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Science of Subluxations
Insights about an often misunderstood term: Subluxation
The term subluxation is often misunderstood and not always accepted due to the lack of knowledge in the field of applied physiology (not just physiology by the book) and the fact that school medicine does not regard the existing studies as valid and therefore is not regarding it as important enough when searching for causes or co-factors of pain and other health conditions.
For people who are not medically trained or have had done studies in anatomy and physiology the explanations given are often very difficult to understand and even for professionals it seems that their understanding of the science of subluxations varies a lot and that there is not one commonly used explanation (by the book) but a whole range of different views depending on the practical experience of the person and the ability to understand this quite complex mechanics.
Evidence based medicine should be regarded as important but science is not always as scientific as it appears and anecdotal evidence (patients reports and personal clinical studies) should be also taken into account when a holistic picture wants to be achieved.
The following explanations represent a mix of different evidence and are still a hypothesis and an attempt to enlighten medical professionals and non medical people alike about the complex mechanisms in the science of subluxations.
A subluxation of a joint is a very small misalignment of the joint so basically the different joint surfaces are not in proper congruence to each other. The joint is blocked in this position and does not find its way back to the natural position by itself.
This blockage is not like the blockage of an old drawer that does not easily slide back it is a blockage due to the uneven muscular tension.
The human structural system is a flexible functional unit of bones, ligaments, muscles and other tissue and all are depending on each other therefore it must not be viewed from a single angle but from all sides.
Different areas have different jobs to do and some have multiple tasks to fulfill for example our muscles. The main job of our muscles is to be the engine in the system by moving the joints within the natural movement range of the joint that is determined by the shape of the bones and the structure of the ligaments.
The second job of the muscles is to add to the stability of the structure and to keep the joint together. If we hang ourselves onto a bar with the hands our body does not lengthen like a rubber band with weight on it would do because the system recognizes the pulling forces downwards and the muscles are instructed to contract in order to avoid that the bones are pulled apart.
When the forces onto our body become too strong and are above the normal level pain sets in to warn us of a possible danger and unconsciously gets ready to protect the structure with reflexes that lets the muscles contract.
The two important systems that do that are the proprioceptive system, our position receptors and the nociceptive system, our pain receptors.
If a movement of a joint does not cause pain, a situation that is normally the case, the joint may become subluxated if the movement lies outside the natural movement range of the joint, either due to unfavorable movement habits or outside forces, and the muscles assume that position as normal and therefore keeps it there.
In most cases the joint re-aligns itself shortly after if the natural re-alignment mechanism which depends on gravity (bodyweight), shape of the bones and the ligaments together with movement can function the way it should which again depends on the alignment situation in the key stones of our structure namely the pelvic girdle and the skull-atlas-axis area.
If this core alignment is too compromised then muscles may keep joints out of alignment simply because they react naturally in order to re-balance the position of skull and pelvis.
Often this situation gets not corrected naturally anymore and the structure starts to rebuild on a cellular level which means that the muscles gets shorter or longer depending on the positions of the joint and eventually is blocking the joint in that subluxated position.
In this case the subluxation leads to muscle imbalances and tension.
However there are other factors that can cause a joint misalignment which starts with a muscle tension first. In these cases the muscle tension leads to the subluxation and again because the core alignment is not in balance can become a chronic subluxation with changes on a cellular level.
Muscle tension and especially uneven muscle tension can be caused by many stress-factors that include structural, chemical, electromagnetic, genetic, psychological and spiritual stress.
If the muscle tension has not let to a change on the cellular level then a self re-alignment of the subluxation is still possible however an outside influence in form of a therapeutic intervention is often needed to start that process.
This can be achieved by re-balancing the structural alignment and keeping it in alignment long enough for the body to readjust down to the cellular level of the muscles or by removing the tension in the muscles together with the proper stretching and movements so the self re-alignment mechanisms can do their job correctly.
Of course a combination of both may be optimal solution and for the long term success stress factors should be avoided or if necessary changed.
