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The Art of the Chiropractic Adjustment: Part V

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The Art of the Chiropractic Adjustment: Part V

The Chiro.Org Blog

SOURCE: Dynamic Chiropractic

By Richard C. Schafer, DC, FICC

You may also enjoy:

Part I and

Part II and

Part III and

Part IV and

Part VI

This series of articles has strived to define certain general principles that underlie almost all chiropractic adjustive technics. Parts I and II reviewed depth of drive, the articular snap, segmental distraction, timing the adjustment, the advantages of placing the patient’s spine in an oval posture, correct table height, and patient positioning objectives. Part III summarized the factor of time in the clinical approach and its underlying biomechanical principles of tissue viscoelasticity, fatigue, creep, and relaxation. Part IV reviewed the need to visualize the loading effects on articular cartilage, joint lubrication, action of the intra-articular synovial tabs, and the articular planes to deliver a corrective thrust most effectively. Here we shall describe the fundamental types of contact, contact points and their options, securing the contact hand and direction of drive.

Types of Contact

The type of contact used in applying a chiropractic adjustment is optional in most situations. The broadest contact that is efficient should be used, because the force will be directed through a larger surface area. For example, a force applied by a fairly open palm against the skin is perceived by the patient far differently than a force applied by a pointed finger against the skin. Thus, a palm-heel, thenar or knife-edge (medial edge of the hand) contact produces less patient discomfort than a pisiform or thumb contact. There are times, however, when a pisiform or thumb contract on a spinous process is necessary to get the job done quickly and efficiently.

Contact Points and Their Options

All contact points are optional at some time. For example, if the site of contact is to be on a thoracic transverse process, the use of a pisiform, thenar, palm-heel or thumb contact could all meet the same objective, essentially depending on doctor-patient positions, the segmental position of fixation, and degree of associated spasticity. Thus, the choice of selecting a transverse process, a spinous process or a lamina contact is a matter of clinical judgment. A mobilizing force directed against any of these structures will induce articular separation, tissue stretching, and the effected segmental motion, although one contact may be more efficient and less painful to the patient than another, depending on the situation at hand.

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About the Author:

I was introduced to Chiro.Org in early 1996, where my friend Joe Garolis helped me learn HTML, the "mark-up language" for websites. We have been fortunate that journals like JMPT have given us permission to reproduce some early important articles in Full-Text format. Maintaining the Org website has been, and remains, my favorite hobby.

One Comment

  1. DrK March 21, 2011 at 12:48 pm

    I feel the author is leaving out one of the most important parts of the chiropractic adjustment and that is getting the patient to relax. Or after apply your contact point waiting for that moment when the patient lets there guard down. I find that once I feel them letting go the adjustment seems more effective with less force needed.


    Check out Part 1.

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