When Your Body is 'Out of Whack'

“Help! My insert body part here is out of whack!” This is something that we hear people say over and over again. But what does that really mean? Can pieces of your body just pop out of place? (spoiler alert: very rarely) If so, can we pop them back in? If not, what are we really doing?

When someone claims they are “out of whack”, they are usually referring to somewhere in the vicinity of their trunk region; commonly the spine, ribs or pelvis. Their chief complaint is often along the lines of “something popped out”, “something is out of place” or “it feels like it needs to be put back in”. This concern is usually uncomfortable but may or may not be associated with pain. So what’s going on?

I’m going to let you in on a little secret - the human body is a pretty nifty piece of engineering and it’s pretty darn strong! We’re made of bones that, by weight, are actually stronger than steel! Those bones are held together by tough little structures known as ligaments. On top of that, we have a bunch of incredibly strong muscles that help to support our joints and prevent them from moving in ways that they shouldn’t. Unless you display a massive congenital hyperlaxity, things shouldn’t just be popping in and out willy-nilly. For something to truly be out of place, there generally needs to be a significant degree of trauma. This trauma will almost always cause damage to the ligaments and capsular structure that were holding the bones together and without that natural stability, the bones may be free to move around. BUT….these are major injures! Think dislocated shoulders, ACL injuries or broken/dislocated backs. These are not little things that will be better once they’re “popped” back into place. This is especially true when we think about the pelvis and spine, two of the most stable structures in the body. The spine surrounds a little structure known as the spinal cord and it’s kinda important. Imagine if your vertebra just shifted out of place because you bent down weirdly or slept the wrong way. You’d be on a spinal board, not walking into a clinic to get put back into place.

So what is going on when you DO have something popped back into place. You feel better right? How can this be? The “popping” maneuver your might have experienced is called a manipulation. It is more accurately known as a high-velocity, low amplitude thrust. This means that the aim is to have a very quick application of force with as little movement as possible. While this can sometimes feel and look like an aggressive maneuver, a well performed manipulation is only moving the body segment a matter of millimeters. Contrary to popular belief, a successful manipulation isn’t always accompanied by a loud cracking sound. This noise is called a cavitation, and is caused by the sudden formation of an air bubble within the fluid of the joint being moved. A cavitation is NOT a joint jumping back into place.

But if no significant movement is occurring, why does a manipulation make you feel better? The short answer is: we’re actually not entirely sure. There is good research indicating that manipulations can be effective at reducing pain but why this happens is still up for debate. The leading theory is due to something called neurophysiological modulation. In lay terms, the rapid movement from the manipulation acts to stimulate the affected area and these signals are sent to the brain. It is thought that the brain responds to this new signal by activating an inhibitory pathway that reduces pain. However, because nothing is being physically put back into place, the effect is purely one of sensation. Once the sensation is removed, the inhibitory effect will begin to dwindle and the original feeling of pain or discomfort can return. For a manipulation to be truly effective, you need to take advantage of the pain/discomfort free period following the treatment. Intentionally moving through previously uncomfortable positions can help to retain the feeling of normality in your body.

Manipulations and mobilisations certainly have their place in the therapy world but it’s important to remember that the effect is transient. They are rarely used as standalone treatments and while they can be quite relieving, there is no indication that they are truly fixing anything (at least not from a mechanical perspective). Next time you feel that something is “out”, don’t panic. Ask yourself, is there any reason that something would truly be out of place? Short of any significant trauma or prior injury there probably isn’t. Remember, this feeling you have is just that; a feeling. The more important question to ask is WHY your body feels out of whack. Finding and addressing the factors leading to this perception will be more effective than simply trying to pop things back into place.

Does your body feel 'out of whack' or like something just isn't right? Book in to see Clay today, and he'll make sure you're feeling your best in no time! Book online here, or call us on (08) 9448 2994

#physiotherapyperth #runningphysio #perthphysio #surfphysio #physio #physiotherapy

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