Structural Alignment

The Heirarchy of Skeletal Support

Muscles are the primary skeletal support mechanism. Simply stated, muscles move bones. If this support system fails in its stabilizing job, the secondary system, the ligament system has the burden of maintaining the skeletal alignment. Over time, due to deferred maintenance of past injuries, these two systems break down in predictable fashion. We call this “aging”, but in truth, it is nothing more than deferred maintenance. In our modern world, we are taught to believe that if the pain of an acute injury subsides, fully or partially, then that’s that. No more thought or care is given to the restoration of optimal mechanical function, or alignment, of the injured joint. This leaves that joint relatively unstable. Eventually the body attempts to stabilize itself, as best as it can under the circumstances. The unstable joints are fused together by bony bridges, starting out as “spurs”, in a last ditch effort to increase joint stability. Just look at grandma and grandpa. Their arthritis, or osteoarthrits, is testimony to this process. While the typical medical doctor may say “its just osteoarthrits, due to normal aging, take aspirin and learn to live with it”, I suggest a more proactive approach.

Mechanical “hands-on” manipulation restores optimal joint mechanics, which by itself stops much musculoskeletal pain and suffering. By optimizing the diet to supply the nutrients often missing in the modern diet we enhance internal healing at a cellular level. This is the normal maintenance on a biochemical level that allows the body to heal and maintain healthy joints. In other words, joints that are properly supported by normally functioning muscles and ligaments and fed good nutrition DO NOT normally break down in arthritic fashion, even if you’re in your 80’s! By analogy, cars that are WELL maintained last for decades, becoming “classics”, while those that are neglected will begin to show the expected signs of deferred maintenance and break down much sooner.

Unfortunately, we see such a large percentage of the population undergo these breakdown processes collectively known as aging that we tend to assume that this is normal and expected and this will eventually be our own fate as well. Good news is, this suffering and misery is usually avoidable. With proper maintenance, the body should easily last 100+ years, along with an endurance, agility and flexibility that rival healthy middle age levels. The more broken down and the older you feel, the more deferred maintenance the body is suffering from.

The Foot and Its Three Arches

The human foot is an engineering marvel. Feet represent the functional foundation upon which the rest of our skeleton depends for its stability and balance. The stress loads we place on our feet are phenomenal. Yet most of us take our feet for granted, never giving them any maintenance or restorative care until they break down with bunion formations, corns, plantar fascitis and heel spurs, producing chronic pain.

To gain some appreciation of the stress our feet are faced with day in, day out, 365 days per year, consider the following: the feet of a 100 lb. person accumulate approximately 25 tons of shock force per foot per mile! Jogging doubles this to 50 tons of shock force per foot per mile and running increases it again to closer to 100 tons of shock force per foot per mile. Many adults weigh closer to 200 lbs., meaning the forces are twice those in the previous example. So with these forces acting on the feet each day, is it any wonder your “dogs are barking” by the end of the day?

The foot contains approximately 25% of the bones in the human skeleton, arranged in three separate arches which work together to help form a functional foundation for our entire skeleton. If any one of these arches starts to fail, or fall, it eventually forces loads onto the remaining arches that cause them to also fail. Being the foundation of the skeleton, the feet are similar to the foundation of a building. If the foundation fails, then the floor, walls, ceiling, and roof eventually fail. Similarly, if the foot architecture is not in neutral biomechanical alignment, there will be ankle, knee, hip, neck, shoulder, TMJ etc. stresses that won’t heal no matter how much therapy is directed to these other symptom locations. Just as the old song says, “the foot bone’s connected to the ankle bone, the ankle bone’is connected to the shin bone, the shin bone’s connected to the knee bone….”.

Most of us have experience with foot/ankle sprains that appear to fit this pattern . The pain may last just a few steps and then disappear. Or the pain may go away after a day or two. In more extreme cases it lasts a week or so. But after the pain disappears from our conscious awareness, we assume the problem is gone, that our sprain/strain injury has fully healed. These subtle painless misalignments don’t show up on x-rays, and are usually unrecognized by both the patient and their healthcare providers. We’ve sort of been brainwashed to think “if it doesn’t hurt there isn’t a problem.” This frequently is far from true based on my clinical experience. Subtle misalignments cause devastating neuromuscular changes, ensuring skeletal instability leading to chronic pain. Taking an aspirin won’t fix this problem.


