Subluxation: Understanding, Medical Treatment, and Rehabilitation

How do you fix a subluxation?

Fixing a subluxation primarily involves professional medical intervention, as it refers to a partial dislocation of a joint. While exercise science plays a crucial role in rehabilitation and prevention, direct "fixing" should only be performed by qualified healthcare practitioners.

Understanding Subluxation: A Crucial Distinction

The term "subluxation" can lead to confusion due to its varied usage in different healthcare disciplines. It's essential to distinguish between the widely accepted medical definition and its specific interpretation within chiropractic philosophy.

• Medical Definition: In mainstream medicine, a subluxation is defined as a partial or incomplete dislocation of a joint. The articulating surfaces of the bones are no longer perfectly aligned but remain in partial contact. This is a significant injury that can affect any joint in the body (e.g., shoulder, patella, spine) and typically results from trauma, overuse, or underlying joint instability.
• Chiropractic Definition: Within chiropractic, "vertebral subluxation complex" (VSC) refers to a theoretical construct involving a misalignment or functional alteration of a vertebra, believed to interfere with nerve function and overall health. This concept differs significantly from the medical definition of a partial joint dislocation and is not universally recognized by the broader medical community as a pathological entity in the same way.

For the purpose of this article, we will address both interpretations, focusing on the medical approach to true joint subluxations and how exercise science supports overall musculoskeletal health in general, which may be relevant to the chiropractic concept of spinal alignment.

Medical Perspective: True Subluxation

A medical subluxation is a serious injury requiring prompt attention. Commonly affected joints include:

• Shoulder: Often due to trauma, leading to partial displacement of the humeral head from the glenoid cavity.
• Patella (Kneecap): Can sublux laterally, particularly in individuals with anatomical predispositions or muscle imbalances.
• Spine: Though less common than full dislocations, vertebral subluxations can occur due to significant trauma, affecting facet joints or intervertebral discs.
• Fingers/Toes: Often from sports injuries.

Symptoms typically include:

• Acute pain
• Swelling
• Limited range of motion
• Deformity or visible misalignment
• Instability or a feeling of "giving way"

How Medical Subluxations Are "Fixed" (Managed)

The "fix" for a medical subluxation is a multi-step process undertaken by medical professionals.

• Diagnosis: A healthcare provider (e.g., emergency physician, orthopedic surgeon, sports medicine doctor) will diagnose a subluxation through physical examination and imaging studies such as X-rays, MRI, or CT scans to confirm the partial displacement and rule out fractures or other injuries.
• Reduction: This is the immediate "fixing" step. It involves manually manipulating the joint back into its correct anatomical position. This procedure, known as reduction, is performed by a trained medical professional. It may require pain medication, muscle relaxants, or even sedation to facilitate the process and minimize discomfort. Attempting to self-reduce a subluxation is extremely dangerous and can cause further damage to ligaments, cartilage, or nerves.
• Immobilization: After reduction, the joint is typically immobilized using a sling, brace, or cast to allow damaged tissues (ligaments, joint capsule) to heal. The duration of immobilization depends on the severity of the injury and the specific joint involved.
• Rehabilitation (Physical Therapy): This is a critical phase for long-term recovery and prevention of recurrence. A structured physical therapy program, guided by a licensed physical therapist or exercise physiologist, focuses on:
  • Restoring Range of Motion: Gentle, progressive exercises to regain full movement without pain.
  • Strengthening: Targeting muscles surrounding the joint to improve stability and support.
  • Proprioception and Neuromuscular Control: Exercises to re-educate the body's sense of joint position and improve coordination, crucial for preventing future subluxations.
  • Gradual Return to Activity: A progressive plan to safely reintroduce daily activities, work, and sports, ensuring the joint can withstand the demands placed upon it.

Addressing Chiropractic "Subluxations"

From a chiropractic perspective, "fixing" a vertebral subluxation complex involves restoring proper spinal alignment and nerve function.

