As a chiropractor it is incumbent upon me to be acutely aware of the areas in which I excel. That is, the areas in which chiropractic best applies while being cognizant of my limitations and those of the field of chiropractic.
Chiropractic is best suited for removing fixations in joints that are stuck. The chiropractic adjustment is designed to break up the fibrous adhesions that might be restricting movement in a given joint and in doing so improving the alignment of that joint. The result is better joint function along with the accompanying decreased pain and less nerve interference.
But what about the joints that are already moving too much? The last thing needed is to further loosen up those joints. The answer is twofold. Firstly, I need to work around a joint that is moving too much. These joints are called hypermobile joints. As supposed to the stuck/fixated joints which are known as hypomobile joints.
While hypermobile joints can certainly be painful, this is a case where the solution lies elsewhere – away from the area of pain. For example, many times after a patient has been in an auto accident flexion/extension x-rays of the neck will show that one or more segments are moving too much. This has the effect of putting more wear and tear on those joints. Kind of like when you break a credit card in half by working it back and forth along the crease until it breaks.
Almost always the same x-ray views will show other joints that are not moving enough. So the solution is to mobilize those hypomobile segments. That takes quite a bit of stress off the hypermobile segments. The idea is to allow those loose ligaments to heal. Another thing I can do as a chiropractor is to recommend stabilizing exercises. Strengthening the core musculature of the body can also help stabilize hypermobile segments.
Lastly, in keeping with being aware my limitations, there are times where I do have to refer out for extra help in stabilizing hypermobile segments. Fortunately, for patients who need it, there is a procedure known as prolotherapy that can help tremendously. This a procedure performed by a medical doctor in which the loose ligaments around the hypermobile segment are injected with a harmless minor irritant. This has the effect of stimulating a healing response that will create a thickening of those ligaments so that they tighten up and give the hypermobile segment more stability.
The bottom line is that we wish to achieve a balance between stability and flexibility in all the joints of the spine and body so that they remain as healthy and painless for long as possible.