Joints are cool. They allow us to bend, twist, and generally move freely. Without joints, we would be very stiff beings, and more or less, a living statue. Our body contains all sorts of joints – fibrous joints that do not move, cartilaginous joints that have limited movement, and synovial joints that move freely. In my opinions, the synovial joints are the coolest joints because they are the primary movement joints (i.e. knee, elbow, shoulder, ankle, wrist, etc.). Synovial joints are what you most likely think about when you think about joints.
Unfortunately, as joints must permit movement, they must sacrifice stability. The amount of stability that is sacrificed is determinant upon the degree of movement the joint offers, with more moveable joints being less stable. The good news is that our body does a good job of protecting its vital structures with more secure joints. This is why the skull is made of fibrous joints, and the sternum, ribs, and most of the spine has cartilaginous joints. These joints are less moveable and more stable in order to protect the brain, heart, and lungs, arguably the most vital organs in our body. The bad news is that our body is not perfect in this regard. In order to allow your head to swivel and move in all directions, your top two vertebrae, atlas (C1) and axis (C2), are composed fully of synovial joints; you know, the moveable ones. From a functionality standpoint, this is great. Imagine living your whole life with a neck brace, always turning your shoulders in order to look to each direction. That would not be fun. However, from a safety standpoint, the fact that atlas and axis have a synovial joint means they are prone to injury. In fact, I believe the atlas and axis joint is possibly the most important joint in the body, and also one of the weakest. To clarify, the joint I am describing is actually three joints on each vertebra, where the two vertebrae meet at different areas of the bone, but for the means of this post, I will refer to them as one joint.
Why is the atlas and axis joint such an important joint? It’s because of the structure that it protects. We all know that the vertebral column houses the spinal cord, in order to protect it from damage, but the atlas and axis encase the top of the spinal cord, which is otherwise known as the brain stem. If you were to look at a picture of the brain, and follow the posterior (back) end of it down to where it connects to the spinal cord, you’ll notice that it tapers off. That area where it tapers down is the brain stem, and it’s what connects the brain to the spinal cord.
This area is extremely important because it contains the nerves that control autonomic function of the body. That is, breathing, blood circulation, digestion, waste elimination, sexual activity, immune function, and postural muscle control nerves all run through the atlas and axis. Normally, if there is dysfunction at a joint (think knee pain), the dysfunction stays in the joint, and only that area is affected. With the atlas and axis joint, if there is dysfunction, there might not be any noticeable effects at the joint, but instead the effects will occur elsewhere in the body. Dysfunction of the atlas and axis occurs when the joint gets moved out of normal alignment. This movement can represent as translation anteriorly or posteriorly (the vertebrae moving forwards or backwards on each other), as well as rotational movement (the vertebrae spinning on each other). When this happens the brain stem becomes pinched by the vertebrae, and the signals cannot be properly sent to the body. Atlas and axis dysfunction can cause body misalignment, body function issues, decreased cognitive ability, and concussion like symptoms.
Possibly the most noticeable symptom of atlas and axis dysfunction is body misalignment. This occurs because the postural control nerves are affected and cannot hold the body in balance. The muscles along the spine (the spinal erectors) are told to tighten on one side, which pulls up the hip on that side, and eventually the result is what looks like a short leg. Obviously, you are not going to walk around at an angle all day, so your body compensates by letting you fall on that leg, and then bows out in other directions to make you think you are “level” and straight. Your other leg is likely going to be affected at the ankle, knee and hip, as it must bend to shorten itself to the length of your other leg. Your spine is going to bow to the side that is not tight, because the tight side is attempting to curve it in its direction. Your shoulders will likely be uneven, with the tight side shoulder being lower due to your rounded spine. Your neck then arches away from the tight side in an attempt to bring you back to being “level,” but it won’t do this completely. Your head will have to be held at an angle to finish “leveling” you out. The result is that you will feel as though you are level, but in reality you will look like a lot like this picture.
As you can see from above, this is not a good position to be in. Just look at all of the opportunities for pain! What is even more gut-wrenching is this is not the only piece affected by atlas and axis dysfunction. What you cannot see from this picture is the dysfunction that can occur in your organs. Digestion and elimination issues present themselves as your body is not receiving proper instructions on what to do with your food consumption. Your immune system becomes suppressed, and your sexual activity is affected by the inability of your body to send proper nervous signals. Your breathing and blood circulation cannot work as efficiently as possible because they lack control from the brain. Cognitive ability of your brain also decreases as your brain spends the majority of its power searching for body balance instead of operating as it normally would. Less brain energy is available for other body processes and outside stimuli. So what looked bad to begin with, just got worse.
More explanatory visuals.
The harsh reality of all of this is that much of these symptoms are not noticeable. It’s hard to notice changes in digestion and elimination, and distinguish between a bad learning day and long-term lowered cognitive function. Much of the time, leg lengths present themselves at a 1/4″ difference, or less. Trying to “feel” a quarter of an inch difference in your legs is hard to do, and unless you have experience being “in” and “out” of alignment, chances are you will not know. Hip, shoulder, and knee pain is rarely attributed to spinal alignment because, honestly, if you didn’t know about the function of atlas and axis then it would be a ludicrous thing to think. Your spine doesn’t just spin around in circles, you know?
That’s why I’m writing this article, so that you can be aware of the effects of an upper cervical dysfunction instead of trying tactic after tactic and never decreasing your pain. As you may have guessed, being out of alignment significantly increases your chances of getting injured. For an athlete, getting injured is the last thing you want to endure, so if you have any doubts in your mind about whether you have atlas and axis dysfunction, go get checked.
What events might cause atlas and axis misalignment? Suffering a concussion, blow to the head, or otherwise traumatic injury that caused your body to move rapidly, such as whiplash, a car crash, or being on the receiving end of a hard body check or tackle means your are at an increased risk of being out of alignment. You can also lose alignment from poor posture mechanics over time. As I stated earlier, the atlas and axis joint is incredibly weak given the goods it protects. Check out this link below to get an even better idea of what misalignment of the axis and atlas might look like.
Click on the “I am a visitor” tab, then click on the buttons in the bottom right to see what a digital rendition of what a misalignment and subsequent correction looks like, and be sure to check out the different angles.
If you want more information on this topic feel free to contact me, and check out the website of the chiropractic group I personally trust with this care at http://www.johnsonspinalcare.com/.