Hand & Wrist

There are more bones in the hand and wrist than there are in the entire spinal column.  There are 27 bones in the hand.  For comparison, there are 24 in the entire spinal column

8 of these bones are carpal bones (wrist bones).  If you just adjusted 1 of them (the Scaphoid), you would feel tremendously better.  A Chiropractor can take it a step further by detailed adjusting of 3 carpal bones (Scaphoid, Lunate, and Capitate) and tractioning the rest, along with complete muscle/soft tissue work.

A Chiropractor could check the shoulder with a wrist problem.  In our office, we usually find a shoulder subluxation (misalignment) with a wrist problem. (we always find a shoulder subluxation with an elbow problem, 100% of the time)

Lets talk about these 3 carpal bones here:

Scaphoid

The Scaphoid could be the most important carpal bone.  If you feel where the long thumb bone (1st metacarpal) starts, now just move slightly off this bone, towards the elbow.  This is where the Scaphoid is.  This is the It usually subluxates (misaligns) posterior and medially.  It is heavily involved with the following:
-  De Quervain Tenosynovitis (strain of 2 thumb muscles)
-  Lateral Epicondylitis (tennis elbow)
-  Radial Nerve Entrapment Syndromes (wrist drop could be seen here)

Lunate

This wrist bone rests just lateral to the Schapoid bone.  My professor once said this is the most commonly involved carpal bone.  But one seminar I went to said the Schapoid could be the most important carpal bone.  Who knows then?  So lets work on both and save the unnecessary confusion

This bone likes to subluxate anteriorly and superiorly.

Capitate

This is a commonly overlooked and neglected carpal bone.  This wrist bone rest between where the 3rd long hand bone (metacarpal) starts.  The Capitate subluxates posterior at the end of the bone towards the hand, and anterior at the begining of the bone, towards the wrist.

If you repeatedly get sprains/strains of the wrist, or have carpal tunnel, you want to get this wrist bone looked at.

Of course you must address the muscle/soft tissues with this region.  You can even help your wrist/hand just by working with a muscle of the chest.  Did you know that by massaging the Pectoralis Minor (2nd Chest Muscle), you can reduce or eliminate your thumb pain?   This is soft tissue work.  This of course will not work if you took a hammer to your thumb.  But if the tension travels from your chest to your thumb via the soft tissue "train", you can help your thumb.  Different muscles, but they are connected by that same train.

It is the same idea as your calves and back muscles.  If you bent down and could not touch your toes, you probably could after massaging your calves.  Massaging the calves relieves tension along the soft tissue "train" to the back muscles, relaxing them.

Carpal Tunnel

The carpal "tunnel" involves the following:
-  4 tendons of the Flexor Digitorum Profundus (muscles that flex the end of the fingers)
-  4 tendons of the Flexor Digitorum Superficialis (muscles that flex the middle part of the fingers)
-  1 tendon of the Flexor Pollicus Longus (muscle that flexes the thumb)
-  The median nerve
-  Hamate, Trapezium, Trapezoid, and Capitate bones
-  Flexor Retinaculum

Along with the adjustment to the carpal bones, a Chiropractor can do muscle work to relieve the pressure of these tendons (tendons are ends of muscles)

Chiropractic gets great results with Carpal Tunnel, and other hand/wrist problems.  Structure determines function, just remember that.

Elbow

Shoulder

A Chiropractor can do a detailed analysis on the shoulder and do the patient a great service.  The humerus is the upper arm bone, and makes up most of the shoulder joint.  The humerus can misalign (subluxate) a number of different ways:

Anterior

If this is the case, the Pectoralis Major wouid be spasmed.  Along with working on this muscle, the Chiropractor can adjust the humerus back to its position.  We personally use a drop piece to perform this. It does not hurt the patient at all.  But there are numerous ways a Chiropractor can do it.   