Plantar Fascitis and Excessive Pronation

In the foot, breakdown of the supporting tissue known as the plantar fascia leads to inflammation or as it is medically known, plantar fascitis. The suffix “itis” refers to inflammation. Improper footwear can be a leading cause of foot breakdown. Fashion footwear is sold for its “attractiveness” not for the benefit of the feet that are trying to cope with the incredible gravitational stresses they are faced with each day. All biological tissues have finite limits beyond which continual strain will cause breakdown. Wearing high-heeled shoes elevates the heel, throwing the body’s weight directly over the arches instead of the heel bone. The heel bone was designed to take the weight stress and is substantially larger than any other of the foot bones. If your center of gravity is not in alignment with the heel bone, you will tend to cause an eventual breakdown of the three arches that help the foot function in a normal fashion. Any loss in height of one arch will eventually overload the other two arches and lead to their collapse. Functional flat feet are the result.

This breakdown of the arches allows the foot to roll inward in what is called hyperpronation or excessive pronation. Hyperpronation in the foot leads to ankle bone misalignment. Ankle bone misalignment leads to eventual knee joint misalignment. And so it goes, right up the skeletal frame. I laughingly call this the “leaning tower of Pisa syndrome”. This famous leaning structure in Pisa, Italy is suffering from an unlevel foundation. Fixing the top floor would be ineffective, because the source of the problem lies in the foundation. Simialarly, many chronic skeletal pains, whether they be in the knee, sacroiliac joints of the pelvis, low back pain, sciatic pain, shoulder, neck, tension headache, etc. have “miracuously” disappeared when I have identified a fault of the foot mechanics and corrected it. Sometimes footwear needs to be changed to a more supportive type of shoe. Other times, chiropractic adjustments specifically designed to optimize the biomechanics of the foot and ankle joints need to be performed to restore normal function to the feet. Occasionally exercises must be performed to rehabilitate muscles that have atrophied due to abuse, trauma and neglect. Be good to your feet and the rest of your body will thank you!

Brain Function, Movement and Posture

Sensory messages from the “motion sensors” in the joints give the brain information called joint position sensation. But to give the brain this information, the joint must be in biomechanically healthy condition. Subtle misalignments that are not painful and don’t show up on x-ray evaluation can cause loss of this vital information with devestating results to the brain’s ability to activate and coordinate your muscles. The result is muscle weakness in the body. Without muscle support, the MAIN skeletal support mechanism is lost and ligaments and joints become vulnerable to further stresses, strains and sprains. This eventually leads to chronic pain syndromes for which many people are told, “you’re just aging, get used to it and take these drugs to cope with your symptoms.”

For example, a misaligned ankle or foot joint will stop sending position sensation messages to the brain to say “hey, I’m here, and I’m moving in such-and-such a fashion.” If the brain stops receiving those messages, it will eventually “forget” or lose awareness about that joint and stop sending nutrients to maintain it. This in turn can lead to recurrent sprained ankles and feet that degenerate, becoming a crippling problem for many.

The sensory messages resulting from movement of joints and muscles activate the brain so it can maintain healthy control of all body systems, including postural spinal muscles. This is how we normally achieve health, including erect posture and pain-free backs. Our muscles work to resist the effects of gravity on our skeletal system and to move our bodies in various ways, including, sitting, standing, walking, dancing, swimming. The resulting sensory nerve input from these activities is what drives our nervous system to control all bodily functions, even while sleeping. Have you ever wondered why your body doesn’t die when you go to sleep? Because gravity stimulates muscles and joints constantly, even when you are inactive or sleeping, and maintains a baseline minimal amount of stimulus arriving in the brain. As a result, the brain sends messages down the spine to control heart, lungs, liver, etc. so we don’t die during sleep. If enough muscles and joints are injured, gravity can’t stimulate them properly and the brain input is compromised. Therefore, sometimes symptoms, including pain, worsen with sleep or inactivity, including sitting or driving for extended periods of time.

This is why keeping your joints and muscles in shape with proper adjustments and appropriate exercise is so vital to maintaining good health. Nerve messages resulting from movement gives your brain the ability to keep you standing up straight. Why is this so important? Because posture has a major effect on rib motion – one of the biggest factors that control how deeply you breathe. If you’re slouching, your ribs can’t fully expand. Therefore, your lungs can’t fully inflate and you’re not able to take full deep breaths of life giving oxygen. This promotes your own demise. Oxygen is the single biggest determinent of your vitality because every one of your trillions of cells requires it do do their particular job. The deeper you’re breathing, the higher your energy, endurance and vitality.

Restoring & Enhancing Optimal Posture

Aside from restoring movement to joints through periodic structural corrections and adjustments, there are several simple exercises you can perform to restore and maintain optimal health and posture. See the cross-crawl marches, breathing exercises, “5 Rites” yoga exercises, all of which I recommend to my patients.

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