Question
For many years I had been seeing an upper cervical
Chiropractor (Blair) for chronic neck and back pain with
good results.  He mainly adjusted my C1 and C2.  When I'm
in adjustment, my low back pain and stiffness go away, my
neck feels loose, and I respond well to stretching,
exercising, activity, etc.  My problem is that since a
severe ankle injury a few years ago, I have been unable to
hold my adjustments for longer than about a week or so,
rather than the 2-4 months of the past.  I have been to
several different types of Chiropractors seeking an answer
to this mystery, but none have been able to help.  I am
otherwise in good health commute by bicycle, and eat well.  
My question is, what can I do to hold my adjustments
longer, and is there a another type of therapy that you
might suggest that could be a adjunct to Chiropractic?
Thanks very much.

Answer
Matt:  from what you're telling me, the problem is your ankle.  If your ankle is unstable, then it will throw off the mechanics of the "kinetic chain" of joints it is part of.  This means that the knee, hip, and pelvis can be altered in how they function as your body attempts to respond to ground forces through a funky ankle.  If your ankle is mechanically stable, meaning that there are no loose ligaments, but it remains dysfunctional, meaning that it has lost its ability to fully bend (toe toward head, or dorsiflexion), then a chiropractor must adjust the ankle at the talus: talucrural joint or subtalar joint (where the ankle meets the leg).   There also could be soft tissue lesions around the ankle that need to get worked.  Lastly, a good foot orthotic can make a difference, too.  If you have high, stiff arches, you will likely need a soft, high-arched, orthotic.  If you have a soft foot with lost arches, then you will likely need a more rigid orthotic with moderate support.  Some pre-fab orthotics can do the job for the average foot:  Superfeet, Powersteps, or ALINE brands are pretty good.  If you cycle, check out the ALINE's.  Also, regarding your neck, it may be time to migrate away from the peculiar upper-cervical-only "belief".   While I respect that you had good results with this, much of the profession, and all of the scientific and clinically oriented profession, regards this technique style as esoteric and unfounded.  I would suggest seeking a practioner with certification in Graston Technique or Active Release Technique (GT or ART, resp.).

'Hope this helps!

Dr. G.