Scoliosis: A Natural, Chiropractic View

Scoliosis.

It’s a term that we’ve all heard from childhood.  Simply put, it’s a curve of the spine.  And in the vast majority of cases, it’s considered idiopathic.  This means no one knows why it happens.

Well, here’s a fairly simple explanation based on body mechanics and the nervous system.

When we stand, our body orients itself.  There are two major ways we do this.

eye
eye

One is by vision.  We look out and level our eyes with the horizon line.

handshake
handshake

The second is called internal proprioception.

This is simply how the body knows where it is in space.  For example, when giving a hand shake, proprioception is what guides your hand to the other person’s hand.  These are two keys to us standing upright.

These two keys line up with two thoughts in Chiropractic of where and why the body creates compensation subluxation (mis-alignment).
In one view, we start at the base of the head / top of the spine.
human-skeleton-down
human-skeleton-down

In this view, once the top is out of alignment, if left alone, the body will slowly compensate downward.  The rest of the neck shifts, the shoulders, then your torso.  This goes all the way down through your pelvis, hips, and even to your feet.

An example of this was a 3 year old boy I adjusted.  Now, with this comes one of the hardest things for parents and family to accept: That cute thing your child is doing, it isn’t cute.  It’s a problem. It needs to be fixed.  This boy’s “cute thing” was that before he ran, every time, he would stop, scrunch down his right shoulder, and then go.  When I saw him, I found his occiput out.  This meant when he stood straight up, his eyes were not level with the horizon.  So before he ran, his scrunching down was to level his eyes.  After almost a year of scrunching, one visit to me and he never did it again.

In the other view, your proprioception of your feet is off.
child's feet
child’s feet

This can come from a subluxation anywhere along the nerve pathway, from your toe up into your neck.  But the result is the same.  Your body believes its feet are

human-skeleton-up
human-skeleton-up

somewhere else.  And your body starts to compensate and shift.  The first major point for this is your hips and, as they’re all on the same level, your pelvis and tailbone.  Once the tailbone is out of position, it moves up the lower back, into your torso, and eventually your shoulders, neck, and head.  For examples of this, go here.


Basically we have top-down and bottom-up models of subluxation and compensation.
twist and arching
twist and arching

Now, let’s take a straw or a piece of string. Hold it at the top and twist.  It takes a while, but the bottom becomes twisted.  Hold it at the bottom and twist. It takes a while, but eventually the top becomes twisted.  But, hold it at the top and bottom and twist, and it’s done, fast.  If you’re like me and accept that both Chiropractic models have validity, this twisting from both top and bottom can occur.  And a scoliosis is a sensible outcome.

There we have it.  A neurological, bio-mechanical explanation for scoliosis.

What’s an easy way to help?  That’s easy.  Consistently remove the subluxation, and let the body grow properly.

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When to NOT Listen to Your Body!

I grew up in a bit of an eclectic life.  One aspect of this involved 300 acres of woodland owned by my grandfather in upstate New York.  I spent weeks and weeks at a time there. We weren’t hunters or survivalists.  It was more of a real life Walden’s Pond.  It was my father’s attempt at creating a connection to nature and his body.

This idea of connection stuck with me.  It’s one of the reasons I found a calling while studying Chiropractic.  The idea that the body wants to exist in it’s ultimate, natural state makes sense to me.  The idea that we should listen to our body appeals to me.

However, as a Doctor of Chiropractic, I face a stark reality: Our body lies to us.

30's female, feet left
30’s female, feet left

This is, in my opinion, one of the key building blocks of the philosophy of the profession.  We believe the body heals itself; that it wants to reach a homeostatic state where everything is in optimal balance; and that this is done via communication through the nervous system.

But sometimes there’s a problem with this communication. Sometimes information arrives at an improper time.  Or it arrives jumbled or with parts missing.  Think of an architect whose plans have run through multiple fax machines.  There’s basic information, but specifics are missing.  The final building, while appearing livable from the outside, may be so off that it may collapse at any moment.

I often have patients that doubt this.

Teen boy, hips left, feet right
Teen boy, hips left, feet right

I understand that.  So I show them an example.  It’s quite simple to demonstrate.  If you stand up straight and are getting proper information, every part of your body should line up with a line down the middle.  And even when we’re sending the wrong information, the body can compensate so well that the untrained eye won’t see the misalignment.  But if you lie down, every part of your body should also line up with a line down the middle.  And when lying down, the compensation can become visible to the untrained eye.

The people in these photos all believe they are straight.

40's male, feet left
40’s male, feet left

Their heads are in a head piece that place it in the mid-line of the table.  However, you can see their feet are not equal on both sides.  This is misinformation.  This is compensation.  This can lead to long-term problems if left unchecked; particularly given how we are living significantly longer than when I was a kid.

