A certain amount of ‘normal’ movement can take place between one vertebra and the next in the spine. The more lax the ligaments, the more relative movement is possible. This means that with lifting, shifting, pushing and pulling motions, a single vertebra or a number of them, can do a slight rotation relative to the vertebrae above and below. What happens sometimes is, because the spine is not meant to do too much of this sort of thing and because the body is designed to protect the spine and nerves, a protective muscle spasm could ensue. This spasm can hold the vertebra in this deviated position, causing discomfort, pain or nerve irritation.
The sequence of deviation would be something like this: You open or close a heavy sliding door. The one-sided force creates a rotation deviation in one or two of the vertebrae in the neck or low back. The local back or neck muscles go into a protective spasm to prevent too much rotation, and of course, injury. This protective spasm ‘locks’ the joints into this deviated position.
When this happens people often complain of pain or discomfort when sitting or lying down. In these positions the joints get compressed into that uncomfortable rotated position. Whereas when people walk, joints are more free to find a comfortable place. If the joints stay in the rotated position a resulting counter-rotation higher or lower in the spine happens eventually. This is the body’s way of compensating, to keep you straight and facing forwards.
In babies this same process can happen. During the birth process, the joints of the spine can be pushed or twisted into uncomfortable places. Especially with traumatic birth, also during caesarean section. Ribs can do translation movements: A shift backwards or forwards along the rib at the attachments. Ribs also do a bucket-handle up or down movement, because of their attachments to the sternum in the front and the spine at the back. So the ribs or the spine can get ‘stuck’ in any of these positions. We now know that what we understand to be colic, is sometimes actually an alignment problem in the spine or ribs. Some chiropractors address this in babies with good success.
A malalignment of the spine can carry into toddlerhood if undetected. Sometimes made worse by boisterous play. A low-grade discomfort of back or neck can keep children from wanting to jump. It can affect the alignment of the head on the neck, also alignment of the pelvis. This has a knock-on effect that creates all sorts of compensatory changes and challenges. Incorrect alignment of head on neck may result in visual disturbances.
Myotatic Activation Procedures (MAP) are techniques for correcting spine and rib alignment. The techniques were designed by Fred Mitchell Sr. MAP techniques address biomechanical dysfunctions. By creating a positional gap between vertebrae or ribs, the person’s own muscles can be used to pull the vertebra or rib back in place through isometric muscle contraction or forced exhalation. This is an active process, as opposed to a passive manipulation. Gapping the vertebrae for MAP techniques are done by tilting the head or doing a side-bend, for instance.
When a vertebra is stuck in a rotation position, the segmental muscles on the one side is in a position of relative stretch – this means they get knocked out or inhibited. Thus making them unable to pull the vertebra straight again. MAP techniques re-activate these muscles from their position of stretch, to pull the spinal joint(s) straight. And because the muscles are reactivated, they can keep the spine straight again. Think of a bicep curl. It is most difficult to do with arm in the straight or stretched out position. Same for these affected joints and the muscles connecting them. MAP techniques can also inhibit the local muscle spasm on the opposite side. These positional corrections and muscle activation techniques are meant to restore specific joint stability.
MAP techniques work relatively quickly. In a single physiotherapy treatment session the rotation deviation is assessed through palpation before and after treatment. The difference is easily visible. Range of neck- or low back movement may also improve significantly. Toddlers can have MAP techniques done. If they are compliant and have a relatively good sense of their body, they can be guided step by step.
Falls, direct hits or accidents can cause rib malalignment. The mechanism of injury can guide the treatment. The way that an injury happened exactly is the important information here. Spine alignment is important for proprioception. Without proper proprioception of the spine, it is very difficult to activate and strengthen core muscles properly. The core muscles protect the spine like a natural corset.
Some physiotherapists in South Africa use MAP techniques. This can be ascertained beforehand when making your appointment. MAP is an amazing treatment; it can feel like a magic trick. Well worth looking into for back- and neck pain, especially with a history of traumatic birth; or specific injuries. A physiotherapy consultation would determine who is a good candidate for this treatment. A chiropractic consult will determine whether spine alignment is the cause for discomfort in babies.