Patients often ask how to get their adjustments to “hold”. I am not a fan of that terminology but I do understand what they are asking. Joints (whether spine or extremities) are dynamically moving and are not necessarily stable after injuries or during the corrective process. Extreme or unsupported movements can stress the joints and subluxate (misalign) them from an anatomically correct position. Not to dive in too far here, but “in”, “out”, and “hold” are all terms that are oversimplified to the point of inaccuracy. While those terms are used they have the potential to mislead people to think the body can be in those states or do those things.
A better understanding of alignment/misalignment is a simple comparison to braces. Braces are utilized for teeth because of misalignment (cosmetic improvement) or conditions (jaw pain, headaches, facial pain, deformity, tooth pain) related to misalignment. The same is true for spines. Misalignments result in head tilts, sway backs, hunched shoulders (potentially non-painful) or in headaches, neck or back pain, numbness, tingling, swelling, loss of range of motion or other conditions related to the spine.
Pain gets our attention and we can relate more to taking corrective measures for pain. Unfortunately, all too often, when the pain goes away we think the problem has gone away, which is often not the case. There does not have to be pain when you are “out” and being out of pain does not mean you are “in”.
With braces we can see the changes in position of the teeth, thereby we know it is working or something is happening with or without pain. Changes in joint alignment can be seen on x-rays as well but they are not accessible with every visit. There are many differences with this comparison but some of the principals can be used for further explanation. Teeth can be held in place with braces and later a retainer. In the spine, correction depends on the adjustment and the cooperation of the patient to be or become the braces and retainer.
One distinction is that spines are connected by muscles and if we corrected the spine with braces the lack of mobility would quickly make a person weak and stiff. Not a practical or effective idea.
I have a few suggestions to help you make your adjustments more stable after correction and throughout the corrective process.
1. Be committed to good posture and stability exercises.
2. Do the exercises as prescribed. Muscles support joints. Your doctor should show you what you can and can’t do. Whether neck, middle back or a lower back problem I always include sitting up straight with shoulders back to encourage the natural curves and strengthen postural muscle tone.
3. Walking 15-20 minutes a day is another way to fire the muscles in the back body to encourage postural improvements. There is no magical exercise list. I have a list a mile long of stretches and exercises which I give patients, depending on their individual condition, phase of care, daily movement patterns and their personal desired outcome. Move! And, a walk outdoors is better than a treadmill.
4. Commit to a plan. Remember that change takes times. If it takes braces years to improve a smile and broken bones a minimum of 6 weeks to heal, it will take that long to build muscles and longer to make it stronger and go through all phases of tissue repair. Consistency will result in better results. Inconsistency may derail progress. When people in braces don’t wear rubber bands or retainers it takes them longer to come to a place of correction.
5. Nourish. Physical correction, especially with pain, may require more sleep, better digestion, more nutrition, or a change in foods to reduce inflammation. I often advise no sugar, alcohol, red meat, flour or dairy during cycles of inflammation.
6. Some people are more sensitive than others. Similar to when braces get tightened and teeth shift, spinal alignments can make a person sore as the muscles and ligaments adapt. How someone responds to a treatment is a guiding principal in making future adjustments. Do communicate that to your doctor. Give your body a chance and the doctor a chance to determine the best care plan and technique for you.
7. Undo what you do. If you sit most of the day, get up and move more throughout the day. If you clench your jaw, set a timer to open and close your mouth more to relieve tension every half an hour. If you are on your feet all day, wear good shoes. If you bend a lot at work, do it mindfully every time.
8. Reduce stress. Any and all kinds. Just like it is difficult to lose weight under stress, it is difficult to heal under stress. Biochemistry influences inflammation and tissue repair. Begin to notice the stressors in your life and move towards reducing them.
9. Mindfully choose 3 things to work on to make your care a success. If I could get every patient to commit to 3 things that contributed to their problem in the first place I have no doubt that results would be faster, less expensive and more lasting. To name a few; lose extra weight, walk every day, stop eating sugar, take up yoga, stop drinking soda, reduce life stress, mediate, go to counseling, make peace with relationships, get a massage or acupuncture, connect with friends, stop bad habits, and more.
My next article will dive more deeply into the topic of better mind / body results.
Yours In Health,
Dr. Erika Putnam