554 Canine Sports Medicine and Rehabilitation
radiographic evidence for a joint to qualify as
having a subluxation (Gatterman, 2005).
Current chiropractic practitioners often use the
term subluxation for articular abnormalities
that cannot be visualized on radiographs, but
respond to appropriate adjustments. For exam-
ple, sacroiliac subluxation implies that ligamen-
tous stretching has been sufficient to permit the
ilium to slip on the sacrum. An irregular promi-
nence on one articular surface becomes wedged
upon a prominence of the other articular sur-
face, the ligaments are taut, reflex muscle spasm
is intense, and pain is severe and continuous
until a reduction is effected. The displacement
is so slight that it cannot be recognized in radio-
graphs. The pain of subluxation is often relieved
dramatically and suddenly by manipulation
(Turek, 1977).
Another definition for subluxation is, “A
motion segment in which alignment, move-
ment integrity, and/or physiologic function are
altered although contact between joint surfaces
remains intact” (World Health Organization,
2005). A motion segment is defined as “a func-
tional unit made up of two adjacent articulating
surfaces and the connecting tissues binding
them to each other” (Gatterman, 2005). The
subluxation theory continues to evolve
(Figure 22.5).
A subluxation is believed to result in
decreased joint range of motion, which results
in a vicious cycle of decreased afferent and
efferent nervous system signals, decreased joint
health, and pain. With joint immobilization,
cartilage degeneration and joint capsule con-
tracture, especially of the flexor side of the joint
capsule, occurs (Millis & Levine, 2014). The
goal of manipulative therapy or chiropractic is
to help improve the joint range of motion and
restore function.Misaligned
vertebraCompress
nerveCompress
nerveSoft tissue
dysfunction &
pain & nerve
dysfunctionInterfere
with nerve
functionInterfere
with innate
intelligenceSoft tissue
dysfunction &
pain & nerve
dysfunction18951940-601980s2000sMisaligned
vertebraMisaligned
vertebra/
joint painJoint
dysfunctionClinical
categories SymptomsSymptomsDiseaseTreatment modelAdjustmentAdjustmentManipulation
&?Manipulation
& modalities
& rehabilitation
& wellnessManipulation
& modalities
& rehabilitation
& wellnessDisease/
disorderFigure 22.5 Evolution of subluxation theory. Subluxation theory has grown and developed since the early days of
chiropractic, reflecting a more thorough understanding of complexity in both pathophysiology and treatment.
Source: Vernon (2010).