Why joint injuries need to be addressed in order to make sure they don’t become chronic.
When you injure a joint (for example, common places to injure a joint include your spine, your shoulder, hip, knee, wrist, elbow, or ankle) there is also damage to the ligaments that help that joint function properly. Before I explain what exactly ligaments do, let’s quickly go over some terminology:
Joints – this is a place where two bones meet and they can move in relation to each other.
Muscles – these go from one bone to another bone, and when a muscle contracts it brings the two bones closer together.
Tendons – muscles attach to bones with tendons. As the muscle nears the bone it transitions into tendon, which physically attaches the muscle to the bone.
Ligaments – ligaments go from one bone to another bone, but they do not have the ability to stretch like muscles and tendons. They are used to reinforce a joint, to prevent motion in certain directions, and to guide movement in the correct direction.
So, when a joint is injured there is a good chance that the ligaments that hold it together were also injured. To illustrate this, when you sprain your ankle, the actual injury is to the ligaments of the ankle joint. When there is a sprain it is an injury to a ligament.
That injury to the ligament always initiates a process beginning with two things: joint instability and proprioceptive deficit.
1. Joint instability – as explained above, the ligaments guide and limit the movement of the joint, and without stable ligaments you will not have a stable joint.
2. Proprioceptive deficit – this is a fancy way of saying that your nervous system will have a decreased ability to monitor and control the movement and position of that joint and the bones that the joint includes.
a. This proprioceptive deficit then causes decreased neuromuscular control. That means that your body has a decreased ability to properly control your muscles. It is called decreased “neuromuscular” control because the nervous system deficit means that the brain and body aren’t properly communicating and that perfect control of your muscles you usually have is lost. Your brain and the nerves in your joint just can’t get the messages across with 100% accuracy if there is an injury to the joint.
Now, all the issues I mentioned above lead to a common result: functional instability. An unstable joint and a decrease in nervous system control over that joint will combine to cause a loss of functional stability. Functional stability is the overall stability of your body or your body part as it does what it is supposed to do. Using the example of the ankle again, functional stability would show itself as trouble with walking correctly, putting more weight on one foot, or tip-toeing around to avoid pain. These are all changes in how the joint is functioning due to the injury.
We are talking about a cycle, and this is the important part. If you are getting by with an injured joint, but it is not healed correctly, then you are forcing your brain and body to utilize coping strategies like limping or leaning (or avoiding activity altogether). All these strategies are meant to help you avoid re-injuring the joint, but they all predispose the joint to re-injury quite often. After all, using a joint or a body part incorrectly is a good way to injure it in a new way or just plain exacerbate the existing injury. As a chiropractor I quite often have patients who describe things like severely injuring a disc in their back because they were trying to shovel snow without standing up straight all the way…because they already had back pain to begin with!
So, now we have an injured joint become a repeat injury. Once you re-injure the joint it is typically more difficult to resolve and get back to 100% pre-injury status. You can see this entire process I just described in the picture below:
So, why is a chiropractor talking about this? Because chiropractors manipulate joints. At Park Bench Chiropractic we work on all the joints in your arms and legs as well as adjusting spines. By locating and correcting vertebral subluxations we help your entire body function better. When we find problems in how other joints are working, such as wrists, ankles, and jaws, we will manipulate those areas as needed. Call our office at (01) 378-0334 to schedule an examination or consultation with Dr. Matt or Dr. Rob in our friendly Frederick office.