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CERVICAL (NECK) DEGENERATION/ARTHRITIS/INSTABILITY…CAUSES & CORRECTION – Dr Alan Mandell, DC

 

Hello and welcome Dr. Mandel here with you. The topic today is going to be cervical instability.

Now I have hundreds of people I really hope they get this message right away. But I’m sure that they will see this video because it will be posted on my channel. Here we are streaming live as notifications are going out but I will continue on and move through this program as quick as I can. This is really going to help a lot of people. This is really going to give you a better understanding what degeneration is, what arthritis is, what spinal stenosis is.

All these types of degenerative processes stem from instability one way or another. So let’s go into the different aspects and a different reasons how and why we’re getting these particular problems. So let’s move on I think that you’ll enjoy this program and we’ll move on. Here this just shows us a little bit that instability will cause neck pain.  Many symptoms not just only neck pain but we’re talking about radiation of the neck possibly in the in between the shoulder blades, into the shoulder down, into the arm and to the hand and fingers. You can get tingling numbness you can get discomfort into the chest when this instability continues the nerves become inflamed and irritated and those joints become more effected. About which we’re going to talk about.

These nerves can play lots of funny games, not only under the skull but even into the jaw and facial area. Which we’ll see in just a couple of minutes. So as we move up here you’re gonna ask me how does this occur? So our next part of  lesson here is teaching you why potentially are you getting these type of inflammatory problems, constant neck problems.

Well let’s look at this we’ve talked about this many of my videos about our head. Our head being 12 pounds and for every inch of goes forward it’s an additional 10 pounds. You can just show you that what people are texting looking down the amount of degrees that they are looking down is proportional to the amount of weight. The more looking down you do the more forces on the neck, the more instability the neck is going to have. The other potential thing is looking here the correct way versus the incorrect way. I always recommend people to jut to chin down or bring that particular thing that you’re looking at via maybe your your phone, maybe your iPad or whatever it is bring it up to your your face. You can look at that okay let’s go on to right here. That’s another particular situation with forward head posture remember that head weighs 12 pounds I’m going to show you something really interesting.

This just shows you a way of stabilizing your neck. You don’t have to use this way this is just an idea. We’re not gonna spend a lot of time on this but look here. Basically you are carrying around a bowling ball how many people out there went bowling one time or another? I have and those bowling balls can get quite heavy. But let’s look right here if you’re sitting and you got a bowling ball right there sitting on your head. I don’t know about you but I know that I can’t take that bowling ball and hold it out in front of me like this for more than a couple seconds.

Now imagine your head with that bowling ball. Weight is going forward like this can you imagine that damage it’s doing. It’s stretching ligaments, stretching ligaments causes instability. So the difference between hypermobility and instability is hyper mobility means that you have stretching ligaments, but you don’t have symptoms instability.  Means you’re gonna usually have symptoms which we’ll touch on in a little bit. So this is the bowling ball here again this is showing just a how it moves forward. The amount of weight going forward looking at your iPad or your book versus scanning or sitting up correctly with those ears over the shoulder extremely important when we look at these bowling balls. It kind of gives us a better idea that next time we do this we’re going to kind of think of something that we better stop this.

We talked about many times it shows you the studies here this is a cap Angie physiology joint volume three showing us the normal posture 12 pounds for every inch which is 2 inches here it’s 20 pounds extra for every inches. 10 pounds but that’s 32 pounds for 2 inches 42 pounds for 3 inches and this is our major epidemic that we are saying right now. Now the other way that we can experience instability is through the old whiplash. Now this happens hundreds of thousands and thousands of people throughout the world. I will say millions of people it may not only be for my car accident it could be just from jarring a P from a sport. Which was shown you in just a minute but what about this slip and fall.

This happens all the time people fall, fall onto the shoulder a significant whipping of the head a jolting of the head stretching the ligaments in the joints. And many people just kind of get up and they may be bashful or shy and they don’t want to make anything out of it and they start having significant problems. Here’s a little soccer injury this is a serious injury this is landing on the neck with the great force of the body causing stretching of those ligaments. Just imagine you know we’re looking at a spine here. Realize that around the spine we have ligaments holding it together,  we have muscles over those ligaments. Obviously when the muscle contraction allows the spine the turn or move or flex but this is very fragile here.

