Question
Hi Dr. James,

I believe I have an anterior collar bone impingement/dislocation...My right-side clavicle protrudes like a bulb at the base of my throat, similarly the left side rib one step below is protruding like a bulb.  I've read that a chiropractor can do a reduction on the shoulder by manipulation/adjustment, but i haven't found much luck that gets into the meat of my isshue. So i wanted to ask you input on that? Also, i've been having success at realigning the structural areas above and below these 2 bulb problems by doing rehab exercises, especially chest since i've had 13 full yrs of swimming thru my childhood.  Are there specific exercises that should help my collarbone into place?  The best 'feel good' stretch that I know at this point is to raise my arm at a 45 degree angle from vertical and roll my arm in a big circle from front to back.  I've just started to incorporate that motion in my rehab exercise with light weights (tho waiting weeks for experimentation results always sucks).  It seems logical to me that doing certain back exercises like rows, in particular the 'elbows to shoulder level' rows, might actually keep my clavicle in the anterior dislocated position...?  i appreciate any input and thanks for reading my long story:) roger

Answer
Dear Roger,

Thank you for your question.  After reading of your circumstances, I can appreciate your frustration.  In order to answer you properly, I抣l first need to give you some background on anatomy and physiology and how they relate to the chiropractic profession.  I抣l then offer my thoughts on how this may relate to the situation you describe.  

There are two branches or schools of thought in chiropractic.  Briefly, they are differentiated by whether they deal with the limited therapeutic approach for aches and pains (commonly termed "mixed" chiropractic because it represents a mixture of a chiropractor with a non-chiropractic matter) or a non-therapeutic approach to optimum body performance (termed "straight" chiropractic because there is no mixing of chiropractic with anything else).  My expertise is in non-therapeutic straight chiropractic.

Therapeutic "mixed" chiropractic is the older approach based on a split from the founding principles of chiropractic about a century ago.  It is likely that the things you had read about chiropractors attempting to address shoulder issues are based upon this branch of the profession.  

Non-therapeutic "straight" chiropractic is the more modern of the two.  It deals with a particular, common situation called a vertebral subluxation.  This is not the same as the findings referenced in your question but they may exist together.  The spine is made of many bone segments which house and protect the spinal cord and the smaller spinal nerve branches that come off the spinal cord and exit between the bones.  These nerve pathways carry information or messages between the brain and the cells of the body.  These messages are essential for the life of the cells.  Without brain messages, the cells immediately begin the process of dying; i.e., they can no longer function the way they should to maintain life.

Because the bones are moveable, they can misalign in such a way as to interfere with the messages and, ultimately, the ability of the person to function at their best or express their optimum potential, whatever that may be.  People with vertebral subluxations are not able to get all they can out of life.

Vertebral subluxations can be caused by a wide variety of factors, what we'll generally call stresses.  These stresses can be physical (such as as exercise routines, sleeping posture and mattress condition, the birth process, sneezing, falling down, etc.), mental / emotional (in its many forms, probably the most familiar use of the word stress), or chemical (such as pollution, drugs, perhaps even alcohol, etc.), which are, unfortunately, uncontrollable and regular parts of daily living for all age groups.  In short, a vertebral subluxation can occur for a multitude of reasons.

Tragically, vertebral subluxations are rarely obvious to the individual they affect.  They usually have no symptoms.  The reason is that most of what goes on inside you happens without your awareness.  For example, try specifically to "feel" your liver.  Try to be aware of exactly what it抯 doing right now.  You can't, so you can't know if it's functioning at its best or something less.  To complicate things, nerve pathways that carry messages of control (termed "motor" nerves) have no way of transmitting ache or pain messages, so your body function may be far from perfect and you'd not have any alerting signal whatsoever.  The branching of the nerve pathways is complex and extensive, making it exceedingly difficult to predict or determine exactly how the person will be affected.  For this reason alone, it is impossible for anyone to give you reliable answers as to a connection between the spine and specific symptoms of any kind, including the things you mention.  Clavicular alignment or symptoms are not valid indicators of whether any of the vertebrae are subluxated.  Certainly, every part of the body must have connections to the nerve system so that vital information may be transmitted between the brain and the cells.  There are some who would attempt to review the possible nerve connections between a nerve root and specific organs or tissues, but this ignores the multitude of variables that determine the expression of function.  The question of how your individual body carries out the myriad of activities just to maintain life is enormous and would require your Creator抯 (or creator抯, for the agnostic) knowledge, or at least far more than our educated knowledge of the complexities of life.

Now that you have more information about the body and vertebral subluxation, how do you make use of it?  Well, first understand that this is not an explanation of why you have the shoulder / clavicle alignment issues you described or whether they are related to vertebral subluxation.  Are there reasons for what you抮e experiencing?  Even though they may be beyond our ability to identify, yes, there are; but pinning them down is not relevant to the matter of whether you will benefit from being free of vertebral subluxations.  Vertebral subluxation is, in and of itself, detrimental to your life.  It is not valid or reliable to try to connect it to the clavicle or other complaints from the things you mentioned, or any other pain or organ or tissue conditions.  In order to know if someone has a vertebral subluxation, it is necessary to have that person抯 spine checked by a non-therapeutic straight chiropractor using a method of "analysis."  When a vertebral subluxation is detected this way, it is obviously important to correct it as soon as possible.  The term for this procedure is 揳djustment.?br>
Since vertebral subluxations are caused by so many different things, people choose to go to a non-therapeutic straight chiropractor on a regular basis to enjoy the most time free of the life-robbing effects of vertebral subluxation. There's a saying that straight chiropractic is not about your back, it's not about pain, it's about your life.  Each person has a unique potential in life.  With vertebral subluxation, it's impossible to realize that potential.

A key question to ask for your purposes, then, would be, Is someone with the alignment issues you list better off with vertebral subluxation / nerve interference or free of subluxation / with the nerve channels open?  It is easy to see that having all the available nerve messages getting through is better than only some of them getting through, regardless of the person's situation otherwise.  It抯 not that you should see a non-therapeutic straight chiropractor FOR your problems ?you should visit one in an effort to be free of vertebral subluxations, even WITH those matters in your history.  Non-therapeutic straight chiropractic is not about diagnosing and/or treating these complaints or any therapeutic-model or medical condition.  It is entirely separate in its goal.  

In order to determine if you have a vertebral subluxation, it would be wise to have your spine checked by a non-therapeutic straight chiropractor - even if you still elect to have therapeutic attention or advice, whether exercise regimen or some other method of forcing geometry into your body, for the clavicle concerns.  It抯 the only way to know.  Remember, the two objectives are not the same.  

As I mentioned earlier, not all chiropractors adhere to this and it is important that you be able to distinguish which ones do if you're going to seek this type of service.  You need to understand very clearly that the practice objectives of therapeutic mixed chiropractic and non-therapeutic straight chiropractic are quite different, as described above.  What I can tell you must not be interpreted from the mixed viewpoint.  It seems that the chiropractors you have visited so far have been of the mixed therapeutic approach.  

If you are interested in finding out how to locate a non-therapeutic straight chiropractor in your area, please contact me at this site again or at [email protected].  

Roger, I wish you the best in understanding what non-therapeutic straight chiropractic has to offer.  It has been my pleasure to provide you with some information.

Sincerely,
James W. Healey, D.C.