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TECHNIC OF ADJUSTING
Definitions
Vertebral Adjusting is the art of correcting by hand
the malpositions of subluxated vertebrae.
A Vertebral Adjustment, strictly speaking, should mean
the complete restoration of normal relation between previously
subluxated vertebrae. As used in Chiropractic, it
means either a partial or complete restoration of such normal
relation.
Maladjustment, as used in the profession, designates any
movement of vertebrae by hand which produces or increases
subluxation.
GENERAL PRINCIPLES OF ADJUSTING
It will be well for the student to master first the general
rules and principles which govern vertebral adjustment and
then to proceed to a detailed investigation of each movement,
in turn, before practicing it. The art of adjusting
can only be acquired by practice, and a high degree of excellence
in it only by long-continued practice. However, the
rapidity with which it can be mastered depends largely upon
the formation of a clear pre-conception of the work to be
done and the manner of its doing.
As the student progresses in the art he finds himself
occasionally guilty of errors which mar, in some degree,
89
90 Technic and Practice of Chiropractic
the efficiency of his work. These may arise from unconscious
modification of the technic first learned or from
unconscious repetition of some necessary modification demanded
by a special peculiarity in one or more cases.
This section is intended to furnish the proper pre-conception
and also to serve as a monitor to adjusters who, by
reference to the precepts herein set down, may discover and
remedy their own errors. It is not intended to furnish
sufficient education to warrant practice without clinical instruction,
which is unwarrantable, but rather to accelerate
the education which practice alone can furnish.
Object of Adjustment
The vertebral subluxation being an abnormality of
relation between vertebrae, it is obvious that its correction
must be a return of normal relation. This can only be accomplished
by bringing about a change of relative position.
Movement of a section of the spine composed of several
vertebrae is not, in the true sense, an Adjustment. It is the
single vertebra which must be moved.
The movement should be one calculated to bring the
vertebra to its normal position in the most direct mminer
possible. Such a movement should be used as will reverse
the direction of the forces which subluxated the vertebra.
It should be applied to the transverse or spinous processes,
or to the lamina, as is sometimes done in the case of the
Atlas, according to the kind of subluxation. Different subluxations
require different handling. Cases vary. Select
Technic of Adjusting 91
the move best suited to the case. This can be determined
most properly by correct palpation which fixes in the mind
of the adjuster the position of every part of the vertebra,
its relation to its fellows, the points of greatest nerve impingement,
etc., all of which should suggest the best method
for correction.
The prime object of adjustment is the removal of impingement
from nerves.
Transmitted Shock vs. Thrust
The movement used in adjusting has been variously
described. Many writers and teachers have used the termi
"thrust" to describe the movement of the hands, and the
term is correctly applied to the movement used by many
Chiropractors. But a careful study of the methods of applying
force in use among the most successful adjusters,
those who have attained the greatest results with the slightest
percentage of failures and a minimum of pain to the
patient, discloses the fact that the chief element of their
adjustment is transmitted shock.
The hand is held in close contact with the vertebra to be
adjusted and the arms and shoulders describe such movements
as to deliver the required amount of force with the
slightest possible change in the position of the hands. The
vertebra bounds away from the contact hand. In the delivery
of a thrust the hand would follow the vertebra, forcing each
portion of the movement. The real effect of a thrusting
motion, since the hand cannot enter the body as a sharp
92 Technic and Practice of Chiropractic
instrument would, is that of pushing. Pushing neither
subluxates nor adjusts vertebrae so readily as does a rapidly
applied shock.
Let us illustrate with a comiiion experiment in physics.
Suspend a number of ivory balls by cords of equal length
in such a manner that each is in contact with its fellow and
all are in a straight line. When the balls are properly adjusted
a straight line should connect their centers. Hold one
end ball firmly in the hand or with an instrument which
renders it absolutely fixed. Then strike sharply with a
light hammer. The balls will all remain stationary except
the one on the opposite end which will fly off to a distance
exactly measurable according to the force of the blow.
How does this occur?
A shock is transmitted through the molecules of the ivory
until it reaches the end ball, wdiich is not held back by another.
Here the transmitted force is expended in molar
motion, the ball leaping away from its fellows as if it had
been hung alone and had been struck with the same force.
It is well known that by placing an elbow firmly against
a man's jaw and then sharply striking the closed fist with
the other hand, open, a very heavy blow can be given ; yet
the forearm, through which the shock is transmitted, does
not move.
Now ivory is very like human bone. Further, it has been
demonstrated that the law illustrated by the above experinient
is equally applicable to the movement of vertebrae.
The pushing or thrusting movement may move a specific
Technic of Adjusting 93
vertebra, but it is probable that the chief factor in so doing
is the element of transmitted shock contained in the movement
and delivered at the instant of release of the hand from
the spine at the end of the movement.
On the other hand it is obvious that a pushing or
thrusting movement may move several vertebrae in addition
to the one directly in contact with the adjusting hand, in
consequence of the way in which the spinal segments are
closely bound together. If a steady strain is used, in which
muscles and ligaments have time to act, one of three results
may occur: (a) the specific adjustment; (b) the movement
of several vertebrae at one time, which does not constitute
an adjustment; (c) the giving way of the spine at
its weakest point, which may be some distance from the
point of contact with the adjusting hand, the ligaments and
muscles having communicated and diffused the strain
throughout a large area. In the latter contingency the
result is usually a new subluxation or the increase of an
old one, instead of an adjustment.
The Rapid Movement
Thus Speed becomes an important factor in correct adjustment.
A good illustration of the value of speed may be taken
from a pile of stakes bound together by a cord. If a man
with a hammer desires to remove the center stake of the
group, and attempts to do so with a slow pushing movement,
the result is a change of position of many stakes, which
adhere to the center stake and to each other. If, on the
contrary, he strikes a sharp, quick blow with his hammer,
meeting squarely the center of balance of the one stake, it
will fly straight from its position leaving the others unmoved.
This is exactly what we desire to accomplish with an adjustment.
By the speed of the movement we expect to
move ane vertebra before adhesion or the contraction of
muscles or inelasticity of ligaments can diffuse the force. |
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发表于 2009-8-29 21:13
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