• Spinal Adjustments: Chiropractors use specific manual techniques, known as spinal adjustments or manipulations, to apply controlled force to vertebrae. The aim is to correct perceived misalignments, restore joint mobility, and reduce nerve interference.
• Supportive Therapies: Alongside adjustments, chiropractors may recommend other therapies such as massage, heat/cold therapy, electrical stimulation, and rehabilitative exercises to support spinal health and muscle balance.

It's important for individuals seeking chiropractic care to understand the theoretical basis of VSC and to communicate openly with all their healthcare providers.

The Role of Exercise and Kinesiology in Recovery and Prevention

As an Expert Fitness Educator, I emphasize that while exercise cannot directly "fix" an acute medical subluxation, it is indispensable for the recovery process and plays a significant role in preventing future occurrences and promoting overall musculoskeletal health.

For Medical Subluxations (Post-Reduction)

Once a medical subluxation has been professionally reduced and initial healing has occurred, a kinesiologically informed exercise program is vital.

• Initial Phase: Protection and Gentle Movement: Under guidance, focus on protecting the healing joint while initiating gentle, pain-free range of motion exercises to prevent stiffness and promote circulation.
• Strengthening and Stability:
  • Isometric Exercises: Early on, to activate muscles without joint movement.
  • Progressive Resistance Training: Gradually increasing load on muscles surrounding the joint (e.g., rotator cuff for shoulder, quadriceps/hamstrings for knee) to enhance dynamic stability.
  • Core Stability: Strengthening the core musculature is foundational for overall body stability, reducing stress on peripheral joints.
• Proprioception and Neuromuscular Control:
  • Balance Exercises: Single-leg stands, wobble board exercises, or unstable surface training to improve the joint's ability to sense its position and react quickly to unexpected movements.
  • Plyometrics (Advanced): Controlled jumping and landing drills to enhance reactive strength and joint resilience, but only once sufficient strength and stability are established.
• Gradual Return to Activity: A phased approach, working with a physical therapist or exercise physiologist, to ensure the joint can safely handle the demands of sport-specific movements or daily tasks.

For General Musculoskeletal Health (Related to Chiropractic Concepts of Misalignment)

For those concerned with general spinal health or chiropractic concepts of "subluxation," exercise and kinesiologically sound practices are crucial for maintaining proper posture, balance, and joint mobility.

• Core Stability: A strong and functional core (transverse abdominis, multifidus, obliques, pelvic floor) is paramount for spinal support and preventing undue stress on vertebral segments.
  • Examples: Planks, bird-dog, dead bug, stability ball exercises.
• Postural Correction: Addressing habitual poor postures through awareness and targeted exercises that strengthen weak muscles and stretch tight ones.
  • Examples: Thoracic extension exercises, chin tucks, scapular retraction exercises.
• Flexibility and Mobility: Maintaining adequate range of motion in the spine and surrounding joints prevents stiffness and compensatory movements that can strain segments.
  • Examples: Cat-cow, spinal twists, hip flexor stretches, hamstring stretches.
• Balanced Strength Training: Ensuring all major muscle groups are adequately strengthened to prevent imbalances that can pull joints out of alignment or create undue stress.
  • Examples: Compound movements like squats, deadlifts, rows, and presses, performed with proper form.

When to Seek Professional Help

Always seek immediate medical attention if you suspect a joint subluxation. This is a serious injury that requires professional diagnosis and reduction. Self-treatment can lead to further injury, chronic instability, or nerve damage.

Consult with a qualified healthcare professional (e.g., orthopedic surgeon, sports medicine physician, physical therapist, chiropractor) to determine the appropriate course of action for any joint pain, instability, or suspected misalignment.

Important Considerations and Warnings

• Do NOT attempt to self-reduce a subluxated joint. This is dangerous and can cause severe, irreversible damage.
• Listen to Your Body: Pain is a signal. Do not push through sharp or increasing pain during rehabilitation or exercise.
• Consistency is Key: Adhering to a prescribed rehabilitation program is crucial for full recovery and preventing recurrence.
• Prevention: While not all subluxations can be prevented (especially traumatic ones), a strong, flexible, and balanced musculoskeletal system significantly reduces the risk of non-traumatic subluxations and supports overall joint health.