Position
Patient is placed as for Dorsal and Lumbar adjustments in position B. Move is applied to rotated, postero-rotary, and antero-rotary subluxations and face turned toward side from which move is to be made. Adjuster, after palpation which discovers the vertebra to be moved and the direction of movement, stands at the head of table facing patient’s feet.
Contact
With the palms of both hands resting against the side of the neck and thumbs extended at right angles to hands, make contact with both thumbs on one vertebra as follows:
If vertebra is to be rotated toward patient’s left, place right thumb against spinous process on its left side and left thumb upon right transverse process from behind it. Press firmly with the palm and fingers of each hand against the vertebrae above, gripping around neck and base of skull so as to hold all parts together.
Movement
The move is delivered simultaneously with the two hands, forcing spinous process toward the right and transverse in an anterior direction. The head must be raised from the bench and wholly supported by the hands and the head turns with the vertebra.
Uses
A powerful comparatively easy move which has the advantage of wide applicability and of avoiding the change of posture of the patient which mars many Cervical moves.
ANCHOR MOVE No. 2
Position
Same as for No. 1.
Contact
For a left subluxation to be moved toward the right, place the left thumb upon the right side of the spinous process so that it hooks over the spinous in position to draw or pull the spinous. Place right thumb against the end of the left transverse as much on the anterior side as possible so that it may exert a prying force in a posterior direction.
Movement
Simultaneous application of force with the thumbs tends to rotate the vertebra as does No. 1, but unlike No. 1 the tendency is to bring the vertebra out in a posterior direction instead of driving it more anteriorly.
Uses
This move is applied to rotated Cervicals which are anterior, more on one side than on the other.
POSTERIOR CERVICAL MOVE
Uses
For a posterior Cervical below the Atlas. The common and careless practice of moving such a vertebra with the Rotary, or the dangerous practice of using the Recoil may be avoided by this move and much better results obtained.
Position
Patient in position C, head projecting well beyond bench so as to allow for a dropping backward of the head. Palpate as for the Rotary and hold palpating finger on tip of spinous process of posterior vertebra while contact is made.
Contact
Contact point is middle of radial surface of first phalanx of first finger and is placed against the tip of the spinous process, directly between it and the floor, as the patient lies. Hand is held rigid and edgewise, fingers together so that the contact finger is well supported.
Completing Position
Use the free hand to hold the head with the Hook Support, q. v. Turn the patient’s chin slightly away from the adjusting hand and drop the elbow of adjusting arm down until a straight line could pass through elbow, spinous process, and patient’s chin. It may be well to crouch and rest the elbow against one knee for solidity. Then allow the head to drop backward until chin is elevated and further backward flexion would strain the muscles. You are ready for the movement.
Movement
A quick throwing movement upward and inward, or toward patient’s chin. As nearly as may be the force should tend to pass along the spinous process in a direction exactly anterior to the (then) plane of the vertebra.
Note: Either hand may be used with this movement.
DOUBLE CONTACT MOVE
Uses
This is indicated for postero-rotary or postero-lateral subluxations. Its line of force is a bisector of the angle between the straight anterior and the straight lateral movement.
Fig. 18. A movement for Atlas when laterally displaced. Contact: metacarpo-phalangeal joint with end of prominent transverse.
Contact
There are two points of contact, both on the first finger, one (first secured) on the radial side of the second phalanx and the other on the radial side of the proximal phalanx. The first contact point is placed against the tip of the spinous, the other behind the transverse process.
Press slightly against the two processes with the finger so as to feel them plainly.
Completing Position
Hold the head with the Hook Support and turn the face away from the adjusting hand (right hand for a P. R., left hand for a P. L.). Drop elbow low and hold it well away from your body so that there appears an obtuse angle between wrist and forearm with the point of the angle toward you. Be careful of this point as the tendency is to make an angle with the point away from you—a weak position.
Drop head backward until firm resistance is felt.
Movement
Force is delivered in an antero-lateral direction as above described, entirely with adjusting hand.
THE “T. M.” No. 1
Uses
For subluxations listed R or L but not Posterior and upon C 6, C 7, D 1, and D 2 only. This movement applies a lateral force to the spinous process so as to correct rotation of the vertebra, but I repeat that it is inappropriate for posterior or postero-lateral subluxations.
Position
Patient lying in position B as for Dorsal adjustment. Find the subluxation by following the record and perceiving that the count assumed to be correct permits the subluxations to correspond to those recorded and that a vertebra in this region is R or L, R. A. or L. A., R. S. or L. S., R. I. or L. I. The laterality of the spinous process determines the next step.
