
A question I am often asked by patients, “Is it a problem with the muscle or the bone, Doc?” Great question and I have an answer, it’s usually both. This question and my answer to it have shaped the way I practice as a doctor of chiropractic over the past 20 years.

There are two divisions, or schools of thought in chiropractic. Straight chiropractors are focused on only adjusting the spine. Their philosophy is that once the vertebrae are aligned and pressure from the nervous system is removed the muscles will intuitively balance themselves. Then there is what is known as “mixers”. Mixers (me included) believe in treating the muscles and the bones and therefore use an approach very similar to physical therapists by incorporating modalities such as moist heat, ice, ultrasound, electrical stimulation, traction, massage, exercise, etc., along with spinal manipulation.

It has been my experience not only as a treating chiropractor, but as a patient of chiropractic, that if there are underlying musculoskeletal or postural imbalances, they must be addressed if proper spinal alignment is to occur.

Let’s use a common postural presentation of many people who come to our office. In fact our latest video addressed this problem; forward head posture accompanied by upper crossed syndrome.

Many people spend long hours sitting at a desk working on a computer these days. Many of these people do not spend this time with ideal posture. Often the ergonomics of their workstation is part of the problem. For example, if a person has their computer screen too low and their mouse and keyboard to far out in front of them, postural faults occur.

Remember that muscles become their function. If certain muscles are continually stretched and others continually put into a shortened position, eventually you will have a group of muscles that are always short and contracted and another group that are long and weak.

In the case of forward head posture and upper crossed syndrome the following muscles are shortened, pectoralis major and minor, subscapularis, suboccipitals, sternocleidomastoids, anterior deltoids and often the upper abdominal muscles. The muscles that become stretched or long and weak are the trapezius, rhomboids, posterior deltoids, deep cervical extensors and the deep cervical flexors.

Don’t be intimidated by all the big fancy words in the previous paragraph. Below is a picture of what I am talking about. It’s really quite simple. If you sit 8 hours a day with poor posture, eventually your body will stay like that. This is why people form “hunch backs” as they age. So, your mom was right when she constantly told you to “sit up straight.”

The average human head weighs 12 pounds. When a person has proper posture their head stays balanced over the shoulders and the muscles from the front to the back are also balanced. When forward head posture occurs the head becomes substantially heavier. For every inch of forward head carriage the weight of the head doubles for the muscles that are attempting to hold your head up, primarily the trapezius muscles (the muscles in you mid to upper back that attach to your shoulder blades and skull.

Is it any wonder that patients with these problems complain of headaches, and burning pain between their shoulder blades?

As a chiropractor, when I have patients present with these types of complaints, it is important that I take my time to take a complete history and perform a thorough physical examination. By doing so I am able to create a complete treatment plan that addresses the imbalances of a particular patient, and it also allows me to find out what they are doing in their daily routine that may be causing or worsening the problem.

For example, a patient with forward head posture and upper crossed syndrome would be adding insult to injury if they were exercising improperly by doing improper sit-ups or by performing lots of pectoral strengthening exercises without stretching the pectoral muscles and strengthening the muscles of extension and external rotation. Likewise they may be furthering their condition by not having their work station ergonomically evaluated.

Taking into consideration all of the imbalances which can occur in the muscular system and realize the force these imbalances place on the skeletal system it would seem common sense that it simply isn’t enough to just adjust a patient’s spine and send them on their way.

An exercise plan should give a person exercises that show them how to stretch the shortened muscles and strengthen the long weak muscles. This way the patient responds better to the chiropractic adjustment and gets better faster.

When it comes to musculoskeletal pain and dysfunction, it truly is both muscle and bone. Yes it is very important to have your spine adjusted when bones are out of alignment with one another. But if that misalignment is caused by poor posture or postural faults then unless they are corrected the bony misalignments will always be present.

We are here to help you achieve the highest level of health possible. If you or a loved one is suffering from headaches, neck pain, burning pain between the shoulder blades, etc., call our office and schedule for a consultation to see If we can make a difference today. Or take a look at the treatments we offer.


chiropractic

Which Causes Pain, a Muscle or a Bone?

Become a subscriber today!