Question
My chiropractor has recently diagnosed me with dislocation of rib ends in my upper back as the result of the 3 open heart surgeries I've had.He said that scar tissue as well as the extreme un-natural force created by those prolonged surgeries are now starting to displace some of the rib ends and the collarbone to dislocate.I've had an earlier acromium procedure which included removal of a piece of collarbone with radical and failed rotator cuff surgery that ultimately resulted in total shoulder replacement on rt shoulder.Besides chiropractic adjustments what other therapy could help,not so much the collarbone but the rib end dislocations.If that's not enough I've also got a severely pinched right side nerve at L5 but adjustments and massages offer only short term relief.HELP!

Answer
Dear Jeff,

First of all dislocation of any joint is a pretty big problem, and I am not sure that I would classify you as having multiple dislocations of the rib heads from the vertebral joint spaces...this would be a very rare condition.  However, you can have a misalignment or fixation of the rib heads within the joint space and this can be quite painful.  If the chiropractor is adjusting the ribs this is a more likely diagnosis.  The collar bone is a similar situation...

Now, what you really need to do is stabilize that area and this might include rehabilitation exercises to balance muscular strain and weakness, and possible taping of the area for support and gentle proprioceptive input to the brain.  I use Kinesiotape and Kinesiotaping procedures in my office to accomplish this, and you can research this at www.kinesiotaping.com.

For the low back...if spinal adjustments only offer temporary relief, then you are missing something.  This my biggest complaint with my profession...some chiropractors just adjust the spine and you are out the door in 3 minutes...NEXT. Well, many patients need rehab as well and this is important.  I would suggest that you look into decompresive techniques such as COX Flexion/Distraction technique and rehab.  And you have to regain lost flexibility in the erector muscle of the back and the hamstrings of the leg.

Furthermore, I would suggest that you need to participate in active rehab protocols (not just passive)for the low back to include stabilization exercises for the Multifidus muscle. Exercises such as prone extension, cat/dogs, bird dogs and resisted extension will help with stabilization, but should also address the abdominal cavity as well...specifically the transverse abdominus muscle, which can be targeted with abdominal hollowing exercises.  This is also a critical component of the bird dog exercise. Sit-ups will not help, and will likely increase back pain...crunches are okay, but your shoulder blades should not rise more than 1 inch above the floor.

Find a chiropractic physician who will work with you and address these issues.  Call Offices and ask if they have a Flexion/distraction table (often called COX), ask if the do active rehab in office, ask if they do stability exercises, and ask if they utilize Kinesiotape.  Bottom line is that you may need a better chiropractor.  Good luck with your search.

Respectfully,
Dr. J. Shawn Leatherman
www.suncoasthealthcare.net