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What Are Extremities?
The extremities joints are any joints outside the spine; the shoulders, elbows, wrists, phalanges, knees, feet, ankles, ears, nasal septum and TMJ. The stability of the extremities and the spine are dependent on each other. It is crucial to make sure that your extremities are also in optimal alignment for the overall structural, fucntional and neurological integrity of your body.
Why Do I Need To Check My Extremities?
Think of the extremity joints as a pulley system, like a cable gym system. The joint is the pulley while the muscles and tendons represent the cables. When the pulley (extremity joint) is in optimal alignment, the cables (muscles and tendons) glide smoothly with minimal energy expenditure. When the pulley is out of optimal alignment then the cables are either are too tight or too loose, resulting in altered function and wasted energy. Over time, the cables wear out faster, the body adapts and eventually the inning over the cable begins to fray and the entire pulley ceases to function.
How Does The Spine Effect The Extremities?
The extremities directly or indirectly connect to the spine. More important, the extremities receive their power and information via the nervous system through the spine. If there is a misalignment in the spine causing nerve pressure the extremities do not receive optimal power and information to perform their tasks efficiently and effectively.
What Structures and Conditions Are Effected By Extremity Misalignments?
- Shoulder joint complex – consisting of the scapula (wing bone), distal clavicle, and proximal humerus bones. Structures that may be effected are the rotator cuff muscles, deltoids, biceps, triceps, chest muscles, neck muscles, and associated ligaments and bursa. Conditions include tendonitis, bursitis, arthritis, impingement, instability and sports injuries and general shoulder pain.
- Elbow joint – consisting of distal humerus, proximal radius and ulnar bones. Muscles that may be effected are the flexor and extensor muscles of the arm, common flexor and extensor tendons of the forearm along with associated ligaments and bursa. Condition include golfers elbow, tennis elbow, elbow instability, sprains, strains, bursitis and arthritis.
- Wrist joint – consisting of the distal radius and ulna along with the eight carpal bones. Structures that may be effected are the flexor and extensor muscles of the forearm, along with associated ligaments and bursa. Conditions include carpal tunnel syndrome, dropped wrist, sprains and strains, arthritis, tenosynovitis, and ganglion cysts
- Knee joint – consisting of the distal femur, proximal tibia and proximal fibula bones. Structures that may be effected are the quadriceps muscles, hamstrings, Ilio-tibial (IT) band, medial and lateral meniscus, patella, collateral ligaments, ACL and PCL ligaments. Conditions include, patellar tracking issues, knee pain, difficulty walking and standing, difficulty going up and down stairs, runners knee, sprains, strains, pain standing up from a sitting position, bursitis, arthritis, degeneration, Osgood Schlatter Disease, meniscal and ligament tears.
- Ankle and Foot joint – consisting of the distal tibia, distal fibula, talus, calcaneus, navicular, cuboid, tarsal, meta tarsal and phalangeal bones. Structures include muscles and ligaments of the lower leg, calf muscles, achilles tendon, tibias anterior. Conditions include ankle instability, ankle pain, tarsal tunnel syndrome, sprains, strains, bursitis, arthritis, foot drop, plantar fasciitis, foot pronation, heel pain, heel spurs, Morton’s neuroma to name a few.
- TMJ (temporo-mandibular joint) – consisting of the temporal bone, mandible. structures include associated muscles, ligaments and bursa of the TMJ. Conditions include, jaw pain, stiffness, headaches, sinus issues, biting and chewing problems.
- Nasal Septum – consisting of the perpendicular plate of the ethmoid bone, vomer bone, cartilage of the septum, crest of the maxillary bone, the crest on the palatine bone, along with associated membranes and cartilage. Conditions include deviated nasal septum, sinus issues, headaches.
What is an Extremity Examination?
Before conducting an extremity examination, Dr. Rahim will always perform a complete spinal exam to see if there is a predisposing spinal condition effecting the extremity in question. An extremity examination begins with a detailed history to ascertain the mechanism of injury. Next is a physical exam consisting of visualization, orthopedic and neurological testing, gait analysis, a Gonstead Extremity Specific exam, and weight bearing x-rays if indicated. Once the causative factor is identified, a series of specific adjustments to the spine and extremities will be performed over a prescribed course of treatment followed by rehabilitative exercises to increase stability, strength and functional mobility.
