This article first appeared in the November 2019 issue of Lifelines, the Life West student magazine.
Flexibility is key to stability
One in three adults fall every year. Falling is the second leading cause of accidental death worldwide and is a major cause of a personal injury. In 2017, 350 million cases of falling were reported, resulting in 650,000 deaths.Medication: Meclizine used for treatment of dizziness has shown side effects like dry mouth, drowsiness and serious adverse effects like seizures. Patients with balance deficits, vertigo and dizziness have benefited from chiropractic care. A study conducted on 60 adults over age 65 years old showed effectiveness of chiropractic care in improving sensorimotor function, multisensory integration associated with fall risk, and physical and mental components of quality of life. Awareness of the body orientation and the preservation of balance in the upright stance are crucial for the performance of daily activities. (Reference 1)
Some joints in our body are for stability and some joints are for mobility:
|Stable Joints||Mobile Joints|
|Low Back||Thoracic Spine|
For a healthy person, effective core stabilization is essential for injury prevention to perform normal activities of daily living. Sacroiliac joint dysfunction has numerous complex etiologies. Proper SI joint adjustment allows lower extremities to be stable during static and dynamic activities while maintaining a free nutation motion. Hypermobility of the sacroiliac joint can be caused by ligamentous instability or be secondary to adaptive biomechanical changes and increased stresses affecting the joint of the pelvis. I experienced, on an average, three to four left ankle sprains per day due to sacroiliac joint instability. This resulted in a hairpin fracture of the left foot four to five times over a period of 10 years.
Effective core stabilization is crucial for injury prevention. Stability comes from inside-out, providing the core with the ability to generate optimal intra-abdominal pressure (IAP), required for maintenance of ideal postural alignment. To maximize IAP, the diaphragm must be positioned parallel and directly over the top of the pelvic floor. In an ideal position, IAP can be distributed multi-directionally:
a) Against spine
b) Into the abdominal wall, causing a stretch.
The net effect of these forces is designed to balance each other, thus creating a buttress that holds the spine in place. This strategy prevents isolated compressive loading of individual segments in the lumbar spine. This is an inside-out strategy and the basis of both static and dynamic stability.
|Optimal Chest and Pelvic Alignment||Open Scissor posture|
|Spine is upright||Spine is extended|
|Pelvis is neutral||Pelvis is tilted forward|
|Diaphragm is horizontal||Diaphragm is oblique|
|Ideal distribution of IAP||Sub-optimal distribution of IAP|
|Optimal coordination of stabilizers||Incoordination of stabilizers|
|Symmetrical loading of spine and pelvis||Compressive overloading of the lumbar disc and joints|
When there is a gross disturbance such as abnormal structural shift in the spine that can give rise to problems with balance and normal body posture. These structural shifts can lead to obstruction of the nerves, and it is this obstruction called vertebral subluxation that can be corrected by specific and scientific chiropractic adjustments. (Reference 3 and 4)
- Holt, Kelly R. et al. Effectiveness of Chiropractic Care to Improve Sensorimotor Function Associated With Falls Risk in Older People: A Randomized Controlled Trial; Journal of Manipulative & Physiological Therapeutics, Volume 39, Issue 4, 267 – 278
- Lindsey, Derek P., Robin Parrish, Mukund Gundanna, Jeremi Leasure, Scott A. Yerby, and Dimitriy Kondrashov. “Biomechanics of unilateral and bilateral sacroiliac joint stabilization: laboratory investigation”. Journal of Neurosurgery: Spine SPI 28.3: 326-332. < https://doi.org/10.3171/2017.7.SPINE17499>. Web. 14 Oct. 2019.
- Hartvigsen J, Christensen K, Frederiksen H. Back and neck pain exhibit many common features in old age: a population-based study of 4,486 Danish twins 70-102 years of age. Spine. 2004;29(5):576–80.