And remember you have the nerves and come out between the vertebra and the disc sit between the bodies of the vertebra. So when they’re stretching like this look how these spinous processes are fanning apart. well that’s ligaments on the back of that and that’s stretching and when the ligaments are stretched it’s kind of like me explaining take a rubber band and over stretch that rubber band. It doesn’t come right back the purpose of ligaments the whole bone to bone to hold it tight. So if those ligaments are loose what happens to the joints they become more relaxed, they become unstable, we start inflaming nerves and causing pain. And here is another and very important thing the old neck cracker not nut cracker but net cracker. You must not crack your neck if you are doing that you can just see the fore side, according to the spine stretching those ligaments and even though you say wow that pop felt good, that noise felt good by the way the noise is just nitrogen and carbon dioxide being released from the joint space.

But you’re gonna say wow that felt good but what you’re doing is you’re stretching ligaments. I can’t tell you how many people how many emails I get hundreds and hundreds talking about I wish I never would have cracked my neck. They’re developing all kinds of problems from headaches to radiating pain chronically for a long time. Please look at my videos on neck cracking. A lot about there and it really talks about some good stuff in there so check that out.

Let’s go on to a little bit of nuts and bolts here’s an ATP open mouth looking at the mouth open up like this and we look at the first vertebrae just called the the Atlas up top called a lateral mass c1 to the left. If you see that you see c2 the axis and you look at the Adhan Toit process that’s a very important area. Because of the Atlas and axis up top that’s where 50% of our movement comes initially. Then the rest of the 50% comes below will be flexion and extension. But the majority of our rotation comes from up top.

Okay a lot of that rotation that’s where a lot of problems a lot of instability occurs commonly and rheumatoid arthritis as well as down in the lower mid cervical region. But we do see quite a bit and with rheumatoid let’s talk about the Atlas bone here you can look at just to give you a little Anatomy not to spend much time. You can come back to this we’re looking at the first vertebra on top called the Atlas it looks like a ring. See that ring up there says c1 that’s the atlas and right below is c2 called the axis and that dens that comes up like the thumb. Well that’s kind of like the atlas that goes around the axis this is really important information. You have the Aylor ligament that keeps things intact but when that area is stretched to be full on your head cracking your neck automobile actions whiplash or just chronic poor posture those ligament start to stretch. Remember that way the head being 12 pounds now becomes 22 pounds 32 pounds 42 pounds 60 pounds and that over time stretches ligaments. Okay I really hope you digest that it’s very very important here is the Atlas here again just talking about instability what happens up there’s a different view you can come back to that .

Rotary and instability quite commonly we see this you can come back and read that little later. Here’s the old x-ray of that same area that is instability called the Adi space. Atlanta dental interval space that is wider than it should be.  It should not be more than believe three millimeters so there are things we can pick up. You come a little lower in the mid neck. You see that ugly those those vertebra count down one two three and four you see those vertebra right us right there I can’t show you and you can see the kissing spinous processes in the back. If you count down from the back of the vertebra number three and number four I can’t show you on the pointer here. But I’ll show you another picture right here.

This picture here shows us a flexion and extension of the neck area if you look all the way to the left everything. If you look at the back of the vertebral bodies which are the square bodies and in the black and the black between those vertebral bodies are the discs. But it’s even when it goes forward but if you look to the right and it says four point three or four millimeters well between c6 and c7. When the neck was extending backwards that area shifted four point three four millimeters and I believe over three point five is abnormal. So that is instability so there are things that we can see with the instability but the problem with instability is that a lot of the problems are static. For example if we ask a patient to bring their head back or forward to the side sometimes the muscle spasms won’t allow them to fully bring it back because of the lack of mobility.