Anterior, Internal Rotation

From the above, add the internal rotation.  This would most likely indicate the Subscapularis muscle is spasmed (along with the Pectoralis Major).  The Subscapularis is a Rotator Cuff Muscle (the biggest Rotator Cuff muscle).  One of the ways a patient can confirm this by themselves is to see if there is pain in the throwing motion.  

The reason there is pain when you throw is simple.  When you throw, you are putting your upper arm into internal rotation.  Well, it already is in internal rotation if you have the above subluxation pattern.  So you are putting the upper arm into MORE of an internal rotation than it already is.  Well, that is going to hurt.  Plus, once the humerus internally rotates, it has to also go anterior. 

Anterior, Internal Rotation, Superior

From the above cases, now add superior.  It also subluxated superior because the Supraspinatus is too tight.  This is a Rotator Cuff muscle.  We use a drop piece for this adjustment as well.  But now we have to add Muscle Work to address this muscle (because our drop piece would do nothing to help this muscle).  We use Active-Release muscle technique to calm this muscle down back to its natural position (so not superior). There are many Chiropractic methods to address this, but we are sharing how we do it.  

The same holds true for this as well.  The patient would have pain when he or she does the throwing motion, and for the same reason listed above.

Posterior

The humerus would subluxate posterior.  We usually find a spasm of the Posterior Deltoid muscle (and of course the humerus was pushed back in the posterior position).   We use a drop piece for all our shoulder adjustments, because we find it provides the least amount of discomfort.  This is what we found in our office, but there are many different techniques to accomplish this.  

Posterior, External Rotation

Once a humerus rotates externally, it has to also subluxate posterior.  When it rotates externally, we also check the Infraspinatus and Teres Minor muscles.  These Rotator Cuff muscles externally rotate the humerus.  We find they are doing too good of a job (because the humerus is externally rotated), and should be relaxed to the humerus can go back to it's natural position.  Along with the muscle work that goes with this, we use a drop piece to correct these this subluxation pattern.  There are many Chiropractic Techniques for this, we are just sharing ours

The patient can check to see if they have this subluxation pattern.  Does it hurt to bring your arm back to throw something?  If it does, then the humerus could already be externally rotated.  When you bring your arm back to throw, you are externally rotating it even further.  I can see why that would cause pain.  

Posterior, External Rotation, Superior

This is the same subluxation pattern as above.  You can even check if you have it by the last paragraph above.  Now add a superior component to it.  The Supraspinatus is too spasmed, making the humerus subluxate superiorly.   We perform the Active-Release technique to relax this muscle, along with the drop piece to correct the posterior and external subluxation pattern.  There are many Chiropractic techniques to do this, we just choose this method.  

Shoulder Blades

You must also address between the shoulder blades.  100% of shoulder problems arise from between the shoulder blades.  We don't adjust this bone, because it is suspended by muscle.  So we just relax whatever muscle is causing its abnormal position from it's natural state.  Most times we have to tell the patient what muscle to work on at home to help our adjustments.  For instance, if the shoulder blade (scapula) is superior and lateral, the Pectoralis Minor is likely a contributor to the problem.  If the shoulder blade is lateral, or you see "winging" of the shoulder blade, then the Serratus Anterior is likely a contributor to the problem (especially if push-ups, punching, or pushing an object away is an issue)

Clavicle

The Clavicle can subluxate inferior next to the sternum (chest bone) and can subluxate superior close to the A/C joint (this is actually 50% of this joint).  This bone must be addressed as well

Bicep Brachii Muscle

Did you know 67% of the long head of this muscle goes attaches to the posterior labrum of the shoulder capsule.  33% of the long head of this muscle attaches to the anterior labrum of the shoulder capsule.  This muscle is so involved in shoulder problems, that we don't know how you can ignore it.  In fact, when it is so spasmed, it messes up with our shoulder checks.  

We now recognize when it is doing this, and we do muscle work on the Biceps Brachii.  Now we can continue checking for the shoulder check.  