What I do, as a chiropractor, is remove points of subluxation ( misalignment ).  This allows the nervous system to function properly.  This, in turn, allows the body’s systems to function better, more efficiently….proper.

Easy way to test yourself:

  1. Measure across the top to find the middle of your bed.
  2. Place your head at the middle.
  3. Lie so you “feel straight”
  4. Have a friend look at your feet.
  5. If they shift to either side, Call Me!
Early 60's female, feet right
Early 60’s female, feet right

Office Injuries

In the course of providing care to my patients, I am amazed by what people consider as “normal.”  In most cases, what occurs happens slowly, gradually, over time.  The body adapts to its situation.  And this may occur so slowly even manifestations of pains or problems may be considered a part of their every day lives.  Here are a few examples related to office work.

computertypeOne patient came in for extreme low back pain.  While in the office during the first visit, the patient was previously diagnosed as having Carpal Tunnel Syndrome.  They explained they found they were dropping things and that their wrist hurt.  While this may have been accurate when originally diagnosed years ago, she no longer had Carpal Tunnel Syndrome.  The experienced problem was from a different nerve’s compression.  Moreover, this nerve compression was not the typical, Chiropractic subluxation.  In this case, it came from the work environment.  At the desk, the patient placed a forearm on the edge so that it effectively stopped nerve flow, near the elbow.  In addition to traditional chiropractic care, the easy, simple solution involved altering hand and forearm position at work.  This removed the external cause of her problem.

 

computerstudyAnother patient came in with years of recurring headaches.  This person spends hours and hours daily working on their computer.  This involves hours and hours of studying the computer’s screen.  What we found is the patient would consistently lean forward and rest their chin on their hand.  This caused an upward pressure through the chin, shifting their normal level of gaze.  So, when the person was outside of work, their head, spine, and musculature were always misaligned.  Added to this, the abnormal field of gaze caused dizziness and helped fuel the headaches.  In fact, this position felt so “normal” to this person, they would “crack” themselves to re-create it.  As a result, the hardest part of care for this person wasn’t on the Chiropractic end, it was in breaking old, bad habits and the false, destructive, sense of “normal.”

 

computerstressYet another patient came in with about a year’s worth of daily headaches and a daily upper back pain.  In their case, they were able to eventually piece together the back pain and headaches increased and decreased simultaneously.  This person also spends the entire workday at a desk, on the phone, and on a computer.  In addition to Chiropractic care, the patient followed suggested changes to their work environment.  These changes altered the stress points on her anatomy.  As this patient’s care progresses, we are now at more then 3 weeks between episodes of either the upper back pain or the headaches.

 

healthappleHealth is not simply a lack of pain.  Nor is it something that occurs entirely naturally in today’s office work environments.  We must work and plan to reach and maintain it at a high level.  As a Doctor of Chiropractic, I believe in finding causes and solutions, not masking of symptoms.  Visits to your Chiropractor can be an easy, drug-free, long-term solution to a chronic problem, even one with an external cause.

Natural Care for Kids’ Earaches!!

Chiropractor EaracheToday we are going to delve into why going to your Doctor of Chiropractic (DC) may be the best treatment for your infant’s earaches.  While Eustachian tube blockage from misalignment is not the only cause of earaches, it is often unacknowledged.  And that’s unfortunate.

 

ChildEaracheThe Eustachian Tubes travel from part of your middle ear to your nasal passage.  The purpose of this is to allow for changes in pressure in the ear by accessing the air outside your body through your nose.  It also allows for drainage of fluids and mucus away from your inner ear.  Ear infections can occur when there is a problem with these flows.  The reduction or stoppage in flow can allow for waste build up and bacterial growth, resulting in inflammation and pain.

 

anatomy-of-the-human-earOne reason these earaches are more common in children is the tubes’ angle changes as we age.  In adults, the angle is steeper, allowing for faster flow of materials.  In children, the tube is almost flat and parallel to the ground when we stand.  This decreases the rate at which fluids and mucus drain from the ear, into the nose and out of the body.  In turn, this allows for easier and faster buildup of materials when blocked.

 

BabyAdjustAs for how your Chiropractor can help your infant, it involves analyzing the top bones of your neck and the base of the skull for misalignment, or “subluxation.”  These cases are very simple cause and effect.  Your child’s Eustachian Tubes are normally at the same level as the base of the skull and top vertebra.  And these flat, almost horizontal tubes are in such close proximity to the skull and upper spine that when the skull or top vertebra are out of alignment or subluxated, they easily press on the Eustachian Tube, decreasing the flow of materials.  This can perpetuate build up of material and bacteria, resulting in inflammation.  With the performance of an incredibly light pressure “adjustment” to gently realign this area, your DC can resolve this subluxation.  The cause of the inflammation in these cases is then removed, and the pain eases quickly.

