Expert: Dr. J. Shawn Leatherman - 11/29/2006

Question
Hello Dr.leatherman.
I am a dancer who had 4 years ago a tear in the cartilage that connects ligaments to the  cternum.I had a long treatment and it took 9 month to heel.I am a professional dancer and still dancing and my question is :
Could I have pain in cartilage at the sternum because of blocked/ very stiff back?could there be a connection for feeling that kind of pain again because a blocation in certain vertebra?
I WILL LOOK FORWARD FOR YOUR ANSWER.
Yael godoy zuckman.
(I use to take Glucozamine chondratine for long time and I believe that that is exactly what I am going to do again.)

Answer
Dear Yael,

You are correct in your assumptions.  Because of the attachments of the ribs to the sternum and the vertebra, there is a close interworking relationship of movement.  If the joint between the ribs and the vertebra is fixated or moving inappropriately, then there can be an associated dysfunction at the sternum.  Having the spine adjusted to alleviate any abnormal movement or fixation at the vertebra will reduce pressure at the sternum, but the chiropractor may need to address the rib connection at the sternum as well.

In addition, you must also appreciate that there will be scar formation at the sternum due to the previous injury.  Because of this you will always be predisposed to re-injury at the sternum or occasional flare-ups.  

Concerning the supplements you used to take:  you should probably be on the glucosamine for life, especially with your dancing (hard on the joints). Omega III fatty acid supplementation will also help to reduce inflammation in the tissues for aid in pain control....specific recommendations below.

Glucosamine/Chondroitin/MSM:  Glucosamine is thought to promote the formation and repair of cartilage.  Glucosamine hydrocloride is the form that is best absorbed by the body, but glucosamine sulfate is utilized more appropriately for repair. Chondroitin sulfate promotes water retention and elasticity in cartilage and inhibits enzymes that break down cartilage. MSM is also important in cartilaginous repair.  You need to consume a minimum of 1500 mg of Chondroitin and Glucosamine, as well as 750mg of MSM per day after injury.  A minimum dosage period would be for two months.

Omega-3 Fatty Acids:  act as anti-inflammatory agents, making them beneficial for patients with any inflammatory condition. There are three major types of omega 3 fatty acids that are ingested in foods and used by the body: alpha-linolenic acid (ALA)-18 carbons, eicosapentaenoic acid (EPA)-20 carbons, and docosahexaenoic acid (DHA)-22 carbons. Once eaten, the body converts ALA to EPA and DHA, the two types of omega-3 fatty acids more readily used by the body. Extensive research indicates that omega-3 fatty acids reduce inflammation and help prevent certain chronic diseases such as heart disease and arthritis.  Typical dosage after injury is 4000 to 6000 mg daily for 3 months.  Then reduce to a maintenance dose of 3000 to 4000 mg daily.  In addition the supplement should be molecularly distilled, pharmaceutical grade, and free of toxins.

If you have any further questions Yael, fell free to write back.  If you would like to lern more about spinal anatomy feel free to check out my website at:  www.suncoasthealthcare.net

Respectfully,
Dr. J. shawn Leatherman