The Hinge-Joint Analogy

Your musculoskeletal system is largley comprised of bones and muscles which are connected together with ligaments and tendons. Ligaments connect bones to bones (joints), while tendons connect muscles to bone. All of these strucures combine to give your body stable form and harmonious movement when working optimally.

During normal use, ligaments gradually stretch when under tension, then return to their original length when the tension is released, similar to how a rubberband or spring works. However, when they stretch too far or stretch for too long, they cannot return to their original shape and stay stretched-out or loose. This ligament laxity causes a joint to be unstable, weak, and puts all of the structures in the joint at risk of becoming damaged. This weakened or damaged tissue causes pain.

Nearly every chronic pain condition is due to joint instability caused by ligament injuries.


The Hinge-Joint Analogy

prolotherapy hinge joint analogyThe purpose of a hinge on a cabinet door is to keep the door aligned in order to properly open and close. When one of the screws loosens, more force is placed on the remaining screws to hold the hinge onto the cabinet door (1). Eventually, the other screws loosen and the entire hinge becomes loose. This then exerts more pressure on the remaining hinges, which also eventually loosen (2). The cabinet door ultimately starts hitting the adjacent door and damage to both doors occurs.

The “treatment” to realign the door and stop ongoing damage is to tighten the loose screws with a screwdriver (3). Prolotherapy to the ligaments is akin to tightening the loose screws on the hinge. Simple as that! All of the attachments must be treated in order to stimulate them to heal (or tighten).


Why is joint stability so important?

Joint stability decreases the chances of joint degeneration and chronic pain symptoms. Ultimately, it also improves your chances to stay mobile and not become disabled due to chronic pain and osteoarthritis. Loss of mobility is no small matter—mobility and mortality are very closely linked! To be blunt, the sooner someone loses mobility, the risk of death in the near future greatly increases. But there is hope! Understanding and addressing joint instability has the potential to turn around many of these instances when mobility is lost due to joint pain!


Let’s take a closer look at the Joint-Hinge Analogy

hinge joint analogy

stable cabinet doors

loose screw no symptoms

hinge loose symptoms develop

Joint instability is a progressive disorder. If you don’t tighten a loose screw, then the next screw is going to get loose. The same applies if you have knee instability. It is going to progress and if you don’t treat the injured ligament, other ligaments in the joint can become injured.

the loose hinge

cabinet door gap normal width

adjacent hinge loosens edge wears out

Joint instability is a progressive disorder. If you don’t tighten a loose hinge, then the next hinge is going to get loose. It is very easy to fix the problem. Just get a screwdriver and tighten it. The same applies if you have knee instability. It is going to progress and if you do not tighten the ligaments and tendons, you will get hip and ankle instability on that side and eventually it will travel to the opposite knee.

wood-on-wood degeneration

Wood-on-wood degeneration in the cabinet is the same concept as bone-on-bone arthritis in the knee. With a damaged meniscus, the bones can make contact without padding and deteriorate.

Summary of the Joint-Hinge Analogy

normal-cabinet opening force hinge

degenerative door cascade


Choosing the best solution (treatment) for the cabinet

comprehensive screw tightening

door exercises

painting the door edge

oiling the hinge

Oiling the hinge, is similar to getting Synvisc shots or chicken comb shots, because both the oil and the shots do nothing to stimulate repair.

professional door holder

door replacement


Degenerative door cascade mimics the joint and spine deterioration processes

degenerative door vs joint deterioration cascade

disc deterioration process vs degenerative door cascade

The Screwdriver Works


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