Friday, June 11, 2010

Adjust Your Ideas About "Self-Adjusting"

Patients frequently ask questions such as "Is it okay to adjust myself?" or "Is it bad that I have my kids walk on my back?" I've even seen a patient walk into the room and "adjust" his own neck without any awareness that he did so, indicating that the habit is so routine that it has become second nature. When I say that he "adjusted his own neck", I use the term loosely. We've all seen people performing these types of maneuvers, stretching their necks from side to side, grabbing their chin or jaw with one hand and the top of their head with the other, giving a quick impulse to release pressure in the cervical spine.

A famous perpetrator of such behavior is Tiger Woods. There are multiple pictures available of the golfer twisting his own neck. posted an article on 5/12/2010 reporting that an MRI revealed inflammation of a facet joint in his neck causing local pain and difficulty in turning his head. (In case you're wondering, the article goes on to state that Woods experienced neck pain prior to his November car accident).

So what's wrong with "self-adjusting"? To answer this question, let's first take a look at the chiropractor's criteria for adjusting. At our clinic, we detect levels in the spine that we believe to be compromised by the "Vertebral Subluxation Complex" (which I'll refer to as subluxation for short). Subluxation occurs when there is aberrant motion in the spine leading to various types of interference to proper nervous system function. This may present as pain, loss of function, hypersensitivity, or, in many cases preclinically with NO symptoms at all! Using posture and range of motion assessments, motion and static palpation, and x-ray evaluation, we quantify the subluxation. To put it simply, we search for the hypomobile segment and figure out in which ranges of motion need to be restored.

When you find a vertebra that is limited in motion, or hypomobile, you will most likely find excessive motion above and below that segment. This is due to the fact that the stuck segment is not fully participating and pulling its fair share of the workload when it comes to range of motion. Areas above and below move more in order to pick up the slack. The increased motion at these segments, when juxtaposed with the decreased movement at the level of subluxation, may have a torquing or shearing effect in the spine.

Now that I've outlined what it is that chiropractors are looking for (subluxations), let's examine why a chiropractic adjustment differs from self-manipulation. Once we find the level of subluxation, the patient is positioned in a fashion that provokes the spine back toward normal. Then a specific force is introduced along the plane-line of a specific joint in order to restore proper motion. Restoring motion to this joint will allow for the segment to participate fully in all movement and ease the burden on its neighboring vertebral brothers and sisters.

When a person tries to coerce his or her own spine back into alignment, he/she is more than likely moving the areas that are already moving too much. So why is that a big deal? After all, as some people point out, it feels good for a little while afterward. Let's think back to Tiger. As I mentioned earlier, there are many photographs of Tiger Woods manipulating his own neck. Introducing force that is essentially a gross mobilization of the area can lead to further instability in regions of the spine that are already moving too much to begin with. Even the most skilled of chiropractors cannot detect the level of subluxation in their own spines and give themselves a specific adjustment!

The moral of this story is that you cannot adjust yourself in a manner that is beneficial to your spine. If you feel the need to chronically "pop your neck", the cure is to stop "popping" and start stabilizing. As we see it, we are partners in your spinal hygiene. Leave the adjustments to the experts (your chiropractor). We'll get things moving in the right direction, and then we'll empower you by providing exercises to strengthen your spine so that you can feel good without causing yourself further or future pain and instability. If you don't, it might just take you out of the game for a while, and life is too short to watch from the sidelines!