for building new bone (PMC11062616, 2024).

Emerging research suggests that maintaining a diverse gut microbiome can help prevent bone loss conditions such as osteoporosis. Dr. Jimenez uses advanced imaging to track bone density in patients with fractures, especially those with digestive or dietary challenges. In some cases, patients who combined chiropractic care, weight-bearing exercises, and gut-focused nutrition saw measurable improvements in bone density within a year.

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Gut-Brain-Muscle Communication

The gut and brain are linked via the gut-brain axis, a network of nerve pathways and chemical signals that influence pain perception, muscle coordination, and inflammation. The microbiome can alter these signals, impacting how the body responds to injury and recovers (IAOM-US, 2024).

Dr. Jimenez has treated patients with chronic musculoskeletal pain that improved significantly after gut health interventions. By combining chiropractic adjustments to improve nerve function with nutritional strategies to restore microbiome balance, he addresses both the structural and biochemical sources of discomfort.

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Dysbiosis: When the Gut Holds Back Recovery

Dysbiosis occurs when harmful bacteria outnumber beneficial ones. This imbalance can be triggered by poor diet, stress, antibiotics, illness, or injury itself. Dysbiosis may:

• Increase inflammation
• Impair nutrient absorption
• Disrupt hormone production
• Slow tissue repair
• Increase risk of reinjury

Signs of dysbiosis in injured patients often include persistent swelling, muscle weakness, bone fragility, and gastrointestinal symptoms. Dr. Jimenez uses a combination of medical history review, dietary assessment, and sometimes lab testing to detect dysbiosis. Treatment may involve probiotics, prebiotic-rich foods, and targeted anti-inflammatory nutrients.

(PMC12137108, 2024)

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Dr. Alexander Jimenez’s Dual-Scope Approach

Dr. Jimenez is uniquely qualified as both a chiropractor and nurse practitioner, allowing him to combine musculoskeletal expertise with advanced medical diagnostics. His approach includes:

• Dual-scope diagnosis: blending orthopedic and neurological assessments with internal medicine evaluation
• Advanced imaging: MRI, CT, and ultrasound for precise injury identification
• Microbiome awareness: screening for gut health factors that could delay recovery
• Legal-medical documentation: assisting in personal injury cases by providing thorough reports that link injuries to their biomechanical and systemic impacts

In his clinic, treatment plans integrate chiropractic adjustments, rehabilitative exercise, nutrition counseling, and soft tissue therapies — all tailored to the patient’s injury type and gut health status.

(DrAlexJimenez.com, 2025)

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Chiropractic Care and the Microbiome

While chiropractic adjustments focus on restoring proper spinal and joint alignment, they may also indirectly benefit gut health. The nervous system regulates gastrointestinal motility and secretion; when spinal misalignments disrupt nerve signals, digestion and gut function may be affected. By correcting these misalignments, chiropractic care can support optimal nerve communication to the gut, potentially improving microbiome stability.

Dr. Jimenez has noted that patients with both musculoskeletal pain and digestive complaints often report improvements in both areas after a combined plan of adjustments and microbiome-friendly nutrition.

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Massage Therapy’s Role in Recovery and Gut Health

Massage therapy supports injury recovery by improving circulation, reducing muscle tension, and enhancing lymphatic drainage. These effects can lower cortisol levels and improve overall relaxation — factors that positively influence gut microbial balance. Lower stress hormones help maintain a healthy gut lining, which in turn supports better nutrient absorption and reduced inflammation.

In Dr. Jimenez’s integrative programs, massage is often paired with dietary strategies to create a comprehensive recovery environment.

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Acupuncture for Pain, Inflammation, and Digestion

Acupuncture stimulates nerve pathways that influence both musculoskeletal and gastrointestinal function. Studies suggest it can reduce inflammation, regulate the immune system, and improve digestive motility. Dr. Jimenez integrates acupuncture into recovery plans for patients with pain and gut issues, especially when stress or inflammation is contributing to both.

This approach is particularly effective for individuals recovering from injuries where both pain and digestive symptoms are present.

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Nutrition and Lifestyle for a Healthy Microbiome

Diet and lifestyle choices have a profound effect on microbiome diversity and stability. Dr. Jimenez recommends:

• High-fiber foods: fruits, vegetables, legumes, and whole grains
• Fermented foods: yogurt, kefir, kimchi, sauerkraut
• Prebiotic-rich foods: onions, garlic, asparagus, oats
• Polyphenol-rich foods: berries, green tea, olive oil
• Adequate hydration: to support digestion and nutrient transport
• Regular exercise: to stimulate microbial diversity
• Stress management: yoga, meditation, or breathing exercises
• Sufficient sleep: to regulate immune and hormonal function

These habits not only maintain gut health but also enhance the body’s ability to heal and adapt to physical therapy.

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Preventing Long-Term Musculoskeletal Complications

Chronic dysbiosis can lead to long-term musculoskeletal problems, including:

• Osteoporosis (weak bones)
• Sarcopenia (muscle loss)
• Osteoarthritis (joint degeneration)
• Chronic pain syndromes

Preventive strategies focus on keeping the microbiome balanced even after injury recovery. This involves continued attention to diet, exercise, stress reduction, and periodic health assessments.

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Action Plan for Patients

Dr. Jimenez provides patients with a step-by-step recovery checklist:

1. Assess gut health early in the rehabilitation process
2. Adopt an anti-inflammatory, high-fiber diet
3. Incorporate probiotics and prebiotics
4. Engage in guided physical therapy and chiropractic care
5. Use massage and acupuncture as adjunct therapies
6. Monitor progress with follow-up imaging and evaluations
7. Maintain long-term gut health habits to prevent re-injury

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Conclusion

The gut microbiome is a central player in musculoskeletal health and injury recovery. It regulates nutrient absorption, controls inflammation, influences hormone production, and supports muscle and bone regeneration. When the microbiome is out of balance, recovery slows, pain persists, and long-term complications can arise.

Dr. Alexander Jimenez’s integrative, dual-scope approach demonstrates how gut health can be incorporated into comprehensive rehabilitation plans. By combining chiropractic care, functional medicine, and advanced diagnostics, patients not only recover from injury but also build resilience for the future.

Maintaining a balanced gut microbiome through diet, lifestyle, and targeted therapies offers a powerful way to improve musculoskeletal outcomes, speed healing, and enhance overall well-being.

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References

• How gut microbes help mend damaged muscles
• Insulin-Like Growth Factor 1 and muscle growth
• Calcium: a pivotal mineral for bone growth
• Microbiome in motion: revolutionizing musculoskeletal recovery
• Owlstone Medical: Gut and immune system
• Digbi Health: Gut’s role in chronic pain
• Aspire PT and Wellness: Gut microbiome and injury recovery
• IAOM-US: Gut microbiome and musculoskeletal pain
• PMC12137108: Dysbiosis and musculoskeletal health
• PMC11062616: Gut microbiome and bone mineralization
• Dr. Alexander Jimenez — Clinical Observations