In chiropractic there are no bad techniques. They are tried and proven over the years to be successful in their own right. How to employ these techniques is another matter. Over the years I have seen doctors talking to the feet, "L5 are you subluxated?"; vibrating patients' heads to "pump" up the CSF pressure; and a host of other equally absurd so-called diagnostic procedures. What is even more ridiculous is that these tests supposedly tell the doctor where the subluxation is, and how the adjustment is made based on some unpublished or secretive neurological pathway that only those of the "Inner Circle" are privy to. It is interesting to note that all the patients get the "Flying Seven" sequence of adjustments anyway, so why not just drop all the nonsense?
The point to be made is this: If you will take a little time and look at the world literature, you will find a common thread woven throughout the realm of manipulation/adjustment: that concept is motion palpation coupled-joint analysis. Let me save you some time: Illi, Gillet, Kaltenborn, Grieve, Mennel, Cyriax, Dvorak, Faye, Grice, Gittleman, Fligg, Palmer, Wyke, Korr, Sato, Carrick, Seaman, Edwards, Butler, Lantz, and of course, Gonstead. All of these authors have made significant contributions to the world literature relative to motion palpation. But even after reading their work, doctors and students still miss the obvious:
Motion palpation is not a technique!Motion palpation coupled-joint play analysis is a method of evaluating the pathokinesiological component and to some extent, the myopathological component of the subluxation complex. You might recall that the subluxation complex as it exists today includes eight component parts: kinesiopathology; neuropathology; myopathology; connective tissue pathology; vascular abnormalities; the inflammatory response; histopathology; and biochemical changes based on a time continuum.
Every technique, bar none, can use motion palpation as a sound rationale and diagnostic tool in the evaluation and determination of your treatment plan. Consider the following quote from Bruce Fligg, DC, in chapter six of Upper Cervical Syndrome:
"... the greatest advantage of motion palpation, however, lies within the specific center around the actual application of manipulation. Motion palpation procedures help us to select the specific manipulation and to identify the specific motion segments that require manipulating. They also establish the angle of thrust, the depth of thrust (amplitude), and most importantly, a tool for outcome assessment, the effectiveness of our manipulation. Ultimately, we must ensure that (1) the manipulation produced increased mobility at the motion segment specifically desired, and (2) the dysfunction motion pattern has been corrected."From this quote it should be obvious that to call motion palpation a technique is indeed an error in comprehension and compatibility of thought processes.
Motion palpation coupled-joint analysis can and will make you a "specific" diagnostician and a "specific" doctor of chiropractic capable of delivering a "specific" adjustment to a "specific" motion unit with a "specific" biomechanical goal in mind, and provide you with a feed back tool that is "specific" to the adjustive procedure of your choice.
I've mentioned the eight components of the subluxation complex. It is important for all to be aware that the Motion Palpation Institute (MPI) teaches an overview of all the component parts, and ever-changing, in-depth pathokinesiological and myopathological courses (see MPI seminars on p. 6-7). MPI continually references other courses that deal with the other six components so that the doctor and student can complete the entire subluxation complex: Dr. David Seaman (author of Chiropractic and Pain Control), and the various diplomate courses in neurology are but two examples.
Each year, usually in Hawaii, MPI hosts its annual Clinical Excellence seminar to address some of the other parts of the subluxation complex, and to introduce or update the existing rationale and concepts of the Motion Palpation Institute. The 1995 topic will be "Neurology of the Subluxation Complex" with a special focus on vertebral-basilar artery insufficiency syndromes; tests and what they mean; new tests; and, do you adjust or refer the patient out? Neurology and nutrition of the subluxation complex as it relates to your everyday practice is also included. The speakers for this program will be Henry Echiverri, MD (neurologist), and David Seaman, DC, MS, DABCN. A yet unannounced topic will also be presented and will be passed on as as soon as confirmed with MPI. Please watch Dynamic Chiropractic for this announcement.
Motion palpation has a lot to offer you, but please remember it is not a technique.
Keith Innes, DC
Scarborough, Ontario
Canada
Editor's Note: Dr. Innes will be conducting his next Extremities 2 (E2) seminar November 19-20 in Chicago, Illinois. MPI's Clinical Excellence seminar, "Neurology and the Nutrition of the Subluxation Complex" will be held March 5-11, 1995 on Oahu, Hawaii. To register, call 1-800-359-2289.
When I graduated from chiropractic college in 1981 and started practice, I heard it all, and very little was positive. “You are a quack; you do not know what a subluxation is; you couldn’t get into a real health care program, so you chose the one that is slightly above a mail-order degree; you have no proof that chiropractic works; Are you really licensed?”, and so much more.
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