For a right subluxation turn the face toward the left and use right hand for contact hand. For a left subluxation turn the face to the right and use left hand for contact hand.
Contact
Thumb of contact hand is placed upon and against the side of the spinous process so that it presses firmly. The thumb is extended almost at right angles to the hand which rests upon the patient’s shoulder with fingers extending, and gripping, over the clavicle. Be sure of the solidity of the position.
Next place the other hand upon the patient’s forehead and press the head backward, or toward the side of the contact hand, until the neck is well flexed and the tissues tightened between the now opposing hands.
Movement
When this tightened condition is reached a quick decisive movement of both hands in opposite directions, but chiefly of the hand applied to the head, will secure an easy movement of the vertebra.
This move is a very valuable adaptation of the old crude and other dangerous “T. M.,” of which No. 2, below, is another, more like the original move but possessing several “safety” features.
“T. M.” No. 2
Position of Patient
The patient sits erect on a flat seat with both feet resting upon the floor as during palpation.
Placing Hands
After careful palpation and selection of a vertebra to be adjusted in this way, stand directly behind the patient. If the vertebra is subluxated to the right use right hand for adjusting (or contact) hand, if to the left use left hand. Hold the hand so that the thumb is at right angles to the hand and tense and firm. Place the palmar surface of the end of the thumb against and upon the tip of the spinous process and grasp the neck firmly with the fingers, which extend over the base of the neck and toward the clavicle. The other hand is placed easily on the top of the head.
Position of Head
The completing of position after contact has been made is governed by two considerations; the need for relaxing the neck muscles and for so supporting the vertebrae above the contact that movement will take place only at the point of contact. If the neck muscles are contracted the movement is almost always defeated and should always be abandoned to avoid strain.
To secure the desired position ask the patient to relax his muscles and allow you to place his head as desired. If he seeks to place it himself the necessary muscular contraction on his part will defeat the movement. The movements of the head must be passive.
With thumb and remainder of adjusting hand properly placed, use the other hand upon the head as follows: First flex the head forward on the chest as far as possible, then rotate it slightly so that the face is turned a little toward adjusting hand. Then flex the head sidewise until a resisting pull of muscles indicates that they have been stretched taut. It is well during the third movement described to let the forearm swing down at right angles to the hand so that it presses firmly against the ends of all the Cervical transverses, distributing the force among them.
Or, after placing contact hand rest the elbow in the angle at the base of the neck and let the forearm extend upward along the side of the neck. Then flex the wrist until the hand will rest upon the patient’s head and perform the movements of the head as described above.
Movement
A quick, simultaneous movement of both hands in opposite directions, two-thirds of which is given with the hand which holds the head. The thumb in contact with the spinous process moves slightly inward toward the median line but its chief use is to hold the vertebra very firmly. To this end part of its force is directed forward against the shoulder and through the ball of the thumb.
Failure to place the head properly or in securing sufficient flexion of the neck before move is attempted are the chief causes of failure. Force must be delivered quickly and sharply and the best adjustment of this kind is usually the one in which the head and hands move through the least space.
Uses
This movement is obviously useful only for the correction of rotation, since the force is directed sidewise against the spinous process.
The “T. M.” was originally intended as a Cervical adjustment, but its greatest use is now from C 6 to D 2 inclusive. Above the sixth its use is questionable because of the possibility of moving more than one vertebra or some other than the one desired.
“THE RECOIL”
(Pisiform Contact)
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.)
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.
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.
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.
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.
PISIFORM DOUBLE TRANSVERSE No. 1
An adjustment to be used only in the Dorsals from fourth to ninth inclusive, for posterior or postero-rotary subluxations. It is probably best to use this movement only for straight posterior subluxations and to apply either the Pisiform Single Transverse or the Two Finger Double Transverse to the rotary displacements in this region.
Contact
Both pisiform bones, each upon a transverse process and both upon the same vertebra.
With patient in position B and the adjuster standing upon his left the contact should be made by the following exact method. Palpate with right hand, which comes to rest upon the spinous process of the subluxated vertebra. Note if it be P. R. or P. L., because this fact will govern the next movement. Let the first finger of palpating hand reach outward about one inch and upward to a point opposite the tip of the next superior spinous process, which point will approximate the position of the transverse. This first upon the side of the posterior transverse, which will be the right with a left subluxation or the left with a right one. Let second and third fingers, now abandoning the spinous, follow the first and rest over the assumed position of the transverse.
