The American Chiropractor

The Misunderstood Component in Musculo-Skeletal Health Care

by Burl Pettibon, D.C., F.A.C.B.S., F.R.C.C.M., Phd. (Hon)

S IT POSSIBLE TO WALK THROUGH A DOORWAY WHEN THE

door is closed? That strange question is a metaphor that can be used to describe the difference in research-based rehabilitation to prepare the spine for corrective procedures with little to no pain versus no preparation at all or, worse yet, substituting bilateral strengthening exercises for rehab to prepare the spine for corrections that are often both painful and ineffective.

Gym type exercises are often called rehabilitation exercises. However, the two have little in common. Gym type exercises are isotonic that work and shorten muscles, thereby opposing positional changes. Phasic muscles are enervated by a1-motor fibers and are consciously controlled and, when totally fatigued or injured, become flaccid. Postural muscles are enervated by a2-motor fibers and are autonomic nerve controlled. The strengthening of these muscles requires isometric exercises.

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When they are fatigued or injured, they become spastic. It is critical to understand that postural muscles dominate one’s spinal position and function as well as posture, stance and gait.

What is rehabilitation and why is it necessary for quality patient care? Dorland’s Medical Dictionary 26th Ed. defines rehabilitation as:

1. “The restoration of normal form and function after injury or illness.”

2. “The restoration of an ill or injured patient to self-suffi-ciency or to gainful employment at the highest attainable skill in the shortest period of time”.

The profession of chiropractic claims that the adjustment is for the restoration of normal form and function of the spine through correction of spinal displacement subluxations. We can agree that abnormal/subluxated spinal forms cause abnormal functions.

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