Bones are moved by muscle; shock is absorbed by discs; joint segments allow for motion. When joints get fixated proprioceptive input (body-awareness sense) is compromised.
Chiropractors assess movement of the spine and extremities. When our biomechanics are compromised, certain joint movement may be restricted, limiting not only motion but also the neuro-electrical communication that travels that same route. The nervous system extends from the brain and connects to each muscle, fascia, and organ, controlling its function. Subluxations (or restricted joints) may first overstimulate the nerve innervation from that segment, but if left untreated may degenerate surrounding tissues and lead to chronic dysfunction and pain.
Restoring motion with a chiropractic adjustment stimulates second-order joint mechanoreceptors that override pain in the short term. Movement allows for DE-afferentation of pain (meaning movement overrides pain). When one experiences lack of movement, pain signals reach the brain’s cortex. Routine chiropractic care allows for more ideal movement patterns, lowering the stress on one’s nervous system and the tissues (muscle and organs) that a nerve innervates.
Athletes rely on proprioception (body-awareness) to perform optimally. The joints in our body contain tons of these sensory receptors. When joints are fixated or hypermobile (move too much), this input system dysfunctions and relays incomplete information to our brain’s cortex, where body-position sense is ultimately perceived.
Whether it’s recovering from a sports injury or staying in peak condition, athletes regularly visit chiropractors to get a natural sporting advantage. For those with injuries, sports-specific rehabilitation is used to strengthen the muscles and stabilize the joint of an injured area.
Auto Accidents / Whiplash
Everyone’s heard of whiplash but why can it become a long-term problem? The mechanism behind whiplash is your lower cervical spine (your neck) hyperextends before full neck extension. Often times the supraspinous ligament is torn. This is a ligament that lies inbetween the spinous processes along your spine.
Negative consequences from whiplash may occur in vehicles moving as slow as 9 mph!!
Defensively, a person shifts the weight-bearing portion from the facets to the anterior part of the disc. This causes a degenerative effect and may lead the tearing of the disc and buckling. The facet joints are the most common pain generators in chronic whiplash injury.
Chiropractic has been seen instrumental in the improvement of this condition and in helping avoid progression to a chronic condition.
Pregnancy & Chiropractic
The female body experiences structural stresses in pregnancy, commonly including : increased lumbar lordosis and sacral base angle, increased segmental mobility (particularly of the sacroiliac and pubic articulations), a weight-bearing shift to one’s heels, and gait alterations. While multiple factors may cause pubic symphysis dysfunction, it has been suggested that instability of the pelvic girdle is the most common cause of pelvic joint pain in pregnancy, including pain in the pubic symphysis.
Maternal hormones contribute to joint-laxity by producing connective-tissue changes that cause ligaments to lengthen and weaken, allowing changes in posture to accommodate the pregnancy. This change puts more stress and increases the work-load of muscles, which usually provides the stability to the pelvic ring. A combination of muscle weakening and joint laxity brings the chance of joint instability and corresponding pain syndromes.
Postpartum studies demonstrate mechanical damage in all women who deliver vaginally if a baby weighs over 2.3 kg (5 lbs). Multiple births create a repetitive strain to the articular surfaces of the pubic symphysis from repeated distraction, disturbance of the symphyseal disk, and damage to the hyaline cartilage.
Restricted motion of one or both sacroiliac joints may contribute to increased motion at the pubic symphysis. This coupled with ligament laxity resulting from maternal hormones may cause repetitive stress to the pubic symphysis.
Many pregnancies (pre-, ongoing-, and post-partum) respond favorably to chiropractic care.
Through interventions including chriropractic adjustments, maternity belts, and exercise advice, a chiropractor is a suitable option for women experiencing structural compensation difficulty in pregnancy (and after).
Borggren, C. L. (2007). Pregnancy and chiropractic: a narrative review of the literature. Journal of chiropractic medicine, 6(2), 70-74.
Robert Fano, D. C., & Linda Mullin, D. C. Chronic Post Partum Osteitis Pubis Managed with Chiropractic.
Disc Herniations & Bulges
Between each vertebra in your spine lies a disc that acts as a shock absorber and allows for movement to take place. The outer portion of the disc is made of collagen, known as the annulus fibrosus, and the inner layer is a viscous fluid, known as the nucleus pulposus. As a disc degenerates one loses the water component as the nucleus dries up. Disc degeneration is a progressive process with disabling potential due to pain. Age, mechanical pressures, genetics, inflammatory and biochemical changes can all act as triggering events in this condition. With nutritional compromise, repetitive loading or natural aging the disc loses its natural matrix turnover balance and more matrix degradation and less matrix rebuilding takes place. Often times, inflammation creates irreversible biophysical changes (even after the stimulus is removed) and spontaneous recovery may not occur.