Now palpate with a deep, limited, massage movement until the club-shaped extremity of the transverse is felt under the middle finger. Hold this point with the middle finger, drawing away the other two, and guide the free hand to an exact contact upon the transverse. Thus if standing on the left, as predicated, the left hand will be first to make contact and with the most posterior transverse, with which most exact contact is necessary.
With pisiform placed, let the fingers extend away from your body; if on the side of the spine opposite you, let them extend downward so as to follow the curve of the rib and to be anchored upon the rib connected with the transverse of contact; if on the same side, let fingers extend downward parallel with the column.
Now—still using the original palpating hand—palpate on the other side from the first contact until the other transverse is discovered. Mark its tip with a quick, deep pressure and a sharp withdrawal of the fingers, so that a spot of anaemia appears momentarily. Carefully place the pisiform of the palpating hand in contact, guided by the anaemic spot. If this second contact is on the side on which you stand the fingers will be toward the head; if on the opposite side, they will follow the rib curve outward and downward.
Re-read the above directions carefully. It will be seen that the technic is quite free from unnecessary movements.
The two hands are now placed almost exactly at right angles to each other, arched fingers anchored to prevent slipping.
If you stand on the patient’s right the use of hands is, of course, exactly reversed, the left hand being palpating hand, and making the first contact.
Completing Position
When hands are in position and adjuster standing so as to face directly across the spine, the arms are rotated outward until the elbows “lock.” The adjuster leans over so as to have shoulders directly over the spine, draws the body back from the shoulder girdle to secure freest play in the shoulder joints, and drops head loosely between the shoulders so as to relax the trapezius and prevent any checking of the force.
Movement
Directly downward from the shoulders through straight, stiff arms. The force is delivered separately with the two arms and yet simultaneously. If the vertebra is straight posterior, equal force must be applied on the two sides; if it is posterior and slightly rotated (P. R. or P. L.), most force must be applied to the more posterior transverse.
Considerable practice and looseness of shoulder are required to use this movement properly. It is a regrettable fact that few adjusters do use it correctly, most of them giving a thrust instead of a transmitted shock.
PISIFORM DOUBLE TRANSVERSE No. 2
This modification of the pisiform double transverse move is here described because of its popularity rather than because the author wishes to recommend it. The position is the same as for No. 1, and the uses also, except that it tends to correct postero-inferior subluxations and is not at all adapted for use with superiors.
Contact
Both pisiforms below the two transverses (caudad). After palpation which discloses the posterior transverse the hands are placed as follows: Palpating hand rests always on the side of the spine next the operator; opposite hand crosses the spine. Both are slanted upward so that the fingers point toward the head with the axes of the hand slightly diverging above. The wrists are thus crossed in such a way as to force the forearms to be somewhat flexed on the arms and to slant away from the wrists at an obtuse angle. This with the contact below the transverses, renders it impossible not to force the vertebra in an upward (superior) direction when movement is given.
Movement
A comparatively slow thrusting movement, which tends to spring the spine. The merit of this method lies in its comparative painlessness. Its technic is not attractive.
TWO FINGER DOUBLE TRANSVERSE
A movement for posterior or postero-rotary displacements from fourth to ninth Dorsal inclusive. It serves the same purpose as the Pisiform Double Transverse but is less painful and often easier of delivery. The palmar surface of the fingers, with the flesh of the patient’s back, make a compound cushion which acts as a shock-absorber.
Palpation—Contact
The usual downward gliding movement of left hand if standing on right or of right hand if standing on left will serve for the discovery of the vertebra listed for adjustment. The gliding hand stops with the second finger indicating the spinous process. The first finger reaches upward and outward to the assumed location of the transverse on the side nearest the adjuster; then the second finger reaches to a similar point on the other side, both fingers pointing toward patient’s head. Now the fingers are rolled a little to make sure that they are in contact with the ends of the transverse, the palmar surface of the tip of each finger being the proper contact point. The heel of the contact hand rests near, but not on, the surface of the body over the midspinal line.
Supporting Hand
The ulnar edge of the free hand is now placed across the tips of the two contact fingers so that it rests directly above the ends of the transverses but separated from them by the finger tips. The upper arm is then straightened and the elbow outrotated until it locks firmly so that the arm makes a straight line directly above the transverses. The body is drawn away from the shoulder girdle, pulling the head of the humerus out of its socket as far as possible to allow free play, for all force is to be given by this straight arm.
