Technic and Practice of Chiropractic

by Joy Maxwell Loban

Position of Patient

This movement is best given on bifid bench of the type commonly known to the profession. Place patient on forward section so that its rear edge rests just below the axilla; this may be ascertained by passing a hand under patient’s arm after he is in position, when the edge of the bench should be felt about an inch below the hanging arm. The thighs should rest on rear section so that the pubic symphysis is free of the bench. The semicircular pubic cut is an advantage in that it avoids injury without making necessary too great a suspension between sections.

Thus the abdomen and the lower part of the thorax are suspended between sections. Under them an abdominal support may be used but it must have the quality of elasticity in a high degree and must lie always below the plane of the other two sections or it will interfere with a perfect adjustment.

For adjustment of the last two Cervicals or any Dorsal down to the sixth, it is best to turn patient’s head toward the direction of the subluxation. This curves that section of the spine into an arc toward the convex side of which movement may be made more easily than toward the concave.

The patient’s hands may lie under the table, loosely, or may reach back and rest upon the buttocks, palm upward. Whichever position secures best relaxation is to be used in any case.

This movement may be used with the roll. (See [Fig. 30] and [p. 285].)

Fig. 21. After palpation. Finger ready to guide contact hand to a spinous process.

Position of Adjuster

Stand on either side of patient, feet apart for base and poise. The direction of the feet and position of body will vary according to the direction of the adjustment, by the following two rules:

Rule 1. For movement of a vertebra away from the side on which you stand, place your arms and hands in such a position that the pisiform bone of adjusting hand, both elbows, and both shoulder joints (shoulders being dropped loosely forward) will fall in the same plane and that the plane of direction in which the vertebra is to be moved. In other words, let the force be applied in a line straight from your body through the vertebra. Always shift your feet to a proper position from which to direct the movement.

Rule 2. To move a vertebra toward the side on which you stand, step close to patient’s body and support yourself with one knee against the adjusting table at the most convenient point. Then place arms so that contact point, elbows, shoulders, and the mid-point of the body’s base, between the feet, are all in the same plane. This insures balance during and after the movement and is the attitude from which the greatest and most carefully measured force can be delivered.

It will be seen that the desire is always to deliver all force in one plane and thus avoid conflict of forces and waste or misdirection through the predominance of one force over the other, and to use both arms with equal facility in the move. There are at least a hundred ways to hinder this movement by varying the preliminary positions. And no one can know the real efficiency of the move who has not become instinctively adept at taking position.

Use of Hands and Arms

Use of hands for palpation has been described. ([P. 46].)

The palpating hand comes to rest with the middle finger on the spinous process of the vertebra to be adjusted. The heel of the hand is raised, the first and third fingers doubled back, and the heel lowered again. Now the middle finger alone is a slender pointer guiding to the contact point.

Place pisiform bone of other hand snugly against the process to be moved. The hand should rest in a slight arch, pisiform against spinous, fingers rigid and flexed on hand, last finger firmly anchored, or pressed into the flesh, to prevent slipping. (Fig. 22 shows the position.)

The anchoring fingers must always extend away from the adjuster. To turn the fingers back across the spine, in moving a vertebra toward you, is always an error, and the price is partial loss of use of one arm.

With the adjusting hand satisfactorily placed, grasp its wrist firmly with the other hand so that the pisiform of the supporting hand rests in the hollow between the wrist and the metacarpal bone of the extended thumb. By this contact force is driven directly through the chain of bones across the wrist and to the pisiform bone without spreading. In grasping the wrist let the thumb extend around the forearm in one direction and the four fingers in the other. Beware of gripping only with thumb and first finger in which case the edge of the supporting hand will rest on the back of the contact hand and spread the delivered force too widely.

Fig. 22. “The Recoil.” Ready for the movement.

Movement

I have said, but have not sufficiently emphasized the command, that the shoulders must be dropped loosely forward. Let me add that just before the movement is given the head should be allowed to sag downward and the muscles to become relaxed. This movement given with stiff shoulders and upraised head becomes a push.

The desired movement is a throwing movement.

Force is released from both shoulders at once, concentrated at the same instant by a slight shifting forward of the elbows, and strikes the spinous process as one force, which is the resultant of the two meeting at the wrist of contact hand and being united there. The two arms use the contact hand as a passive instrument for driving the vertebra.

