Michael Koplen, M.T., D.C., Q.M.E.
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Spinal Fixations and Corrections
Michael Koplen, M.T., D.C., Q.M.E.
Chiropractic is a “Core Healing Technique” and other treatments do not provide or replace what it does. When a vertebra becomes stuck out of normal alignment, nothing will correct it besides a proper adjustment that releases and restores the stuck, misaligned vertebra to its normal mobility and position.
Other therapies such as massage complement what Chiropractic does. They help to support Chiropractic adjustments. They help the spine to stabilize better. In many cases, they help prevent vertebrae from slipping out of alignment. Likewise, chiropractic care complements massage therapy. It complements massage by restoring normal nerve transmission to the associated muscles and through normal spinal functioning, both of which allow for normal muscle tone and function to occur.
I recommend massage therapy for nearly every patient. If people received massage regularly, it would greatly improve their health and their lives for many reasons. One reason is that massage helps prevent vertebrae from becoming stuck out of alignment. Yet even with regular massage, proper exercise, good nutrition and stress management, vertebrae inevitably fall out of alignment. At the least, gravity and stress are always challenging the spine and at some point vertebrae are pulled or compressed beyond their ability to maintain proper mobility and position. They will inevitably destabilize. When they do, they must be properly adjusted in order to be restored to normal.
Other healing approaches are not and cannot be replacements for spinal adjustments. They cannot be because they can neither ultimately prevent vertebrae from falling out of alignment nor can they reposition the vertebrae back into their proper alignment once they drop out of position!
For over twenty years I have observed many people wrangle with this reality. They sincerely believe that there must be something that they can do on their own to correct their misaligned, fixated vertebra. They believe that there must exist some special exercise, yoga stretch, breathing technique, or massage approach that will fix their spinal misalignments.
Patients ask me if I know of a technique that will allow them to “self adjust.”
They feel that if there was such a technique that could allow them to correct their misaligned vertebrae themselves, they would not have to be “dependent” on Chiropractic adjustments to correct their situation. Or they want to believe that if massage were to “work the muscles” deeply enough, or for long enough, or by using a special massage technique, that this will allow the attached vertebrae to “release and reposition.”
Some people believe that because I am a Chiropractor, I can “self adjust” my own spine. I explain to them that no technique has been discovered that can allow a person to properly and fully adjust their own vertebrae. When one or more of my vertebrae fall out of alignment I am in need of having a(nother) Chiropractor adjust me, just as like anyone else’s spine requires being adjusted by someone who is qualified to do so.
A question that many people ask is what is the difference between them popping their own spines versus me (i.e. a Chiropractor) adjusting their spines? It would much easier to explain the difference between people “popping” their spines versus me “adjusting” them by demonstrating it on a plastic model. For now, here’s the answer in words: There are two components to vertebral misalignments. The first component is the improper, misaligned position of the vertebrae. Vertebrae typically fall out of alignment anywhere from a quarter of an inch to an inch. They slip posteriorly (backwards, except C1). This is readily seen on XRays. For those of you who are technically minded and curious to know which view shows this best, it is a standing, weight bearing lateral view. In addition to slipping backwards and downwards, vertebrae can also have other vectors of misalignment, such as rotational distortions and lateral flexion components. All of these angles of misalignment are important to address when adjusting the vertebrae precisely and thoroughly.
The second component of an improperly positioned vertebra is fixation. Misaligned vertebrae are also fixated (“stuck, jammed, frozen”). Where two or more vertebrae are joined together (i.e. the “joint”) normally, they interface with one another similarly to two suction cups that are barely touching together but are not compressed. The suction cups’ interface should barely be touching, allowing pivoting and swiveling to occur freely and fully in their ranges of motion. However, when vertebrae fall out of their normal alignment with one another, their adjoining joint capsules become compressed together like two suction cups being pushed together and consequently becoming stuck. Synovial fluid inside the joint capsules creates further adhesive tension between the two joints. In order to release this compressed, adherent state, a specific adjusting force must be applied. Stretching cannot do it – it cannot provide enough specifically directed force.
