Question
Ok....so I train in Brazilian Jiu-Jitsu, which has a pretty high injury rate. But in February (2011) I got caught in a dangerous submission move called a Twister. The twister is a sideways body bend and neck crank, which involves forcing the head towards the shoulder while controlling the body, hence causing lateral hyperflexion of the cervical spine. The technique involves tension in several bodyparts, and depending on the flexibility of the recipient, can also involve pain in the knees, abdominals and torso. The twister is often confused as being a spine crank since it involves a degree of lateral non-cervical spinal flexion. The main pressure is however on the cervical spine, hence making it a neck crank. It is performed from a back mount single vine ride position, where the top man has one "hook" threaded through the bottom man's legs and secured behind the ankle. The top man then pulls the bottom man's opposite arm behind his own head and grabs hold of his opponent's head, pulling it down to his shoulder. Once I realized i was caught in it and I went to tap, my whole back was in instant pain. They called the gym`s chiropractor in after hours and took x-rays, did ultrasound therapy while waiting on the x-ray. And it showed that I rotated four vertebra (forgot which ones specifically - but know it started from the bottom at L1). And then dislocated two ribs - I think off of T11 and T12. Those ribs have continued and continued to give me problems. I rested, iced, and repeated for several weeks. They kept dislocating. And then other ones different from the original injury site began to dislocate as well. Three and four at a time. I`m literally going in every two weeks to have everything reset and I am totally and completely frustrated. And my doctor just keeps saying it will heal eventually. So I would love a fresh take on what I need to do. It would truly be helpful.

Answer
Dear Rainy,

All athletic competition comes with the risk of injury.

Here are a couple of thoughts that I have had after reading your email:

1) First of all, x-rays might show rotations of vertebra, but how do you know if the rotations were there before the injury or not?  Often, people will have long term distortions, curves, rotations, etc  without any symptoms at all. Typically, unless you actually dislocated the spine (remember, dislocation is completely different from subluxation...), a shift in rotation or position of the spine, if it is indeed new, is usually due to muscle spasm, and will improve as the spasm decrease.  If you dislocated the vertebra, this would most likely cause you to be paralyzed, so I doubt this has happened.

Again, if you actually did dislocate the ribs, this is a very serious injury, and you should not be adjusted. The cartilage and ligaments that hold the ribs to the vertebral bodies and the sternum will require healing after such a severe injury as a dislocation. I would bet that it is more likely that you actually suffered rib subluxations instead of dislocations. Ask your chiropractor to clarify this.  I would never adjust dislocated ribs on a patient.  

Finally, healing does take time.  It is also fact that if you created instability in the spinal joints and rib joints due to ligament tearing, these joints could remain unstable indefinitely. In other words, ligaments and discs do not heal very efficiently.

That being said, if you hope to gain any stability, it is going to require time, and it is going to require strengthening exercises. Increasing muscle strength can help to compensate for some joint instabilities.  Your doctor should help you to find core strengthening exercises that you can tolerate well.

In summation: 1) I doubt that you have dislocations. If you do, you should not undergo manipulative therapies, and should consult with an orthopedic doctor.
2)Since this is likely, in reality, to be a sprain/strain syndrome of the spine and ribs, time, therapy, and rehabilitation are going to be your biggest benefits.

Good luck,

Keith Biggs, DC
http://www.eastmesachiropractor.com