Lifestyle, nutrition, a strong muscular system and a balanced attitude are important factors as well.
Conclusion: Subluxations are not to be seen as unavoidable diseases but as natural reactions of our body in order to compensate for stress-factors on a multiple level.
A change towards a re-balancing is often possible by reversing the whole process that led to the subluxation. This however may sometimes require outside help and in any case self therapy and discipline based on an individual assessment of all factors that should be followed by a tailor-made approach towards a better balance following natural laws of physics, physiology and anatomy in combination with non-physical aspects.
The Dorn Method fulfils all requirements to be an effective method for a re-balancing of the structural system and is best applied as core or base therapy before any other approach but in complement with such.
by: Thomas Zudrell
New science on Pain and Manual Therapy
Pain is not good one might think.
This is true to some extend however we also need to understand that Pain is a natural way of our system to indicate that something is not right which again is good.
Only if we recognize that something is out of balance, i.e. feeling pain, we are apable to react upon it and either prevent damage, avoid further damage or start a repair mechanism.
Pain science is quite advanced but does not fully understand all factors involved and more important is that many Health Professionals do not understand even the more simple and basic principles of Pain.
The result is that many suffer unnecessarily or using drugs that are normally intended to give a short term pain relief only and often in too high doses, over a too long time period or that have more negative side effects than benefits.
When Pain is treated the wrong way or not at all and we endure it then a not very desirable situation can appear, i.e. the development of chronic pain.
An important role in this plays a, not fully understood, mechanism that is often called Pain-Memory. It is believed that we can store the memory of Pain in our brain and even in every single cell of our body.
In a situation like that it is possible to feel pain that is triggered by a small action like light pressure etc. or even non-physical triggers like emotions without the obvious presence of physical damage, chemical influence, mental stress or mechanical overload.
Movements that would normally not cause any Pain then become very painful experiences and our reaction to that in consequence is some form of compensatory actions and movements that are less painful.
This cycle can lead to serious problems and may lead to drug dependency, long term therapies and treatments or surgery.
Manual Therapy can in many cases ease the pain to some extend but often is only a short term solution. It is the body only that can achieve a healing and long term solution, any therapy or treatment is only an encouragement from the outside to re-gain the necessary balance so that the inert natural healing mechanisms can do that work.
It should be understood that therapeutic solutions which are more natural are likely to achieve better results than others with some exceptions in specific individual cases.
Most Methods of manual therapy have been, so far, also a pulling (traction) and a quite forceful mobilization or adjustment with fast thrusts etc. or strong pressure.
Manual Therapy ideally should involve a multi-level approach to treat the whole system of muscles, joints, ligaments and fascia.
Proper structural alignment is likely the most important factor in this scenario because it is the prerequisite for an optimal nerve information exchange within the body.
Joints are complicated structures which have been fine-tuned over millions of years by Evolution and not a
problem of ‘wear’ and ‘tear’, as modern medicine is seeing it.
The joints have, for their optimal function, different receptors with different ‘Job’s’ – first described by Barry
Wyke in 1967.
It is quite interesting that these Mechanisms didn’t find their way into the general Anatomy books; nobody seems to be interested in that, with the exception of the Pain science.
Today we have detailed knowledge about the complex Help-System that our body uses for protection of damage.
It is the multilevel cooperation of damage-receptors, Position- receptors, a reduction system with lowering impulses from the Brain.
This is done through the guidance of muscles and tendons by stimulating the Proprioceptors in the joint capsule and an influence on the Gamma system of the Muscle with its peripheral and central part.
Proprioception is the Self-recognition system of the body. Even with our eyes closed, we still have a quite clear impression about our position in the space surrounding us, the position of our arms and hands.
This is possible through sensory-systems in the joints and muscles that constantly transform information to the
brain about the position within a space.
This requires a constant change of signals in order to be properly recognized by the brain and nervous system, e.g. a camouflaged soldier can only be seen while moving, an incense is smelled only for a short while before we stop recognizing it etc.
