Joint centration is a common term used to describe the proper alignment of joints. This is the most beneficial or optimal position for a joint to properly support the body, as well as to allow for the most desirable movement. In short, joint centration allows for the best possible distribution of loads at the articular surfaces. Traditionally, chiropractors have talked about “subluxations” and bones being out of place. I believe the joint centration model to be more accurate in describing the benefits that chiropractic treatments provide. In this article, I would like to briefly describe the importance of joint centration in dealing with musculoskeletal pain, and what is involved in achieving joint centration.
Joint dysfunctions are the result of muscular imbalance, although traumatic injuries can surely play a role. There are many patterns of muscular imbalance, as well as mechanisms for how they develop. The take-home message is essentially that there are some areas where muscles have excessive hypertonicity, with other areas demonstrating instability. When the body has these muscular imbalances and joint dysfunctions, it leads to excessive wear and tear, as well as associated pain, disability, and increased risk for injuries.
So how do we treat these muscular imbalances and misaligned joints? Three approaches have been shown to be beneficial. I have found that integrating the following therapies gives the greatest results:
Myofascial release– Anatomists have now demonstrated that myofascial tissues run in a continuous series throughout the body. This webwork of connective tissue conveys mechanical information communicated across the entire body. Tension in one area can and usually does affect distant locations. Relaxing overactive musculature through stretching, myofascial release, and trigger point therapy both balance the body and help to eliminate pain.
Spinal manipulation– Some of the proposed mechanisms of action of spinal manipulation are releasing entrapped synovial folds, disrupting periarticular adhesions, and neurologically relaxing hypertonic musculature. The soft tissues and joint capsules of the spinal column are also rich in mechanoreceptor/proprioceptor nerve endings. Stimulation of these receptors by spinal manipulation help to override pain by releasing GABA in the dorsal horn of the spinal cord, as well as releasing endorphins and serotonin down the descending inhibitory pathway. Low back research specialist Stuart McGill, PhD, emphasizes that spinal adjusting stimulates proprioceptors in such a way that it acts as a restart for the central nervous system, allowing for more coordinated muscle activity along the spine.
Functional rehabilitation– The final key component in establishing proper joint centration is regaining coordination and stability within the weak or inhibited muscles. This involves training the brain and nervous system and focuses on coordination of the muscles to provide stability of the joints. The patient is encouraged to perform slow, controlled, and purposeful movements allowing them to become more in tune with their bodies. This body awareness and ability to perform fine motor movements greatly reduces mechanical stresses on the joints and prevents the occurrence of future injuries.