THE HEEL CONTACT
A movement for the adjustment of posterior, postero-superior, or postero-inferior subluxations in the Dorsal region (except middle four) and in the Lumbar. May also be used for postero-laterals when laterality is very slight. Given with patient in position B. Contact point, heel of hand with spinous process.
Heel Contact
By the “heel of the hand” is here meant the depression between the scaphoid and pisiform bones. This hollow forms a natural receiver for a spinous process and thus avoids lateral slipping.
The four fingers of adjusting hand are spread out and anchored upon the patient’s body. The wrist is held at a right angle to hand and the arm straightened, the elbow being outrotated until it “locks,” that is until it will move no farther. The other hand grasps the wrist of the adjusting hand.
Adjusting Hand
The rule is to use the right hand for adjusting hand if standing on patient’s right and palpating with left, or to use left hand if on left side and palpating with right. The fingers are to be directed toward the patient’s feet. Exception to this rule is made with the last two Lumbars, where it is more convenient to change hands and direct the fingers toward the head.
Fig. 23. “Heel contact.”
Movement
This is given almost entirely with adjusting arm; that is, with the arm whose hand is in contact with the vertebra. The supporting hand serves merely to guide the force to a definite point as if a straight rod were working through a fixed circlet. Indeed, the force in this movement is delivered almost straight down from the shoulder. Shoulder should be dropped well out of its socket so as to secure play for a sudden downward movement without raising the hand from its contact. If the shoulder is stiff or the head of the humerus remains in the glenoid cavity the movement cannot be properly given without raising the hand. Movement is quick, sharp, and deep, i. e., directed to the center of mass of the vertebra.
It may be directed straight toward floor to correct a posterior, inclined slightly toward the head or feet to correct approximation, or—as some aver—slightly sidewise to correct a mild degree of rotation.