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June 2018 Newsletter

Hypermobility of Dr Alaina cropJoints

by Alaina Rowswell-Kuliikowski DC DICCP

crackingneck

Many times in my office, I meet a young person who has developed a habit of cracking some joints. Oftentimes he targets the knuckles, back and neck. Usually, I’m told this feels good. In opposition, usually the parent tells me this ritual has now become a habit and there’s concern over joint health.

Is cracking your own joints healthy? After all, we are chiropractors and it makes a noise when we adjust our patients. Isn’t that exactly the same thing? Well the answer to that, is yes and no.

The cracking noise that you hear when joints move is the same whether there is a Chiropractic alignment to a joint or just a random self mobilization. The noise you hear when a joint capsule is stretched is a release of gas that makes a popping noise. Technically, the word is cavitation. But, even the smallest child will call it cracking. My affectionate term is popcorn.


The important thing is to understand
 why we would elicit that type of sound. If someone is feeling tight or stiffness, they will often crack the joint. Following, there is a hormonal release of endorphins and indeed the patient is right, he does feel better. The question is was this type of movement to the joint healthy?

In trying to understand this, I often ask my young patient how often a chiropractor (who has her doctorate in understanding the health of joint motion), should see her patient. I get a variety of answers, but when I asked for clarification if it would be okay that this patient return to my office six to seven times per day for me to crack their joints I am met with an absurd glance. No, it would be malpractice and possibly even endangering the health of a child to adjust them multiple times per day. However, many children (and adults) are cracking their own joints more than seven times per day habitually. This is not healthy. In fact, our ligaments that hold the joint into stability are made up of a cellular structure close to elastic. If an elastic material is stretched many times, the elasticity is lost. Easily, it is seen that by habitually cracking, a joint can cause joint instability due to lack of elasticity.

neck pain

This can cause Benign Hypermobility Syndrome. This is a condition where the joints are unstable because the elasticity of the ligaments that hold the joint has decreased. Another term in the literature would be OMS or over manipulation syndrome. “Symptoms of OMS will vary depending on the location of the spine that has now become unstable and hypermobile. Neck pain, thoracic pain, and low back pain may be present. Since the ligaments are unable to hold the vertebrae in place, the muscles will try to help out. The result will be muscle spasms in the various areas of the spine, and most likely pain radiating elsewhere. When the neck is involved symptoms such as tinnitus, anxiety, blurred vision, facial pain, vertigo, dizziness, headaches, neck tenderness and others are experienced.”

Can a chiropractor or osteopath cause this over manipulation of a joint? That is not common. The health care provider is educated and trained to examine joint function and promote alignment, stability and wellness of a joint. Additionally, we are are trained how to help people overcome these hypermobility syndromes. Sometimes frequent adjustments are necessary in the early administration of a care plan, but that decreases in frequency as time passes.

I am asked often if cracking is dangerous or does it cause arthritis. The literature is available to support that an uneducated and inexperienced self over mobilization is totally different than a Chiropractic adjustment. There are certainly risks that the Chiropractor is aware of with any manipulation. That’s why we do frequent examinations and are held to the responsibility of diagnosis. Particularly, cracking your own neck should be avoided. The consequences of cracking without proper examination can result in stroke or in very rare instance death. It is important to realize there is a significant difference between a self over manipulation to random joints that may foster malalignment or surrounding joints to become more immobile and an adjustment from a chiropractor. In each case trusting a licensed professional is highly recommended.

References

https://www.scientificamerican.com/article/what-makes-the-sound-when/

Kingston, Bernard. Understanding joints: a practical guide to their structure and function. Cheltenham, Stanley Thornes, 2000. 240 p.

https://mobile.nytimes.com/2013/10/29/science/what-causes-a-neck-to-crack.html?_r=0

Benign Joint Hypermobility Syndrome

Over Manipulation Syndrome

http://livrepository.liverpool.ac.uk/3004183/1/Revised%20Hypermobility%20%28CHANGES%20ACCEPTED%20%26%20references%20formatted%29.pdf

Hypermobility disorders in children and adolescents
Author:Kevin J.MurrayMB, BS, FRACP(Paediatric Rheumatologist)

“Knuckle Cracking”: Can Blinded Observers Detect Changes with Physical Examination and Sonography?, Boutin RD, et al. Clin Orthop Relat Res. 2017.

Cracking and arthritis
“Effect of habitual knuckle cracking on hand function.” Ann Rheum Dis. May 1990; 49(5): 308–309.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3506737/

“Man dies after ‘cracking’ his own neck.”

Cassidy JD, Bronfort G, Hartvigsen J. Should we abandon cervical spine manipulation for mechanical neck pain? British Medical Journal, June 8 2012

Best Practice & Research Clinical Rheumatology Volume 20, Issue 2, April 2006, Pages 329-351(9)

news notice

Starting on June 27, 2017
Dr. Joshua Leuppie and Dr. Jeremiah Davis will be hosting a patient education and trigger point class at 6:30 pm. A light meal will be provided. Please bring a friend or family member to teach techniques for home care. Topics covered will be soft tissue mobilization, stretches, different lifting techniques and exercises. It will be a workshop in nature. Please sign up via email riverviewchiropractors@gmail.com or at the front desk.

We have a new sign in process.
As you walk into the office, look to your left. We have a sign in Kiosk! We are starting to provide a digital process to update your information, make appointments and to sign in to let the provider know you are here. Tune in, in the future you will also be able to pay for your chiropractic care digitally.

FOOT CARE
We are doing custom orthotics! Our custom orthotics are supplied through Powerstep. We think you will be very pleased with the product. We are offering them at an introductory price of $225 for the base orthotic. This is a $100 savings over the same product that other podiatrists use in the area.

Orthopedic Sandals powerstepsandal
Also we have available some orthopedic sandals available for the summer season. Mens and Womens sandals are available in black and brown, Women’s sandals also have a teal option. We just love them. They are $60.

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Recipe Of The Monthprot pwdr pancake

Protein Powder Pancakes

Ingredients:

2 scoops of protein powder
1 Banana
2 eggs
1 tsp baking soda

Instructions

Mash the protein powder and soda into a fresh or frozen banana
Add eggs and distribute into a smooth batter.
Pour into a greased hot frying pan into small cakes (on a medium flame) flip when edges are dry.
You can add a few dark chocolate chips, or sliced berries to add something special.
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