Disc degeneration can lead to herniations, where the components of the nucleus pulposus comes in contact with the vascular system of the epidural space. Substances within the nucleus as well as the resultant inflammatory components can irritate nearby nerves and create substantial pain that may radiate into one’s legs. Before this stage, one may experience local back pain with the tearing of the outer annulus.
Fortunately, this process is often self resolving within 6-8 weeks, but aggressive chiropractic treatment is suggested so that this does not progress into a chronic stage.
The problem with nerve compression is the inflammation and restricting blood flow to the nerve. Also, large herniated fragments resolve better than smaller ones.
There is a good prognosis with nonoperative care with larger extrusions or sequestrations and in those who experience a 50% reduction of leg pain within the first 6 weeks.
Those with scoliosis often demonstrate strong superficial muscles but dysfunction of deeper proprioceptive ones (i.e. rotatores, mutifidi, and intertransersarii, etc), the ones that convey information of where your body is in space.
Scoliosis may create a respiratory compromise due to a smaller and stiffer chest. An abnormal spinal curvature can also affect the normal biomechanics of the ribs. The chest is stiffer because of the surface tension placed on smaller alveoli (small vessels in your lungs).
How can a chiropractor help? Well, depending on the severity of the curve and level of spinal maturity, interventions range from merely observing the condition for progression, stimulating and/or strengthening proprioceptive input (muscles and joints) through adjustments and exercise, offering heel and/or ischial lifts to drive a lumbar curvature, bracing in a bit more advanced cases, and potential referral for surgical consultation in very severe circumstances.
250,000 hip fractures result from slips and falls per year. How can chiropractic help?
The goal is to improve proprioception, or body position sense.Treatment from a chiropractic intervention includes adjusting the upper cervical spine, lumbosacral region and/or one’s feet.
General strengthening guidance in addition to standing unstable-surface training and whole-body vibration has been seen beneficial.
Also, while peak stregth declines by 15% per decade over 50 years (for those sendentary), resistance training in the elderly can improve strength by 10-30%!! Muscle mass can increase in cross-sectional area at any age and a 20% strength increase can be attributed to a neurological component.
Bed Wetting (Nocturnal Enuresis)
Primary vs secondary: primary enuresis is the 5 year old who has never been able to hold urine in. (We don't put a label on it any earlier than 5 years old). These are most likely congenital (anatomical) issues, which may require surgical intervention.
Secondary Enuresis is the person who shows urinary control, but then loses it.
Chiropractors do really well here with secondary enuresis.
We may use a combination of assessing diet (66% demonstrate food allergies, esp. cow’s milk and citrus fruits) and neurologic interference via the lumbosacral plexus. Sacral nerves innervate the urethral sphincter, bladder and detrusor muscle. Chiropractic adjustments are aimed at restoring the neurological integrity of the involved segmental dysfunctions. In other words, our goal is to restore proper nerve firing to the bladder and urethra, in turn, allowing the person to gain urinary control again.
Fascia & Scar Treatment
Fascia is a connective tissue that surrounds muscles, tendons, and ligaments.
The ability to out-jump, out-run, or out-throw someone depends on the ability of the muscle fibers to contract as well as the elastic recoil properties of the fascial network supporting these movements.
Fascia functions and dysfunctions along with muscle. Muscles rarely transmit their full force directly via tendons into the skeleton. They rather distribute a large portion of their contractile or tensional forces onto fascial sheets.
When traumatized, a fascial lesion heals by spider-webbing together with irregularly arranged collagen, rather than running smoothly parallel to one another. Such adhesions may prevent proper fascial, muscle, ligament and tendon function.
Damaged ligaments treated with instrument-assisted soft tissue manipulation were 31% stronger and 34% stiffer compared to untreated ligaments. This intervention also increases blood flow after 24 hours.
FAQ About Chiropractic:
DO I HAVE TO SEE A CHIROPRACTOR FOREVER ONCE I BEGIN? . . .
Frequency is completely situation based. An acute situation typically is seen more aggressively (more frequently) at first and as the symptoms and underlying cause improve the treatment plan can decrease in frequency while focusing on restoring proper biomechanical function long term.
People don’t expect one dose of medicine to clear a chronic condition.With chiropractic, one dose=one adjustment. While a few adjustments may take the pain away, it is unlikely adequate to retrain the body or restore its framework and balance physiological compensations.
HOW MUCH IS IT GOING TO COST? . . .
In addition to its conservative treatment approach, chiropractic is also very cost-effective. As a prevention for more invasive interventions, it is more affordable than surgery while carrying significantly lower risk for complications. Further resources on cost effectiveness:
HOW EFFECTIVE IS IT (Can you help me)? . . .
Every individual presents with a unique case. Treatment is based on experience with similar patients with similar conditions. Most see improvements quite quickly with improved range of motion and symptom relief. However, the long term goal of restoration depends on complicating factors (other health issues) and/or aggravating factors (things in your lifestyle that provoke your complaint) as well as patient compliance.