If we gave you any of the above Humerus subluxation patterns above, that means that we either cleared your Biceps, or you did not have a Biceps Brachii problem

Subacrominal or Subdeltoid Bursitis

Both these bursas are connected, so I doesn't matter which one is inflammed.  You got to deal with both.  They are right above the upper arm bone (humeral head).  A bursa is a shock absorber.  You want to not let the synovial lubricating fluid in the joints dry up, causing bursitis.  Dr. Walker recommends a daily juice of 8 ounces of Carrot, 4 ounces of Radish, and 4 ounces of Watercress.  This will help restore normalcy to the bursa

(Fresh Vegetable and Fruit Juices. N.W Walker D.Sc)

I would also work on the upper trapezius and middle deltoid muscles.  If the upper trapezius and middle deltoid muscle gets tight, it pulls the head of the humerus up under the acromion.....also causing Subacromial Bursitis.  Too make matters worse, this superior head of the humerus further compresses the Supraspinatus muscle.  

You must work these muscles to get the humeral head down, this will decompress the supraspinatus.  When this muscle is decompressed, you can now work on it.  

James Waslaski.  Orthomassage

Foot & Ankle

Knee

To work on a Knee, we would first check for subluxations in the low back, thighs, and pelvis. Then we would check a knee.

The Knee can subluxate a number of different ways:

Tibia Anterior and Medial

  There will usually be point tenderness (painful at touch) at the anterior aspect of the medial meniscus with this.  One of the hamstring muscles (Semimembranosus) helps pull the medial meniscus posteriorly during knee flexion, to prevent meniscus impingment.  So this muscle has to be addressed if this is the case.  

Tibia Anterior and Lateral

There would be point tenderness over the front aspect of the lateral meniscus.  The Popliteus muscle helps to pull the lateral meniscus posteriorly during knee flexion.  This muscle unlocks your knee so it can bend.  In our clinical experience, it is involved in 99% of knee problems.  This muscle has to be addressed. 

Tibia Posterior

There would usually be a dull ache in the back of the knee.  There could also be pain below the knee cap spanning from one the inside of the knee to the outside.  

Fibula Lateral

The Fibula is not weight bearing like the Tibia, but a lot of muscles needed for the leg and foot/ankle attach themselves to this bone.  So, not needed for weight bearing, but needed for all those muscles to work.  So, a very important bone. There will usually be a dull ache over the head of the Fibula (the top of the bone)

Patella (Knee Cap)

Since this bone is entirely suspended by muscle, we usually don't have to work with it.  This is because we work on the muscles.  But sometimes it needs some extra TLC.  When it subluxates, it likes to go Superior Medially or Superior Laterally (the last one is the most common).  This is a traction move.  

This is a Tug of War situation where your Quadriceps and the Tibialis Anterior are on opposite sides of the rope, and your Patella is in the middle (the knot part).  We can tell you real fast which muscle group is winning just by doing a quick check on them.  

Additional Muscle, Soft Tissue Work:

Along with the 17 muscle stretches involved in working with the low back, we would also address the Adductor muscles (3 of them).  In fact,  in our clinical experience, the Adductor Magnus is involved in 100% of knee issues.  

The Pes Anserinus bursa likes to drop down somewhat.  This is in the anteriomedial aspect of the knee.  3 muscles come together at this region (Sartorius, Gracilis, and Semitendinosus).  We gently push the bursa where it should be.  

We would also address the Calf and Hamstring muscles.  Especially looking at where the calf (Gastrocnemius) attaches to the hamstrings above the knee.  This area has to be worked on in knee pain, in our opinion.  

This is Muscle and Soft Tissue Work, along with adjustment.  Every Chiropractor has techniques to deal with these issues.  We are just sharing ours.  

Pain that runs down side of thigh into lateral aspect of knee?

We would check your Tensor Fasciae Latae muscle, which then attaches to your Iliotibial Band, which goes into the lateral aspect of the knee.  The Iliotibial band is really connective tissue (not a muscle) that runs down the side of the thigh.  