So it’s very very hard to pick up instability in the neck in many cases that’s why you have to have a pretty thorough diagnosis and a good clinician, a good doctor to really examine that. So down in the middle of the neck there that is degeneration. They’re down one two three four five six that’s degeneration now by the way when we get degeneration in the neck you see how it looks different. The lower neck then the the vertebrae above how the disc spaces are thinner. When we get degeneration that happens quite often when there’s instability. So a lot of arthritis osteoarthritis spondylosis all degenerative changes for set G generations Fassett imbrication Spurs even fusions osteophytes syn desmo fights. These are all calcification that takes place in the spine.

It stems from instability when something’s unstable things degenerate it’s like if your knees unstable the joint D generates the hips unstable the hips T generates that the shoulder is unstable the shoulder G generates. It does stand from instability so if we look up here this allows you to understand that these nerves when they become on when these these joints when they become unstable affect other areas this causes TMJ problems in the jaw.

The studies are out there and what do we do when we have TMJ we only look at the job well potentially it may be coming back here I want to throw that out just for a source of knowledge. Here’s an x-ray here showing you a normal neck, compressed neck. We can see forward head posture causing all that degeneration all those discs are really thinned out that is instability. When those discs get thin the vertebrae become closer together affecting on those nerves here’s another area here the importance of normal structural integrity of the neck area that when you have forward head posture its throws the integrity off it affects the nerves. It affects the neurological system we then can get tinnitus vertigo, headaches, lightheadedness, giddiness this is where it comes from.

Many of these cases come from degenerative problems and instability of the neck by the millions more than you could imagine. So and that’s why people are on drugs are not getting well because they’re not getting to the root of the source of their problem. Degeneration here is normal discs above and degenerative discs below look at the difference. But degeneration comes from instability. It’s so important instability is a leading cause of degeneration.

So another next question that rise is what do I do I’ve got degeneration, I’ve got instability, I’ve got pain, I got issues?  Well anytime there is instability, they usually there is ligamentous laxity and we generally do not want to excessively put it through a excessive amount of range of motion. So we like isometric exercises now here I like using ice excuse me if it’s inflamed I like using heat if it’s chronic. The difference between ice and heat is anytime you have inflammation even acute or even semi acute or even later on acute because you have a chronic problem does not mean that maybe one day you’re spending a lot of time looking down. Maybe you’re lifting maybe you had an accident or an injury and you inflamed it again. You had to go back to whenever in doubt use ice. Ice is really important ice takes away inflammation. Heat brings in circulations you can read this later that’s good to know.

Another question that quite commonly comes up is what about a caller my neck feels unstable? Well if you were just in a significant action or an injury I would say yes I would tell you to stabilize I would definitely tell you to stabilize the first several days. But that’s it you know it’s like people with lower back in sciatic they’ve done the studies they said people used to stabilize the lower back and lay in bed all the time. They thought those people would heal quicker they felt me heal slower because what happens is the muscles atrophy. If you don’t use it you lose it so that neck those neck muscles with that collar, those muscles start to get weak or weaker and weaker and weaker.

Obviously you need muscles that are strong to hold the head up so the first couple days and toss it and get rid of it. If you don’t have surgery if you don’t have anything significant nothing torn nothing broken get rid of it no good no good. So these are the basic the isometric exercises pretty much what we’re doing is we’re just taking the head pushing force against it about five seconds and relaxing. Doing about twelve repetitions doing in all different ranges of motion those are important.

The other thing is I love this, so this is one of the trap stretches we’ve done on our videos. Just spending the knees slightly crossing the arms and holding above the knees and kind of when you stand up you feel all these muscles under here on the traps just stretch. Try that sometime hold out hold that and kind of stand up as you’re holding it you feel all these muscles start to open up and stretch. That’s very safe you’re not putting them the neck through any mobility this right here I love it. The quadruped Ed arm leg raise we kind of call this like the halfway Superman. Excellent for core, excellent for the neck, excellent for the muscles around that stabilizing neck. Realize that even though this is not directly hitting the neck indirectly it’s helping the neck. Very important people you need to understand that when you have an injury up here you need to look at what is stabilizing that particular area down here.