Imagine two big bathroom plungers being pushed together tightly. It would be extremely difficult to “pop them free” by simply stretching them. A certain force would be required to release their adhesive suctioning, such as pulling quickly on each end with a significant force. When the quick pulling force releases the adhesive tension, a popping sound usually occurs. The popping sound is caused by gas that was trapped and compressed now releasing and expanding.
Here are a couple of simple analogies. When a can of soda is opened, the increased space allows the formerly trapped gases to rapidly expand, causing popping sounds. The same phenomenon applies to a cork popping free from a champagne bottle.
These same principles hold true for misaligned vertebrae that are compressed together at their suction-cup-like joint interfaces. They cannot be stretched apart. A specific force, referred to in Chiropractic as an “adjustment,” must be applied to release the adhesive fixations that exist between the vertebrae.
Granted, a vertebral fixation may be relatively new or very mild, in which case there can be a release created simply by stretching the area. We have all experienced this, where we twist, bend or stretch and feel a release and hear a popping sound. But when vertebrae become significantly fixated, stretching or just pushing on them will not cause them to release, at least not completely.
There is another very important aspect to spinal adjusting in addition to it releasing the fixated vertebrae. As we mentioned earlier, a proper adjustment also takes into account the direction of misalignment. The adjustment should be directed specifically into the proper vector that allows vertebrae to return to their normal positions. The mantra for adjusting vertebrae properly and thoroughly is, “Release and Realign.”
Patients also ask, “What happens when we pop our own spines?”
When someone pops their own spine, they are creating a partial release of the fixation component. Because the release is only partial, and the misalignment factor still remains, people who pop their own spines receive only partial, temporary relief at best.
Most everyone who consistently feels a need to pop their spine will describe how they feel like they could do it several times a day. That is because they are not correcting the problem. They are only getting momentary, partial relief by partly freeing up compressed vertebrae. If they were “correcting” the situation, they would essentially fix the problem and not feel an ongoing need to pop it several times a day.
What’s even more discouraging is that the vertebrae that typically move in these instances are not the core problematic ones. The vertebrae that pop when we stretch or push on them are what we call “compensations.” They are called compensations because they are being twisted or torqued in a compensatory reaction to the pressure transferred to them by the adjoining vertebrae that are the primary fixated.
Rarely can we actually release the primary problematic vertebra ourselves through stretching or exercise. It is the torqued, compensatory vertebrae that release when we pop our own spines. Occasionally we may get a primary misaligned vertebrae to “pop” when we stretch, bringing some sense of partial relief, but we cannot fully release these vertebrae, nor can we reposition them properly .
People ask, “Is it dangerous to crack our own spines?”
It is, for at least two reasons. The first reason is that cracking one’s own spine is almost always done by applying a strong rotational force. Crude rotational movement can cause harmful sheering of the discs between the vertebrae. It can also cause damage to the attached tendons and ligaments. Furthermore, self adjusting our spines cannot adequately correct the misalignment factor. Leaving the problem uncorrected is a danger to our spines, nervous systems and general health – one reason being that it causes nerve impingement. It also leads to progressive degenerative arthritis development.
Some people dislike the thought of having their spines adjusted and hearing a popping sound. They imagine it to be painful or harmful. The truth is, having one’s fixated vertebrae adjusted feels liberating! The alternative – leaving the vertebrae stuck – allows degenerative disc disease and degenerative arthritis to develop, which eventually leads to spinal fusion. It also causes annoying pain and limited mobility as the degenerative process progresses.
Please understand that when discussing the negative effects of “self adjusting,” we are referring to people who often feel a need to do it several times a day, and they usually twist their spines excessively to get them to release. The releases do not ultimately correct their underlying problem. This is different from the releases that most of us experience naturally while stretching or when exercising. The releases that happen spontaneously as a result of other intended movements are actually healthy. In these situations, mild, early onset fixations are releasing. Some releases also come from tenden insertions releasing pressure in their synovial sheaths.
What affects the spine affects the muscles. And what affects the muscles affects the spine. It is important for patients to receive massage and chiropractic checkups. This will help insure that their muscles, other soft tissue and their spines and nervous system are feeling healthy and functioning at their best!
In summary, if you feel chronic or unresolved pain or limited mobility in your spinal region, it is best to have your spine evaluated by a Doctor of Chiropractic. We are Specialists trained to detect and correct such problems and their related conditions.