We will have to check the Gluteus Maximus (the big butt muscle), because that muscle also attaches to this band.  Therefore, your Gluteus Maximus influences even your knee.  Which makes sense, The Glut Max is the main muscle that gives you propulsion.  It would need to influence your knees to accomplish this task.  

Hips

This section really doesn't talk about the hip.  For the actually hip, click on the thigh section.  The reason we were deceptive is because of the following:

90% of the hip pain is not the hip.  It is actually the sacrum.  This is the bone between the 2 pelvis bones. 

The sacrum can subluxate a number of different ways:

Base Posterior

the Sacrum subluxates posterior on both the left and right side

Posterior Right

the Sacrum subluxates posterior on the right.

Posterior Left

the Sacrum subluxates posterior on the left.  

This is probably the 2nd most important bone in your body, and the Atlas (first neck bone is the first).  Some people switch those two around.  We just make sure both are in alignment.  Every Chiropractor has techniques to address both bones.  

The muscle work we address with the low back, would be the same ones we address with this problem area as well:

Hamstrings

(we stretch 3 of them here, but there are 4 hamstrings in total)
Gluteus Maximus
Gluteus Medius
Gluteus Minimus
Obturator Internus/Externus
Superior/Inferior Gemellus
Piriformis
Quadratus Femoris
Psoas Major
Quadriceps (4 of them)

There are 17 muscles above.  We will address these muscles with you.

Chiropractic gets great results with hip issues

Pelvis

The Pelvis is actually 3 separate bones fused into one bone at puberty.  The bones are the Ilium, Ishium, and Pubis

A very effective technique to adjust the Pelvis is the Gonstead Technique.  This is the technique we use.  There are many effective techniques, but this is the one we use.  

The Pelvis has 2 main ways is subluxates (with some rotation variations):

Anterior and Superior

The Pelvis rotated forward; and in doing so, subluxated anterior and superior.  We adjust this misalignment at the Ishium part of the bone (the part of the bone where you sit on)

Did you know that by stretching your Sartorius, Tensor Fasciae Latae, Psoas Major, and Latissmus Dorsi....you can reduce this type of subluxation. This type of subluxation can give rise to what is called a "Droopy Glut Syndrome"

Posterior and Inferior

The Pelvis rotated back; and in doing so, subluxated posterior and inferior.  The Adductor Magnus (the 4th hamstring) can contribute to a posterior pelvis.  This is a great muscle to work on, since it is involved in 100% of knee problems.  If you can't flex your hips properly, we would definetely check this muscle out.  

Tailbone Pain?

If this is subluxated, you probably have to sit on a donut cushion.  Chiropractic and muscle work are great for this condition.  

The Tailbone can subluxate in a number of different ways:

Posterior left

This means the "tail" of the Tailbone is subluxated to the left, and must go back to it's neutral position

Posterior right

This means that the "tail" of the Tailbone is subluxated to the right, and must go back to it's neutral position.  

There are a number of ways Chiropractors can adjust this bone.  One way is to adjust it internally.  We don't do that, we adjust the bone externally.  We use an Activator technique for this bone.  This is an instrument, that cause no pain.

The muscle work involved with this case is not as extensive as a low back case.  We will explain what muscles have to be worked on:

Gluteus Maximus

One of the places that this muscle starts from is the Tailbone (Coccyx), this is why we have to work on it.  If you adjust the bone back in place, and this tight muscle is constantly pulling on this bone....you still got problems

Tensor Fascia Latae (TFL)

  The Gluteus Maximus inserts into the Iliotibial band.  The TFL inserts into the Iliotibial band.  So by working on relaxing the TFL, you help relax the Iliotibial band as well.

Iliotibial Band

This is a must to work on because of the Gluteus Maximus and the TFL muscles attach to it.  Did you know that people in professions that require them to wear a utility belt get Iliotibial Band problems alot?

Chiropractic and Muscle Work are excellent to get rid of your Tailbone problem, and get you from stop having to use a donut.  

Thigh