The objective point, the distance to which the movement is mentally thrown at the instant of delivery, should be the center of mass of the vertebra, varying according to the section of the spine.

Contact Point

The exact contact point of hand with vertebra varies. If the vertebra is to be moved toward the right the pisiform rests against (not upon) the left side of the spinous; if toward the left and inferior, against the right side and just above, in the notch between it and the next superior process. The rule is to so place hand that the spinous process is between the pisiform and the direction to which movement is given.

On the hand the contact may be said to vary, according to the direction of subluxation and position of adjuster, so as to describe a circle around the pisiform in the course of the various changes of position necessary to the use of this movement. No error could be greater than to attempt to use always the same face of the pisiform and to adapt the position of hands and arms to this end, when any face or aspect of the little bone is equally good with any other.

Which Hand Used

When standing on patient’s right use left hand for palpating hand and right hand for contact with the vertebra, using left hand again to grip and reinforce the contact hand. Exception to this is made by introducing an extra change of hands with C 6, or 7, D 1, L 4 or 5, and Sacrum. The change is necessitated by the insecurity of the usual position or the fact that it cramps the wrist of contact hand. To make the change: palpate as usual, hold subluxation with second finger of palpating hand, substitute second finger of other hand and withdraw palpating hand, which is then free to make the contact.

When standing on left side exactly reverse the use of hands. Palpate with the same hand which would be used if patient were sitting. Introduce no unnecessary move into the placing of the hands. This will be found to produce better results than any other technic for this portion of the move.

Delivery of Force

In using this movement it is perhaps best to deliver nearly equal force with both hands; certainly whatever forces are released by the arms should be simultaneous. It is possible, however, to allow one arm to preponderate in the movement without marring its efficiency, but the amateur adjuster will do well to balance his forces at first.

Speed and Concentration

Speed is a prime essential. By its employment a very ordinary amount of muscular strength can be made to accomplish a large amount of work and very difficult adjustments may be accomplished.

Concentration of mind at the instant of adjustment, so as to secure muscular control and perfect co-ordination of the two arms as well as to direct and concentrate the forces used at a given and strictly limited area, is also essential.

Uses

For ordinary adjustments of Dorsal or Lumbar subluxations, excepting the middle four Dorsals, for breaking ankyloses by repeated applications of force, and for overcoming muscular resistance in patients who are unable to relax at all, this form or style of adjusting is probably the best. It is most useful in the Dorsals. In many instances Lumbar vertebrae will move better by application of a slightly slower force, especially if a roll is used. The Recoil may be used with the roll.

While it is easily possible to move any Cervical in this way, making no change in the technic except to use the ulnar side of the fifth metacarpal bone for the contact instead of the pisiform, it is inadvisable in most cases above the sixth, and in some instances absolutely unpardonable. The shock to the nervous system and the danger of moving two or more vertebrae or of subluxating a normal one are too great. In at least one instance hemiplegia instantly followed the use of this move on the Axis, and headaches and nerve exhaustion are frequent sequelae.

For these reasons it is probably best never to use “The Recoil” above the sixth Cervical. For every form of subluxation there is an easier and safer mode of correction.

Name

This has been called “The Recoil” because of a belief that if force be applied to a vertebra in the form of a very rapidly transmitted shock the vertebra will rebound to the shock and settle in its normal position, the intelligence within the body utilizing the force thus blindly applied to bring about this result.

This belief is erroneous. First the vertebra and all surrounding tissues are misshapen to fit their abnormal position and relation and this shape gives them a tendency, if rapidly loosened, to settle into the old abnormal position. Second, there is no such conscious intelligence which has power to replace a subluxated vertebra. If this supposition were correct, then the Innate Intelligence would do well to utilize those jars and shocks which ordinarily produce subluxation to bring about normality and keep the spine perfectly aligned.

There is no such internal rebound or recoil as stated above. The chief value of the movement lies in its speed, according to principles equally applicable to other moves, and in accord with the Law of Momentum.

Sources of Information

This movement as described above contains many essential principles which follow Parker and Palmer, developers of “The Recoil,” but the technic is considerably modified to suit the author’s own views. It cannot be claimed, therefore, that this is “The Recoil” as now taught by Palmer, since the chief stress is here laid upon the movement of the vertebra in a predetermined direction and not upon the withdrawal of the hands to let “Innate” do the work. The name “Recoil” is really inappropriate for the move as described.