are meant to move. The advancements of
modern society have made our lives more
efficient and more stressful. While modern
man can communicate and travel great
distances, the methods require very little
movement on the part of each traveler.
D. Zacharow wrote, "compared to
primitive man living an outdoor life,
civilized man has become a standing-around
and a sitting-around animal rather than
a running-around one."
Today, when someone
says they've been running around,
it usually entails sitting in a car, standing
in an elevator, standing in lines and sitting
in waiting rooms.
None of these activities actually challenge
the muscles to move through their full
range of motion. Repetitive immobility,
replicated on a daily basis, leads to
chronic, postural overload and adaptive
shortening of the muscles and fascia.
This shortening of the myofascia exhibits
itself as stiff joints, decreased flexibility,
loss of fluidity, and poor posture. Fascia,
according to Cailliet, "envelops
individual muscle groups that separate
that group from adjacent muscle groups.
There is a fluid between the fibers of
this fascia that acts as a lubricant
to permit freedom of movement of each
adjacent muscle group."
If you continually
stress and tighten a muscle group,
the fascia and muscles will adhere together,
restricting their range of motion and creating
postural imbalances. "What most of us think
of as balance is this sort of a state
of contraction, of holding things together
so they will not fall apart. Over time,
this sort of posture becomes habitual,
and it results in chronic rigidity,"explains
Joseph Heller in his book, Bodywise. The
goal of any chiropractor, when looking
to correct vertebral subluxations, is to
help the body regain balance and reduce
this chronic rigidity.
When a body is out of alignment, there
exists an unequal pull of gravity upon
all the body parts. Ida Rolf recognized
this years ago and addressed the relationship
between gravity and posture. She noted
is an upright animal, and if that upright
body is out of line, then the rules of
the game say that the gravity is pulling
If you, as a physician,
wish to realign the spine, for the
better, then you must recognize the relationship
between the body and gravity. As Ida states, "you
must find that pattern in which a body
can be aligned so that gravity can pull
who are intent upon the restoration
of health in each of their patients should
observe the patient's standing and walking
posture. Watch for instability and restricted
movement. In Posture and Pain, Kendall
notes that "normal joint range for
adults should provide an effective balance
between motion and stability. A joint
which is either too limited in range
or not sufficiently limited is vulnerable
Testing and observing
the patient through their full range
of motion, from the neck to their feet,
will reveal the results of habits and patterns
which may have begun in infancy. How will you attempt
to correct those postural imbalances?
And once there is improvement, what do
you do to help the patient maintain that
balance? One tool in a chiropractor's
arsenal that is often overlooked is a
stretching program. Most patients who
enter chiropractic offices have sedentary
lifestyles, and lack of movement is their
primary activity of the day. Their favorite
excuse is that they don't have time to
stretch or exercise. It should be part
of physician's job, as Edison once said,
to "interest the patient in the
care of the frame and health of the
should become a habit, done regularly,
just like brushing your teeth. Without
stretching, the patient continues to promote
a pattern of restricted movement and muscle
fatigue. Guyton points out that muscle
fatigue comes from a prolonged and strong
contraction of a muscle. It is the interruption
of blood flow, due to contracting muscle
tissue, which leads to muscle fatigue,
due to the loss of the nutrient supply
and the lack of oxygen.
Teach your patients that inactivity is going to create
postural imbalances, with muscles that
are both tight from contraction and weak
from being overstretched.
One local irritating factor or metabolic
abnormality of muscle is that pain and
other sensory impulses can be transmitted
to the spinal cord which leads to a reflex
This means that
influences such as overworked muscles,
lack of blood flow or severe cold will
promote continued muscle contraction.
Interspersed within the muscle fibers
are stretch reflexes which serve as sensory
feedback for muscle fiber length.
One set of reflexes,
when sensing muscle stretching, will work
in opposition to keep the muscle from overstretching.