Movement
If the subluxation is a straight posterior the force is driven directly downward so as to be distributed equally to the two contact points. If it be a postero-rotary, most force is directed to the more prominent (posterior) transverse. Force should be delivered quickly, keeping in mind the principle of transmitted shock.
Contrary to the general belief, as much force can be developed with this move as is needful for any ordinary adjustment. The fact that it is often recommended for use with children or with sensitive or frail patients has led to the belief that it is a relatively ineffective move, whereas its value in such cases lies only in the fact that it inflicts less pain than some others.
PISIFORM SINGLE TRANSVERSE MOVE No. 1
Like the movement just described, this adjustment may be used in the Dorsals from fourth to ninth inclusive. It should be limited to those subluxations which are rotated without being posterior. In such an instance the spinous process appears to be laterally displaced without being posterior, or may appear slightly anterior because it is describing an arc about a fixed center of rotation in the body of the vertebra. One transverse process appears anterior and the other posterior to the line of their fellows.
Palpation
Palpate as for the Recoil and use the same adjusting hand as in that movement, i. e., right hand if standing on right side and palpating with left, or left hand if standing on left and palpating with right. When the palpating fingers have discovered the subluxated spinous process, the first finger seeks a point even with the tip of the next superior spinous process and about an inch to the side on which is the posterior (prominent) transverse. The second and third fingers follow and, dipping inward with a rolling or massage motion, discover the end of the transverse.
Contact
Now the adjusting hand is placed with its pisiform resting directly upon the blunt end of the transverse. If the contact is on the same side of the spine with the adjuster the fingers of adjusting hand extend across the spine and are anchored on the other side, the hand arching sharply and fingers extending somewhat downward. If contact is on opposite side of spine the fingers follow the rib curve downward and outward and are similarly anchored. In every case the fingers should extend away from, and never toward, the adjuster’s body. To violate this rule renders one arm almost useless through its position.
At this juncture the palpating hand becomes a reinforcing hand, to grip the wrist of the other and to aid in the movement.
Movement
The force is directed in a straight anterior direction, quickly and decisively, as if a spinous process were the lever used. Remember that contact must always be made with the posterior transverse. To drive this anterior is to rotate the vertebra around its vertical axis and to bring the spinous process toward the median line, while the opposite, and more anterior, transverse becomes more posterior, as it should be.
PISIFORM SINGLE TRANSVERSE No. 2
Uses
For rotated first or second Dorsals with which, for any reason, the “T. M.” fails. This move involves a use of the head as a lever, as does the “T. M.” No. 2. Inadvisable unless the posterior transverse of the rotated vertebra can be palpated—but often used in cheerful disregard of this detail by those sublimely capable adjusters who do not need to find a vertebra before moving it.
Palpation—Contact
Palpate as for No. 1 above. Very deep palpation will be necessary because the spinous process here is nearly horizontal to the body and the transverse is very deeply placed, overlaid with heavy muscles.
When process is found place pisiform bone of free hand upon it, pressing the muscles aside as much as possible to avoid bruising and resting a considerable amount of weight upon the contact hand. Fingers of contact hand may extend across the spine or downward and parallel with the spine. Or, the hands may be changed so that the palpating hand becomes the contact hand and is placed with the fingers gripped over the base of the neck toward the clavicle.
Head Leverage
The free hand is now placed upon the forehead and the head, which faces toward the contact hand, is flexed backward until the muscles seem taut.
Movement
Is a quick, but fairly gentle, movement of both hands together, so that the head is rocked still further backward at the instant an anteriorly directed force is applied to the prominent transverse. The result is rotation of the vertebra—unless there be a loose articulation in the Cervicals which gives way under the force applied to the head.
THE EDGE CONTACT
(“Point 2 Contact”—“Knife Move.”)
Name
This movement has various names. The name “Point 2 Contact” is handed down from the days when Palmer used three contact points and three moves and designated the middle of the ulnar side of the fifth metacarpal bone as “Point 2.” The name “Edge Contact” was applied later, during the improvements in its technic when the hooking of the thumbs stiffened its efficiency and made it very valuable. It has since been rediscovered (though in constant use) and re-named “Knife Move.”
Uses
A movement which uses the spinous process as a lever and is applicable to D 2, 3, or 4, and to any Dorsal or Lumbar from D 8 down, when posterior, postero-superior, or postero-inferior. It does not correct rotation except insofar as the shape of articular processes may aid an anteriorly directed move in rotating the vertebra.
Some Chiropractors have used the Edge Contact in the Cervicals but this is always improper, as it is practically impossible in some, and difficult in all, cases to cover only one spinous process when the head is resting on its side.