Nagging Tennis Injuries? Is it a Sign of Something More Serious?
Whether you’re a 40 something mom who plays a few times a week just to stay fit or an elite tennis star, it seems I hear some of the same complaints over and over. Could the shoulder problems, tennis elbow, rotator cuff injuries, or even arthritis in the knees be a sign of something more serious? Well we need to take a closer look at what is really causing the issue, how it’s commonly treated, and how an alternative approach using video x-ray might show things in a different light.
As an example, let’s say you have tight shoulders (a VERY common problem) that seem to be affecting your tennis game. Many doctors, including most traditional chiropractors, will focus on the shoulders. While they mean well, and can do a great job of relieving the symptoms, there might be a greater problem that’s not being addressed, an underlying structural issue.
Imagine you have a house on an unsteady foundation. It’s pretty reasonable to expect the walls will begin to crack, the floorboards will start to creak, and you may even have trouble opening the windows. Traditional doctors and traditional chiropractors are typically going to look to “manage” the secondary conditions. They are going to constantly be patching up the drywall, hammering down the floors, and oiling the windows. While this approach can be effective, it’s like filling a pothole on Monday, only to find by Friday it needs work again. The point is, it’s always going to be an uphill battle if there is a primary condition, in this case a structural shift, that’s not being addressed. So if this were your house, would you repair the cracks in the drywall and take care of the floor? Or would you first look to correct the foundation first?
So what is a secondary condition?
Well, as you may have guessed, we call it a secondary condition because it results from a primary condition. Let’s take another look at the tight shoulders. What if you have a structural shift in your spine (the primary condition), causing the tight shoulder muscles. The most reasonable approach would be to take care of the structural issues and naturally the secondary conditions will take care of themselves or can now be addressed more effectively. By working only the muscles, you’re simply patching the drywall or hammering down the floors, only to find you’ll need to do it over again in the near future. Now I’m not saying this approach will fix everything, rather, only those things caused by the structural shift in the spine. If you have bone spurs in your shoulder, you may find structural correction will go a long way towards alleviating your secondary conditions, but it’s unlikely to effect anything else being caused directly from bone spurs.
So you might be asking, how do we know if someone has a structural issue? While there are several objective criteria we can use, I’ll cover one in detail. Below you’ll see an example of a video x-ray. This is the gold standard for assessing the motion in the spine, no matter what part of the healthcare industry you’re in. Let me first orient you to what you’ll be seeing. We are looking at a side view of the neck with the jaw and teeth to the right, the back of the skull in the upper left, the shoulders in the lower left, and the spine itself directly in the center.
You will first see normal extension (looking up towards the ceiling). The spine is freely movable and the head extends all the way back to the shoulders. Take note of how far back the head comes.
This will be followed by a spine with “vertebral locking” and you’ll notice the drastically decreased motion of the spine, as the back of the head no longer approaches the shoulders, and the patient can no longer look up towards the ceiling. This area also happens to be the same area where the nerves controlling the shoulder muscles exit the spine. If this isn’t functioning properly, you can imagine the muscles it controls will be affected. If any of these indicators are present, you have “vertebral locking”, indicating a structural issue.
The third example shows the same patient from the second example, following structural corrective care and the “vertebral locking” is no longer present, as the patient is nearly identical to the example of “normal”
Below you will find a breakdown of the video with extended details and still shots of the images. In the first image, keep in mind the following when identifying normal
1. The back of the skull
2. The shoulders (with an arrow identifying the distance between the shoulders and head)
3. Angle between adjacent spinous processes (aka the points you feel with your fingers on the back of your neck)
4. A smooth, reversed “C” shaped curve in the neck on extension (as opposed to an “S” shaped curve when vertebral locking is present)