Issue link: https://www.massageandbodyworkdigital.com/i/77400
2011. http://emedicine.medscape.com/article/1265682-overview. Malanga, g. "Patellar Injury and dislocation." Medscape. Accessed Resources Banit, d. "Atlantoaxial Instability." Medscape. Accessed january january 2011. http://emedicine.medscape.com/article/90068-overview. Mccarthy, j. "developmental dysplasia of the Hip." Medscape. Accessed january 2011. http://emedicine.medscape.com/article/1248135-overview. Polansky, r. "joint reduction, Finger dislocation." Medscape. Accessed january 2011. http://emedicine.medscape.com/article/109206-overview. Tham, e. "dislocation, Hip." Medscape. Accessed january 2011. http://emedicine.medscape.com/article/823471-overview. "Why Popping Your Neck is Harmful." Spinecare chiropractic group, Inc. Accessed january 2011. www.spinegroup.com/Advice/Nkcrk.html. or poor function in the extremities and viscera. Many of the operating principles of chiropractic and osteopathic medicine point to improved spinal alignment and subsequent effi ciency of nerve transmission that occur when the vertebrae are in the best possible relationships to each other. It is worth pointing out that the issue of vertebral subluxations and their relationship to pain and dysfunction is still a topic of heated controversy among many experts. TREATMENT Treatment for joint disruptions depends on the cause. Ligament laxity that contributes to frequent subluxations and a risk of eventual osteoarthritis may be treated with injections of chemicals that promote the growth of fresh collagen to tighten stretched-out structures. This is called proliferant therapy or prolotherapy. Traumatic situations that involve other tissue damage may call for surgery. If the joint capsule and supporting tissues are severely compromised, a surgeon may work to tighten the ligaments to return the joint to its pre-injury status. Closed injuries and small-scale subluxations are usually reducible through manipulation and traction of the affected joint. Chronic and congenital situations may be treated with splints, braces, physical therapy, and exercise to strengthen the muscles surrounding the compromised structures. MASSAGE? Obviously the role of massage and bodywork for a person with any type of joint disruption depends on the severity and stage of the condition. New, acute, and traumatic situations may call for a visit to the emergency room before they call for the work of a massage therapist, but even with an acute injury, a therapist skilled in lymphatic work may be able to help reduce infl ammation as long as no risk of infection is present. In subacute or chronic conditions, massage can have several useful applications. Inevitably, whether a weakened joint is in the upper or lower extremity, compensation patterns emerge as we protect that part of the body from unnecessary stress. These patterns can include postural distortions, twisting, limping, or other alterations to gait, and they can be the source of as much, or more, pain than the initial problem. And, because the joints in the rest of the body are likely to be strong and healthy, rigorous massage to address compensation patterns is safe and appropriate. Muscles around weak joints tend to become hypertonic in order to function as stabilizers. This can be useful in the short term, but can become problematic if the proprioceptors come to accept this new level of tightness as "normal"—when the joint is ready to bear weight, the muscles may no longer be able to reduce their tightness. Finally, when ineffi cient muscle tightness occurs at the spine, it is more diffi cult for a chiropractic or osteopathic manipulation to be successful, and harder for that adjustment to hold: ingrained muscle tension tends to pull the vertebrae back into subluxation. Massage can address both of these problems by easing tension before an adjustment and helping to reset tension levels afterward. Therapy Foundation. She is a writer and NCBTMB-approved provider of continuing education. She wrote A Massage Therapist's Guide to Pathology (Lippincott Williams & Wilkins, 2009), now in its fourth edition, which is used in massage schools worldwide. Her latest book, Disease Handbook for Massage Therapists (Lippincott Williams & Wilkins, 2009), is also available at www.lww.com. Werner can be reached at www.rutherwerner. com or wernerworkshops@ruthwerner.com. Ruth Werner is president of the Massage earn CE hours at your convenience: abmp's online education center, www.abmp.com 105