 

HappyKidsWhile subluxation may occur in anyone, when it occurs at these levels in infants, it can manifest as an earache.  A visit to your Doctor of Chiropractic can be an easy, drug-free, long-term solution to chronic earaches in your infant.

My Chiropractor Adjusted my Neck and my Back Pain Went Away! Why?

Exercises that can be done in SarasotaLet’s say you were out at Siesta Key Beach for some Paddle Board Yoga and it’s a class like every other class.  So when you have a pain in your low back and you can’t figure out why.  You’re left perplexed.  Particularly since it started when you turned your neck, not your back.  You’re thinking you should be experiencing neck pain, not low back pain.

 

 

Chiropractic Adjustment

As an intelligent, self-aware person in Sarasota looking for natural, drug-free relief, you decide to go to your Chiropractor.  After your easy exam, you receive treatment which today was only a quick, simple, pain-free adjustment to your neck.  And, viola!  After a short sensation of warmth, the low back pain is gone.

Why is this?  How can this be?  Is this the mumbo-jumbo mystic magic you heard about as a child?   …Not at all.

Spinal Cord Nervous SystemAs chiropractors, we deal with the nervous system.  So, we deal with the spinal cord, which is fascinating.  As humans, through it, we send nerve impulses both to and from the brain.  Not only that, but the nerves are organized and grouped together in tracts.  The nerves traveling to the brain for our senses of pain, temperature, proprioception, vibration, and light touch are all on the outside perimeter of our spinal cords.  And they travel the entire length of the spinal cord.

This means when there is a spinal misalignment, aka a Vertebral Subluxation, these areas are some of the first to receive pressure and compression.  So, a Vertebral Subluxation in the neck can press on the nerve designed to send pain signals from the lower back.  This results in the brain processing a false sensation of pain in the low back.  By removing the pressure on the spinal cord at the right location, proper information flow through the nervous system is restored, and this low back pain is eliminated.

It’s finding causes like this that make the skills of Chiropractors truly unique and desired.

Bone Growth!

3 Ways Bone X-rays Are used to Determine Age

And

Why It’s Important

Ossification is the process of laying bone tissue.  Basically, it is the solidification of bone.  It occurs at different rates, starting at different ages, in different areas, and even in multiple stages for these areas.  It’s not the same everywhere.  When looking at an X-ray, bone will appear whiter and brighter than other areas.  From this, by examining an X-ray, we can look at different bones to determine age.

 

Lumbar Spine VertebraeWe can start at the spine itself.  At birth, each typical vertebra is basically 3 sections of bone connected by cartilage, while the sacrum and coccyx vertebrae are basically cartilage.  Cervical, or neck, primary ossification finishes by end of 3rd year.  But as we travel down the spine to the lumbar vertebrae, the process slows.  The Lumbar vertebrae won’t finish until after year 6.  Throughout the whole spine, secondary areas start to ossify at puberty and end at 20-25 years.  So, by looking at X-rays of a vertebra, depending on where it is, and how far along the ossification process a primary or secondary ossification center is, we can estimate a person’s age.

 

HipWhat we call the hip-bone is really 3 bones: the ilium, ischium, and pubis.  They start to fuse to create our hip-bone when a person is 15-17 years old.  They finish fusing between 20 and 25 years of age.  Moreover, in radiology, there is a term known as Risser’s Sign.  Risser’s sign references the ossification of the cap of the Iliac Crests, or the bone you touch when you place your hands on your hips.  Risser’s sign breaks down the arch of the Crest into 4 equal sections and a final, finished stage.  For girls, Risser’s sign is apparent from 14-16 years.  For boys, it’s 15-18 years.  Risser’s sign also has a direct correlation to vertebral ossification.  So, by looking at X-rays of a teen’s hip, not only can we determine Risser’s sign and the person’s age, we can determine how far along in its development a person’s spinal column is.

 

WristOur wrist consists of 8 bones, known as the carpals.  When adults, these bones align in 2 rows of 4 bones per row that connect to the 2 long bones, radius and ulna, of our forearm.  Unlike other bones, these all only have 1 ossification center.  Also, unlike other bones mentioned, they do not start to ossify until after birth.  These start from the age of a few months to 8-12 years:

Capatate and Hamate appear first, a few months after birth

Triquetral and Lunate 2-4 years

Scaphoid, Trapizium, Trapezoid 4-6 years

Pisiform 8-12 years

Radius and Ulna near Carpals fuse at 16-18 years

Moreover, during their development, the carpals may overlap and be in places not normally expected.  Additionally, these bones develop differently from one another in the same region.  As such, for younger children, the most common way to determine age is an X-ray of the wrist.  Specifically, we take an X-ray of the left wrist and compare it to a chart/atlas.  Based upon which of these 8 bones is developed, we can estimate a person’s age.