Whatever goes wrong down here is gonna affect the neck as well just like when your feet are pronated okay or you’re flat-footed or you have this plantar fasciitis you end up the arch has dropped that’s gonna bow the legs and effect internally. Rotate the hip affect the imbalance all the way up to spine and affect the neck so these exercises are real good believe it or not for neck conditions.

Here’s another thing that we talked about just in the recent video we did but you put something like up against our pillow and you can resist against going backwards you can go you can actually let me skip that see if I can come to this no I mean don’t be where did it go here’s the other one go on laterally you can do it. Going forward the resistive exercise is good to call isometric isometric exercise means you’re strengthen the muscle with no move with no movement generally the first four or six weeks we like to do that with significant inflammation, significant instability.

But if it’s chronic then generally you can usually put it through range of motion if it’s chronic but if it’s newly inflamed if it’s unstable if it’s related to an injury you do not want to put it through excessive mobility. Now chin tucks are one of my favorite not only for forward head posture for her instability for degeneration for osteoarthritis for spondylosis for any type of neck problem. Unfortunately the weakest muscles of our neck are the anterior neck flexors and those are the muscles that stabilize the head that keep your head from going forward.

So these muscles are weak then I know that you have forward head posture and I can tell you that if you have forward head posture you have weak and tearing next lectures. You need to make sure you’re doing that you can do that lying down on your back just just a chin and you can put pressure against the bed. You can go upside down you can go on your belly and jut the chin and come up against gravity. Going upwards there are different ways you can be creative but that is one of the best things for your neck I can promise you. I hear the plank the plank is an excellent thing although I realize many people can do this for whatever reason.

Although I will take you to the last important thing called the transverse abdominus now these are our muscles of our core external abdominal obliques or rectus abdominis internal abdominal oblique and our transverse abdominis.  Although the transverse abdominis is the most important muscle four core that is a deep deep deep abdominal muscle. I want to take your fingers or your hand and put it on your belly come on everyone right now when you’re sitting up I want you to push in your belly and COFF like this. Guess what those muscles deep in there is your transverse abdominis. That’s how important is now those muscles stabilize the lower back now in order to work this muscle I have a duo. I have a video on this it’s called the no sit-up exercise but I’ll show you how it works very simple you’re sitting up take one of your hands or both your hands. You can do it like this put it on your belly button do it right now and I want you to go ahead and squeeze your belly button back into your spine. Squeeze your stomach in as far as you can but let’s just like this.

I’m gonna squeeze in and hold it for five seconds now you feel that huh relax it okay squeeze your belly in against your spine all the way back and hold it for five seconds again go ahead squeeze it come on squeezing and squeezing. It hurts that’s just two of them try doing a dozen of them try doing two sets of those I want you to start doing that exercise that will strengthen your ear. I’ve got your transverse abdominis that will strengthen your lower back strengthen your core and help your neck. Because what it’s gonna do when you sit up it’s gonna keep you upwards and keep you stable and keep you strong because when your transverse abdominis is weak this is what happens.

Okay we collapse our shoulders go forward a head goes forward and we start developing more instability this is kind of an interesting video and I kind of like that myself because it really touches on some important highlights. I really hope that you enjoyed this video and if you did please share it on your social media I asked you if this is your first time seeing my videos I asked you to check my channel out motivational. Check me out on Facebook motivational doc there I would appreciate you like to leave me any comments or any reviews on Facebook.

I always like to see those I really would like to get a thumbs up here and there if you don’t mind and I ask you to subscribe if you have not. Because you will continue to get cutting-edge information on the self-help probably the most thorough neck therapy self-help therapy. you’ll get that’s free and hopefully will save you lots of money in the future. We don’t have to run the doctors where you could be helping yourself. That’s what this channel is all about and hopefully you’ll share it much love to everyone out there with good health and we’ll catch up with you real soon bye bye now

 

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  1. Good Day,

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    Cheers
    Lucas

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