 Chiropractors’ focus on the spine is enhanced by recognizing the dynamic influence of the legs on the body’s overall structural and functional integrity, according to James Brantingham, DC, PhD, Director of Research at Cleveland Chiropractic College–Los Angeles, whose research on chiropractic extremity care has grown deeper and broader since he joined the CCCLA faculty in 2004.
The son of one of California’s leading podiatrists, Dr. Brantingham understood from an early age the importance of the feet and legs as a supportive foundation for proper musculoskeletal balance. Following his father’s footsteps into podiatry did not spark his enthusiasm, but after spending a day observing at a chiropractor’s office—including a memorable case where a patient entered the office barely able to walk and left smiling and pain-free—Brantingham’s career direction was clear. After graduation, he practiced in Thousand Oaks, California for 14 years and then followed a winding path that led through chiropractic university programs at Durban University of Technology (DUT) in South Africa, and the University of Surrey in England, where he earned his PhD in clinical research, before returning to California to join the CCCLA faculty.
Most people think of chiropractic as primarily focused on the back and the spine, but there is a long history of chiropractors adjusting the extremities—the arms and legs. How far back in chiropractic history does that extend?
D.D. Palmer’s earliest pamphlets, which predate his 1906 and 1910 texts, described adjusting the foot. I looked into these with [chiropractic historian] Joe Keating. Palmer was talking about, at a minimum, adjusting the foot and ankle.1 He demonstrated a great interest in this. At the same time, Modernized Chiropractic, the reputed first 1906 chiropractic textbook by Smith, Paxson and Langworthy, had a full chapter devoted to adjusting the foot.2 Looking at Palmer’s 1906 and 1910 textbooks, we can make a reasonable attempt to determine the specific conditions to which he was applying the foot adjustments.
These appear to include, at a minimum, a sprained or subluxated hip, sprained or subluxated knee (actually a proximal fibulotibial problem), metatarsalgia, Morton’s metatarsalgia or neuroma, or a pinched nerve in the forefoot, and what we now commonly call “plantar fascitis” or “fasciopathy.”3 He also talks about adjusting the shoulder, the hand and the ribs.3 When I did a paper on D.D. Palmer and extremity adjusting, I found over 22 references to adjusting the foot, particularly the great toe or hallux, other foot joints and the ankle for a variety of disorders and pain.4, 5
Foot and ankle problems can have their source at the foot and ankle. But in some cases, these can be secondary effects of a problem in the spine. In my experience, causation can go in either direction—the spine causing a foot problem or the feet causing a spinal problem. Could you please describe your concept of “full kinetic chain chiropractic care.”
There is clearly a tie-in to the full kinetic chain and there’s research supporting this. Iverson, a physiotherapist, did a recent study on generalized adjustments of the lumbosacral spine, and determined that if the hip was stiffer on one side and the patient had patellofemoral pain syndrome (knee pain), then that was a clinical predictor for adjusting the lumbosacral spine on the same side, which would relieve knee pain. Souter did a similar study for anterior knee pain, which is another name for the same condition. This paper won an award at a World Federation of Chiropractic conference and clearly showed that knee pain was relieved by adjusting the lumbosacral spine. So that’s a clear tie-in. Other studies have shown that when patients have knee osteoarthritis, it makes the disability of hip osteoarthritis worse. Still other research shows that in patients with hip osteoarthritis and knee disability, the stiffness in the knee makes the hip osteoarthritis worse. |