A different set of reflexes, sensing
muscle contraction, will work to oppose
the continual contraction. Stretching
regularly helps to overcome the body's
natural tendency to move towards imbalance. "Balance
is not a static condition," states
Heller, "but is a process of constant
flux, a fluid expression of wholeness and
know that frequent movement is necessary
for good spinal health. Vertebrae, when
properly aligned, have a natural fluidity.
This fluidity is lost, however, if the
soft tissues are in constant holding patterns,
influenced by tension, stress and pain.
A stretching program does
not require a lot of time, nor should it
be done only at the outset of pain or stiffness.
Any program can be successful if it is done
consistently and with purpose. Most muscles
need 20 to 30 seconds to begin releasing
tension, but a longer time is preferable.
Give your patients a small number of stretches
that they can easily do at home or at work.
They can do stretches which may be done
standing or sitting, and should address
their major area of complaint.
should also be a set of basic stretches
for the spine which include the four
directions of movement; flexion and extension,
rotation, and lateral flexion. These
back stretches should be done daily.
Some people use the stretches to help
wake up in the morning while others prefer
to stretch at night. Anytime is acceptable
as long as the stretches are done slowly
and gently, although warmed up muscles
are going to stretch more easily.
patients should know that stretching may
be accompanied with mild discomfort.
This is normal. If sharp or moderate
pain occurs while attempting to stretch
a muscle, caution the patient to stop
and see if they are stretching correctly.
If they resume the stretch and the pain
persists, have them stop and consult
you. It is important for you, as the
teacher, to observe how your patients
do the stretches the next time they come
into the office. This helps you assure
them that they are stretching correctly,
and secondly, it tells you if they have
been compliant in following your directions.
Let your patients know that this is not
a chore that they have to do, but rather
a mini vacation for their muscles to relax
and release any built-up tension. Patients
of all ages and in all occupations will
benefit from having a regular stretching
program. If the program comes from you,
then whenever they stretch, they are going
to think of you and the importance of chiropractic
Printed as "A Stretch
in Time" in Chiropractic Products
Magazine, Sept., 2002
And how to prevent them
trauma disorders (CTDs) are
conditions caused by the continuous and
repetitive use of muscles, tendons, ligaments,
joints and nerves. They can occur in nearly
every area of the body, but the most common
area are the wrist and low back. The symptoms
of tightness, stiffness, numbness, pain
or discomfort, tingling or loss of strength
and stability are due to an inflammatory
breakdown of that particular body part.
CTDs will develop over long periods of
time and are chronic in nature. This is
why it is necessary to get up and move
often throughout the day and to incorporate
a regular stretching program which will
relax and release accumulated stress
Common causes can occur from over-activity
involving constant repetitiveness, lifting
heavy loads or improper body mechanics.
How you sit, stand, grip, lift carry, type,
sew, repair, pull, push, assemble, or play
a sport has an inherent risk of injury,
particularly if there are faulty body mechanics
and/or the absence of adequate rest.
stretching affects the muscles, joints,
and tendons, the first line of defense
against CTDs is to stretch daily to prevent,
or at least reduce, the risk of creating
a CTD somewhere. This stretching should
be coupled with adequate rest in order for
the body to repair itself and recover from
the repetitive activity.
line of defense against CTD is good
This comes from an awareness of your body
position, how long you stay immobile, and
how much excess stress is influencing your
activity. Often simple adjustments in chair
or desk height, or repositioning equipment
to a more accessible place helps in eliminating
some occupations have a greater
risk of creating a CTD, and some body types
tend to be at greater risk, all CTDs are
preventable at some point in time. If you start
performing a new activity incorrectly, the
chance of preventing a problem in the future
is diminished. If you work, or play, so
hard and for so long that you never allow
yourself time to rest, then the odds of
you creating a CTD increase dramatically.
Remember, you were not born with back pain
or Carpal Tunnel Syndrome, and many people
never get a CTD in their life, so why should