Pillar 4 - Spine & Joint Alignment
Chiropractors and physical therapists have sometimes been considered oppositional to each other, because both of their fields of practice overlap in the same area of joint realignment. Chiropractors are traditionally focused on spinal nerves and passive adjustments, or manipulations, while physical therapists are focused more on bodily joint positioning and active adjustments through exercises and stretching. However, these generalizations are by no means exclusive to either profession, and actually serve to emphasize their common ground and importance toward preserving good health through proper alignment.
Varying Degrees of Malalignment
Hopefully you have never suffered a traumatic dislocation before, but if you have then you know how truly disabling and painful it can be to have a joint out of alignment, or malaligned. Not only does the joint hurt, but the surrounding muscles are in so much pain and spasm that you can't even move. This is because your brain has nerve receptors in the joint that tell it how your bones are positioned and whether or not to activate the muscles in a smooth manner for functional use. Of course, if the bones are not in a usable position, the brain is going to tell the muscles not to work properly.
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Have you ever felt, or do you now feel, that you are out of alignment? Maybe you sense that you are not balanced when you stand, or that a joint of your arm or leg doesn't seem to sit properly in its socket because of tension, clicking, or instability. If so, which area is malaligned?
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If you are wondering whether or not your brain can inhibit muscles around a joint that is only partially out of position, then you are right. Your brain is smarter than you think. It can instantly tell when the body is not in the best position to generate strength, and tells the muscles not to contract with as much "confidence." This subconscious, poor muscle effort manifests as weakness and ultimately pain.
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​Did you ever try using an ace-wrap, support sleeve, or athletic taping technique to reduce your pain and increase your strength or activity tolerance?
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At a very small, micro-level, you are actually stabilizing and improving your joint alignment with this external support. Although you may certainly feel like the support is helping, the change in bone repositioning is so minute and subtle that an X-ray image will not be able to notice it.
The Wonder of the Mulligan Technique
The Mulligan Technique is a highly specialized type of active joint repositioning technique that was pioneered decades ago by a New Zealand physical therapist, named Brian Mulligan. He found that if he used his hands to softly apply a very specific, but gentle, stabilizing grip around an injured joint then it would hurt his patients less and they could move better. The unique "trick" to his technique was that he had to continue holding the joint, while his patients were moving, in order for them to feel relief. After a certain number of repetitions, the patients' brain would then sense that they were moving painlessly on their own and the new corrected alignment would "stick," even after the treatment had ended.​
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Have you ever instinctively pressed your hand into a painful body part to make it hurt less? If so, do you like heavy pressure or light pressure better?
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The wonderful qualities of the Mulligan Technique are that it is both safe and gentle, because you are in control of the joint realignment process. If it is painful in any way, then the technique and hand placement of the specialist is readjusted until it is not painful. Unlike the quick thrust manipulations that you may have seen or experienced at a chiropractor, this technique is not scary or super risky.​
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If a certain Mulligan realignment technique works especially well for you, your specialist can usually teach you how to do it for yourself in a home program. We may also be able to use a special taping technique to hold the newly aligned position secure when you leave the clinic to go home.
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Have you had repeated adjustments or stretches in the past that provided relief, but only for a short time? Do you find that your body likes the correction but that it never lasts?
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This pattern of consistently falling out of alignment after having adjustments to your spine or joints may be due to one or two key factors. First, the painful region that requires frequent adjustments may actually be caused by another deep-rooted problem elsewhere in the body that is not being addressed. An example may be a chronic sore shoulder that is continually being pulled out of alignment because of a pinched nerve in your neck. The second factor that can cause relapsing malalignment may be that the corrective adjustments are simply too passive. Unless your brain accepts and reinforces the joint repositioning through active movement, such as with the Mulligan Technique, your body will have a much harder time "learning" to integrate the new alignment on its own.
The Garden Hose Analogy
Invariably, most orthopedic and musculoskeletal pains will be connected to your spine once they become chronic over a long period of time. Whether the problem actually started in your spine or not, the peripheral nerves in your body will sense any pains in your arms and legs and transmit that impulse to your spinal cord. In time, that painful stimulation at the spine can cause other small deviations in the local neck and back vertebrae alignment that further perpetuates the pain and tension of the muscles surrounding the original painful injury.​
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Do you ever notice when your painful body part is inflamed it may sometimes cause other areas of your arms or legs to hurt that were never injured? Do you find that one particular limb of your body seems to have most of the problems all the time?​
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We often use the analogy of a garden hose to describe how peripheral nerves function in the body, by nourishing or "watering" joints, muscles, and tendons with appropriate, healthy stimulation. This easy flowing and open stimulation will promote warmth and blood flow to the area that makes you feel good. However, if the nerve suffers any sort of injury it will impair this normal flow, similar to a kink in a hose. Although the water may still flow through the hose to its open end, albeit more slowly, the additional turbulence and restrictions are now going to make other minor, insignificant bends in the hose much more problematic.
Understanding Root and Branch Problems
You are now starting to understand more about the differences between a root-type of pain and a branch, or symptom-type of pain. Read the essay below to learn more about the interconnection between your spine and what you're feeling in your body .
Having read the about how the spine's influence extends into the arms and legs, do you feel that your pain may has a clear connection to your neck or back? Do you feel that your pain is definitely separate from any arm and leg problem, or is it hard to tell?
Putting It into Practice
It is now time to take all the discussion and theory you've learned in Pillar 4 about spinal anatomy and joint alignment, and apply it in practice to your specific painful problem. Your specialist will decide which selected techniques will be best suited toward helping you move and function better. This can be a complicated process, and may sometimes require multiple sessions in order to prevent too much stimulation to your body at one time. Wear loose and comfortable clothes so that you may be taught self mobilization techniques that you can perform later on your own while at home.​