The Art of The Chiropractic Adjustment: Part II
SOURCE: Dynamic Chiropractic
By Richard C. Schafer, DC, FICC
The two most important instruments for chiropractors are their hands and a well-designed adjusting table. Some graduates in recent years have not been taught the optimal applications of either. The following suggested procedures, regarding the art of articular correction, are based on established biomechanical principles. They are not new. They are the teachings of pioneer chiropractic.
Seven cardinal rules are suggested for the application of any adjustive technic. They concern:
(1) preadjustment tissue relaxation;
(2) preadjustment patient positioning;
(3) directing the impulse drive carefully in line with the facets’ plane of articulation;
(4) applying the active contact on the strongest logical point of the segment;
(5) using the mechanical advantage of leverage;
(6) applying segmental distraction before the thrust; and
(7) timing the thrust.
The well-designed adjusting tables available today contain a multitude of potential adjustments to help achieve these goals. It is unfortunate that many DCs practice for years with little knowledge of why these many position and tension variables are available or when they should be used. This column will attempt to solve this apparently widespread mystery.
The Oval Posture
Adequate adjusting tables are primarily designed to position the patient’s spine in an “oval posture” (mild flexion). This is because it is difficult to open thoracolumbar foramina and facets if the table does not have an abdominal support that can be arched. It also avoids postural compression of the discs, permits free movement at the posterior articular processes, reduces muscle tension, and enhances the corrective forces of a properly applied adjustment. Without an abdominal support that can be lowered and released of tension, it would be contraindicated to adjust a pregnant woman in the prone position. Today, a large number of other optional mechanical adjustments and automatic mobilization devices have been incorporated that enhance the application of chiropractic technics. Some distract from this goal, however, and these will be described later.