Why is this important?  There are a few reasons.  For the wrist, FOOSH (Fall On Out Stretched Hand) injuries are common.  This is when we fall face first and save our noses by stopping ourselves with our hands.  A Scaphoid or Navicular bone fracture is possible from FOOSH injuries.  And due to the lack of blood vessels in the wrist, these can result in deterioration of these bones.

 

In an older child, a displaced Lunate may replicate Carpal Tunnel Syndrome, or a fracture of the Hamate may injure the Ulnar nerve resulting in a loss of grip strength.  Knowing a child’s age, we may rule out different problems if the bone does not yet exist.  Also, knowing a person’s age as determined by vertebral or hip X-ray may alter choices of treatment for things like Scoliosis.  Lastly, we must take into account the age of a child for Chiropractic care.  Depending on the child’s age and osseous development, adult techniques involving rotating a spinal process (or tip) or a technique involving a patient’s hip may not be appropriate.  This is why as Chiropractors, we adjust children differently than adults.

6 Myths about Kid’s Feet!

6 Myths about Kid’s Feet!

AKA  Why Vibram FiveFinger Shoes Couldn’t Win!

vibram

I was in school earning my Doctor of Chiropractic when the Vibram FiveFinger craze hit.  In fact, it had such an impact that my classmates had the code for clinic attire changed to make them acceptable.  If you came in to our clinic as a patient, your student-intern may have been wearing them.  Myself, I never believed the hype.  Whether on campus, visiting home and walking either Siesta Key Beach or Sarasota Square Mall, I was amazed every time I witnessed a pair.  This didn’t stem from me not believing walking barefoot was better for you, but because I believe from infancy most Americans today practice a form of foot binding, not un-like the Japanese in centuries past.  So, my view was our Western feet are not fully, naturally developed.  And as such, we cannot reap the benefits of this type of foot apparel.  In fact, I predicted all sorts of aches and pains moving up along the entire leg and hip as modern supports were removed and weaknesses were exposed.

Natural Growth

I came across a fantastic article, Children’s Footwear: Launching Site for Adult Foot Ills, by Dr. William A. Rossi, DPM that conveys this.  It was published by Podiatry Management in October 2002 and they are kind enough to grant me permission to use the article.  I thank them for that.

6 Myths about Children’s Footwear

  1. Room for Foot Growth:  One idea today is to put your child in a shoe that is at least ½ inch larger than his or her foot.  What this does is it places conflict between the foot and the shoe at the hallux crease.  This is the crease across the width of the shoe.  It should match the base of the big toe.  Also, the heel winds up misaligned.  This places unnatural stress at these points.
  2. Support for the Arch:  The common myth here is that the foot needs support because we walk on hard surfaces in today’s world.  While we do this, there are also many people in 3rd world cities with the same roads and surfaces.  They develop natural arches, all without the support.
  3. Snug Fit rule:  Many people endorse a snug fit.  While this may keep the shoe on, it does, in fact, restrict the movement of one’s toes.  This restriction results in a lack of full development of toes and musculature.
  4. Ankle support:  This is the idea that a baby or child needs support around its ankle because they are weak.  In fact, as with the snug fit rule, this results in the contrary state.  The lack of development of the region’s tissues and muscles result in a continuation of this weakness.  It is self-perpetuating.
  5. Heel support:  There is an idea that a child’s heel should be keep in place and it’s mobility reduced so as to instill stability.  However, the stability of the heel comes from the Achilles Tendon and the surrounding musculature.  As with the rest of the body, increased usage of the tendon and these muscles results in increased strength.  And by extension, this results in increased stability.
  6. Pronation support:  While no one wants a child to develop hyper-pronation, there is no standard for normal.  And without a normal, we can’t define abnormal, other than by opinion.  Moreover, as with other aspects of a child’s foot, when one adds these anti-pronation supports, one weakens the body’s natural ability to adapt and strengthen itself.  Which, again, leads to a self-perpetuating cycle of continued problem.

BabyFoot

The common theme presented by Dr. Rossi meshes well with the Chiropractic philosophy.  Dr. Rossi consistently decries the restriction of movement by the foot and ankle, of modern day foot binding.  He repeatedly expresses that proper stimulation and movement is required for proper tissue, muscle, and tendon growth which result in a true, natural foot.  I would add that not only must these specific external limits be removed, but the body’s internal subluxations which hinder the proper stimulation and neurological response.

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