Near, Far and Bizarre

There’s this thing called ‘kinetic chain’. That’s how your body connects – like the old song, “The foot bone’s connected to the ankle bone…”, etc. The song is pretty simplistic as a view of anatomy but great for teaching about the parts of the body and how they connect together. Sometimes, when I treat someone for a complaint of neck discomfort, I adjust the neck (NEAR), perhaps the shoulder on one side or the other (FAR). And, sometimes I adjust the hip or ankle – for their neck issue (BIZARRE).

Sometimes, I get the ‘look’. The look that says “Why adjust my ankle for my neck?  The ankle doesn’t hurt!” When that look happens, I admit I’m a bit fond of explaining things to my patients, and ‘kinetic chain’ is one of those things. Most of my patients love a bit of science and explanation, and I hope you do too.

Everything is Connected

Ok, the body is all interconnected, still - how can the ankle possibly relate to a neck issue? If a joint, tendon or ligament is not working (inhibited) in the foot, it can change how we get around. The change can be very subtle. It can affect how much pressure we put on the foot, the angle our foot makes as it pushes off the ground, or the angle it makes as it comes back down.  It can change how far in front we place our foot, and so on. 

These actions, in turn, cause subtle changes in how we use the entire leg, the bones, muscles, tendons, and joints. Like the old song a bit further on: “The foot bone is connected to the leg bone, the leg bone is connected to the hip bone”, then the backbone, etc." And these are only bones in the song. Because joints (the ends of bones) have nerves, muscles, tendons, and ligaments crossing over each joint, all the muscles connect, through the joints – from the toes up to the head.

Then there’s all the other ‘stuff’ in our bodies, skin, arteries and veins, fat, lymph channels, organs - and so on.  All this other 'stuff' helps connect EVERY part of our body to each and every OTHER PART.  If we change the way our bodies move and cause additional restrictions – up the ‘kinetic chain’, look at how much can be affected! A restriction doesn’t have to be painful to cause issues in other places that are painful.

As chiropractors, we are educated and trained to NEVER ‘chase’ pain. It’s just a symptom of an issue in the body. It’s our job to hunt down all the factors that may be contributing to the complaint. Even if the ‘root cause’ is an ankle ligament.

A Case of Bizarre

One patient had recurring upper back pain, once a month on average, and it was usually rated at about 6-7 out of 10 - on a scale of 0-10. In our discussion of his symptoms, he mentioned it usually happened after a car trip, in his wife’s car. He wasn’t driving on these trips but had his iPad to read a book on the way. I asked him about how long the trips were, how he sat in the car, how often they took breaks, etc. 

The trips were 3 hours and 5 minutes each way to visit her mom. He told me he sat with his right leg out to the floorboard and his left leg either crossed over the right (to hold the iPad closer for reading) or pulled up tight to the seat. He positioned this way because he felt the seat was not comfortable and could not be adjusted to suit his comfort. They took no breaks during the trips.

Given this information, I evaluated his pelvis and found he was misaligned. Not by much, but enough. I asked him about walking in a store or on sidewalks. He told me “Sometimes it seems I just veer off to the left, I’ve even run into the ends of the shelves at the store”. We talked about what he might do to change this posture in the car – add a pad to make the seat more comfortable, add an iPad mount to hold it for reading, and either keep both legs extended to the floor-board or both legs pulled up to the front of the seat.

After adjusting his upper back (NEAR his area of complaint), I adjusted his pelvis (BIZARRE). His low back (FAR) also had an adjustment. The next morning, we received a text: “Upper back feels great, pain is gone today and I slept like a baby!” At his next visit, he reported his pain level had returned but was reduced overall to 2-3/10. He also related that he was walking straighter and even felt taller.

After a few additional treatments and after a couple of car trips, he returned for a visit to tell us he had installed a mount for his iPad and was consciously trying to keep his position balanced in the car. They were also taking a break around the halfway point to get out, stretch, and walk a bit. He reported his upper back pain had almost disappeared (less than 1 on a scale of 0-10.) He was released from care and advised to keep doing what he was doing to keep the problem to a minimum.

Now - What's the Point?

What is the point of this story? Had I not sought additional information and paid attention to his pelvis, his upper back pain might have reduced after each treatment, then return after each trip to around the same pain level. That would not have made for a happy patient, and I would feel I was not helping his health or well-being.

Talk with your chiropractor, make sure they listen to what you have to say and don’t be surprised if they treat you near, far, and maybe somewhere ‘Bizarre’ for your complaint. We are doing our job, providing the best health care.  

Respectfully, Dr. Armour, https://armourchiro.com/nearfarbizarre/