OCCIPITO—ATLANTAL MOVE
To move an Atlas so disposed that its one side is posterior while the whole vertebra is laterally displaced in the same direction; to move, for instance, an Atlas R. P.
Have patient lying on back in position C with head projecting beyond bench and supported by adjuster’s knee.
Placing of Hands
Place the first three fingers of one hand under the most laterally prominent transverse so as to hold it firm, first placing the first finger carefully just behind and against the end of that transverse and then reinforcing it with the second and third fingers, slightly tensed, and resting their tips on the lamina close underneath the occipital bone.
Next place the other hand so that the thumb rests firmly upon the patient’s jaw and the first finger extends backward along the lower margin of the occipital bone.
To complete the position rotate the head gently toward the side of the laterally prominent Atlas, until it rests, face toward the side, and is supported by the three fingers of the one hand and the heel and wrist of the same hand. It will be noted that when the head is rotated the first finger of supporting hand slips to a position directly upon the tip of the transverse process and the other two take its place against the posterior aspect of the tip of the transverse. The Atlas now rests with its intertransverse line almost vertically upward from supporting fingers, which hold it against further rotation.
Movement
When the neck muscles have been thoroughly relaxed by slight and gentle movement, throw the upper elbow sharply away from your body, which has the effect of transmitting force through the thumb to the jaw and sharply rotating the head still further, loosening its articulation with the now firmly held Atlas. The condyloid joints thus loosened tend to settle into their proper relations, the weight of the head causing it to slip downward—laterally upon the Atlas.
Uses
This is really a movement of the head rather than of the Atlas and is an easy movement when practicable. It requires complete relaxation and will often fail. It is probable that many apparent Atlas subluxations are really subluxations of the head upon that bone which leave Atlas and Axis in normal relation. This move is most used to loosen the Atlas when it resists ordinary adjustments.
“THE BREAK” No. 1
(Lateral Cervical Move)
The principle involved in this and the three succeeding moves is the same. The contact is made with the end of the laterally prominent transverse process of a Cervical vertebra other than the Atlas, and the movement is directed entirely from side to side. It is to be used only for lateral and not for rotary or anterior or posterior subluxations, a point to be remembered as it is just as easy to produce as to correct subluxation with this move.
Position
Have patient lying on back in position C, with head projecting beyond bench and supported by adjuster’s knee. Following a record previously made count downward to a subluxated vertebra and palpate both transverses with the two hands at once to find if one is prominent laterally, remembering that the record indicates merely the position of the spinous process.
Having found the laterally prominent transverse, place the tip of the finger of the corresponding hand on the spinous of the subluxated vertebra; that is, if a right subluxation, use right hand and if a left, use left hand. Then draw the hand around until the middle of the proximal phalanx of the first finger rests against the end of the transverse. The tip of the finger will be freed from the spinous by this movement.
Hold the adjusting hand tense, edgewise to the neck, fingers together and pointing downward. The thumb may rest against the patient’s jaw or may be free; the essential thing is the snug contact of the first finger against the transverse.
Fig. 10. “The Break,” No. 1, from right. Contact; first phalanx with end of right transverse.
Movement
With the hand in position and the head supported by the Hook Support, bend the head laterally, keeping the face upward, until it is felt that further movement would strain the muscles.
Deliver the movement in a straight lateral direction, quickly and entirely with the contact hand.