Nociception is the Pain-recognition system of the body. If the stimulus is within a given normal or natural range no nerve stimulation is triggered, if it is outside that range the nociceptive system reacts and we feel pain.
The exact mechanics are more complicated as described and not as important in our case,
what is interesting for us is following:
Rhythmic, slow and steady movements and controlled movements are capable to lower (reduce) pain impulses by sending touch- and movement signals to the Brain before the pain-impulses arrive there.
Through specific impulses like traction and pressure the structures of the Motion-apparatus are stimulated in
a way that movement and position is better recognized by the joint-receptors.
Impulses of the same strength are not recognized by the nervous system. A change only happens through
change in the impulse-level.
The better the recognition possibility of the Proprioception, the better the ‘realization’ of the environment, the
movement and reaction-possibility of our body.
In simple words we can say that natural movements do not cause us any pain and movements outside natural ranges could cause damage and usually are triggering painful sensations.
So we have to take in consideration what actually is normal and natural.
In most cases for example traction is not a normal situation and will cause muscles to tense in order to avoid a separation of the bones of a joint structure. If traction stays within certain limits though it may actually relax an existing muscular tension.
Pressure is a natural situation since we are under the permanent influence of gravity and air pressure but if in excess it will cause pain and muscular tensions, but it also can in specific cases ease extreme tense muscle points like trigger points.
Long term misalignments, also called subluxations, certainly cause problems due to the necessary compensatory reactions of the body that often lead to structural changes and inflammations within the joints and connected tissues.
Movements that normally would not cause any pain are then often quite painful and thus avoided or altered.
Normal movement ability on the other side is necessary to keep the whole system healthy and able to react properly to outside stresses.
If we imagine our system as a computer controlled biological machine, where the brain is the computer, then an overload of pain stimuli is like saving a wrong message on the hard drive, i.e. when I move this joint it is painful etc.
This can be understood as pain memory and later a small event can trigger strong pain sensations.
In order to break that cycle we need to change the message than we want to be saved onto our hard drive, i.e. if I move this joint it is not causing any pain.
This logically requires that we stay within the natural ranges of movement, traction and pressure while applying any therapy or treatment, at least in most cases.
Ideally a Manual Therapy or Treatment achieves a harmonizing of the nociceptive (pain) and mechanical impulses from the nerve-endings through stimulation of the Proprioceptors (position-messengers).
This Treatment then brings the bio-mechanical and neurogenic functional disruption of the movement segment in harmony and fulfills all pre-requisites for a Pain Reduction treatment.
Not all manual therapies achieve this some seems to be better than others but all have common parts. In conclusion we should use therapies that include all necessary parts or combine different approaches in order to be more complete.
All functions in our body are trying to be in the best possible balance by onstantly reacting upon all the outside stresses and the permanent happening of re-building and destroying.
All of this requires a certain time, the healing time, and by assessing the different scenarios we can assume that it takes approximately six to eight weeks for most to occur.
In order to allow the body to do those, 3 main factors need to be considered:
1. Avoidance of harmful actions = Prevention
2. Therapy = Re-Alignment / Re-Balancing of the Problem
3. Self Help / Self Therapy as after care = Maintenance
If we leave out any of these 3 factors chances are that we do not achieve the desired result because the system is not able to make all required adjustments for a real healing to take place.
Because we tend to wait for symptoms like pain to tell us that it is time to react we often miss part 1 already.
The therapies we choose, i.e. part 2, often do not fulfill the necessary requirements to be effective.
Part 3 is likely to be done far too short term because we usually do not feel any more pain when the actual process of healing is in progress since pain is no longer necessary then, e.g. when a bone fracture is re-aligned and fixed with a cast or bandage the pain subsides very fast.
Conclusion: Further research in Pain science is needed to better understand all mechanisms involved. A therapy approach that combines different treatments and integrates prevention and maintenance is best to achieve a state of wellness and not just an absence of pain.
The Dorn Method fulfills all requirements to be an effective pain reducing method.
By: Thomas Zudrell