Better Health: Them bones, them bones Published in Citrus Chronicle

March 12, 2014

Written By Dr. Cheryl McFarland-Bryant

As children, most of us learned that “the leg bone is connected to the knee bone” (some of you, in fact, will now be humming that all day).

Unfortunately, as we have grown older, too many have forgotten the crucial line of connection from “foot bone” to hip and backbone.

The fact is, muscle and ligament wear and tear in and around the foot can affect the joints of the ankle, knee, hip, sacroiliac and spine. A misalignment in the foot (due to injury, arthritis, damage caused by poor-fitting shoes, etc.) affects the alignment of the ankle, and this affects alignment of the knee, which affects alignment in the hip, which affects alignment of the sacroiliac joint, which affects alignment of the spine. “Them bones, them bones,” indeed!

All is connected

The nervous system controls the amount of tension in the muscles and ligaments that control the joint. This tension on the attached muscles and ligaments tracks the bones through the joint movement. Because joints are designed to move in specific directions, an abnormal amount of force exerted by tissues on one side of the bone or bones will pull joints in directions and through motions that they are not designed to accommodate. And, as might be expected in a linked chain, abnormal movement in a joint below affects the joints above, including the spine.

Over time, the uneven tension wears out the smooth cartilage surface of the joint, eventually resulting in pain, locking up of the joint, and such obviously abnormal alignments as knock knees, feet turning out (a sign of ankle pronation), or sacroiliac rotation. The legs should be straight, vertically, and when the ankles turn in or the knees bow in or out instead, this puts extra stress on the hip and sacroiliac joint, leading to further problems.

The chiropractic approach to helping these bones line up again is to start with their base cause (at the lowest affected extremity) — stimulating the muscles and following up with appropriate exercises to correct the abnormal movement of the joints of the arms and legs. Neuromechanical impulse adjusting of the muscles and ligaments, for example, uses a low force instrument adjustment tool to stimulate the nerve endings, called mechanoreceptors, that give feedback to the brain and spinal cord.

A toe-to-head solution

By applying gentle instrument stimulus to rhythmically tap the overly excited muscle mechanical nerve receptor, then adjusting the joint that that muscle is tracking incorrectly, and following these actions with guidance in performing proper exercises, chiropractic can stop the early degeneration of osteoarthritis, whether it be of the spine, the hip, the knee, or the ankle. The early signs of bunions and “hammer toes” can be corrected this way as well. This approach has helped many people postpone surgeries such as knee and hip replacements, and may even alleviate the need for surgery altogether (because surgery is always risky, it should be a last resort). For those who have already tried surgery, this approach can be used to keep the alignments true.

The alignment process outlined above may have some of you thinking: “Ah! Physical therapy.“ However, chiropractic is generally a superior approach for ankle, knee, hip and low back rehabilitation. For one thing, in the State of Florida physical therapists are not allowed to manipulate or adjust per state law and thus may not be able to do all that can be done to help you stop degeneration. For another, physical therapy relies heavily upon stretching, and peer-reviewed, double-blind studies have shown that stretches, improperly done, can actually cause harm.

A chiropractor can guide you in active stretches, done in-clinic, in which the patient moves the joint and then the massage therapist or doctor just adds a second or two of extra pressure (one such method is called “active isolated stretching” and was developed by Aaron Mattes, who has an institute in Sarasota, devoted to teaching this form of therapy). Active stretches are performed after exercises to strengthen the muscles surrounding the abnormal joint.

No gym membership required

Exercises? Now you are envisioning a sweaty round of weight lifting, aren’t you? Relax. Your chiropractor will tailor a few exercises to strengthen the specific muscles that, in your unique case, are too weak to oppose the over-stimulated muscles. The combination of a weak muscle and muscles stuck in the “on position” (hypertonic) causes the bones to move in poor tracking patterns. As explained previously, this tension wears out the joint cartilage.

The Doctor of Chiropractic manipulates the muscles using gentle instrument thrusts with power tools with names such as “Impulse” or “Pro-Adjuster” or “Arthrostim.” The chiropractor will feel for the hypertonic, or overly tight, tender muscle “belly,” which is the location of over-stimulated mechanoreceptor. Mechanoreceptors are the muscle’s connection to the nervous system, giving feedback to it regarding the state of pressure on the receptor. Tendon and ligament mechanoreceptors are reset with instruments as well.

Using these gentle approaches to rehabilitate joints, modern chiropractic methods can correct alignment and stop or reverse the degeneration processes referred to as osteoarthritis, degenerative arthritis, and “old age wear and tear.” Before you consider surgery for any kind of joint problem, consider making an appointment with a Doctor of Chiropractic first. It could keep those bones jumping.

Dr. Cheryl McFarland-Bryant maintains an active Florida Medical Technologist license.