Adjustment by Hand Only

While I strongly feel that soft tissue evaluation and treatment compliments the chiropractic adjustment, I have always regarded the adjustment of the spine and pelvis the heart and soul of chiropractic. I have been to the Gonstead clinic at least 20 times and have blended motion palpation with many techniques of adjusting. I laugh when I hear that, "All Hammer does is friction massage." When I was an intern at the Lincoln Chiropractic Clinic in the late '50s, we were expected to move the bone. We had an instructor by the name of Dr. Lucas who originally learned about adjusting as an apprentice in a chiropractor's office. He enrolled at the Lincoln college and eventually taught technique. Whenever an intern could not move the bone, Dr. Lucas was called in and I remember a speedy, accurate thrust that always seemed to do the job. My early training emphasized that moving the bone got the results. After 35 years in practice, I have not changed my opinion.

As knowledge about the neurology of the articulation has progressed, it has become apparent that the chiropractic adjustment has an important reflexogenic affect on the nervous system. The adjustment acts on sensory receptors, especially the type I and type II mechanoreceptors located in the fibrous capsules of the apophyseal joints. The adjustment stimulates these receptors and relaxes tight muscles segmentally and intersegmentally locally and distally; inhibits pain signals from reaching higher brain centers, improves coordination, postural sensation and kinesthesis and inhibits preganglionic sympathetic neurons, thereby restoring normal blood flow and reducing vasoconstriction, among other things.¹ The spinal fixation creates an inactivity in the mechanoreceptors creating a diminished proprioceptive effect on the central nervous system. The adjustment revives these deactivated mechanorceptors and affects the areas mentioned above.

Barry Wyke in his classic article, "Articular Neurology and Manipulative Therapy,"² states that the stimulation of these mechanoreceptors are determined by the "amplitude and velocity of the joint movement." The so-called "painless, gentle, nonforce techniques" used by practitioners who deride the spinal adjustment can never be as effective as the chiropractic thrust. I also doubt that the use of activator instruments could stimulate the amount of mechanorectors that a good old fashioned adjustment is capable of stimulating.

The chiropractic adjustment by hand is the mainstay of our art and science. I fear that the lack of proficiency and confidence present in many chiropractors causes them to seek alternative methods of spinal care.

Do our colleges and state boards thoroughly examine the expertise of new chiropractors entering the field? From my personal experience, I have my doubts.

References

1. Seaman DR: Chiropractic and Pain Control, (2nd. ed.). Asheville, NC: Drs. System, Inc. 1993.

    

2. Wyke, BD: Articular neurology and manipulative therapy. In Aspects of Manipulative Therapy, Proceedings of Multidisciplinary International Conference on Manipulative Therapy, Melbourne, Lincoln Institute of Health Sciences, 625 Swanston Street, Carlton, Victoria, Australia, August 1979, pp 67-72.

Editor's Note:

Dr. Hammer's next Subluxation Myopatholgy (SM) seminar will be held May 21-22 in Ft. Lauderdale, Florida. You may call 1-800-359-2289 to register. Dr. Hammer's book, Functional Soft Tissue Examination and Treatment by Manual Methods: The Extremities is available on the Preferred Reading and Viewing List, pages XX, part # T-126.