Download File - Logan Class of December 2011

Tri 5 Upper Cervical Review v.1.0
Fall 2004
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DISCLAIMER: These moves are taken out of “Spinal Biomechanics and Specific Adjusting” by Otto Reinert. Please be
advised that if you have not purchased this book yet, you are not allowed to view this summary. This summary is to put
everything together on one easy-to-read file – not to knock off the book or to avoid sales. By viewing this file, you agree that
you have already purchased this book. Furthermore, all of the contents listed below are either exact or paraphrased directly
from said text. I take no responsibility to incorrect information due to any error. Simply reading this material will not
establish technique. For that, you will need practice that you get from class under direction of your instructor.
OCCIPUT / ATLAS ADJUSTMENTS
Posterior Atlas
Name
Adjusting Hand
Non-adjusting Hand
Patient Position
Doctor Position
Procedure
Thrust / LOD
Other
Name
Adjusting Hand
Non-adjusting Hand
Patient Position
Doctor Position
Procedure
Thrust / LOD
Other
Name
Adjusting Hand
Non-adjusting Hand
Patient Position
Doctor Position
Procedure
Thrust / LOD
Upper Cervicals
Page 1 of 6
Posterior Atlas: Prone *
Lateral index contact of superior hand to the TP of posterior atlas.
Flat thumb of inferior hand on the occiput on the opposite side of the subluxation with fingers directed
superiorly
Prone
Standing on side opposite of atlas posteriority
Patient is prone and doctor standing on side opposite posterior atlas. Place adjusting hand. Place nonadjusting hand. Flex head laterally toward side of atlas contact, rotating it slightly in the opposite direction.
Gradually increase pressure of the contact against the atlas toward the anterior while exerting counterforce
against the occiput. Apply thrust
Quick impulse thrust; anteriorly and slightly superior.
Face piece is level, abdominal piece is locked, foot place elevated. This move can be performed with doctor
on either side by reversing the manual contacts.
Posterior Atlas: Supine *
Contact the TP of the atlas on the same side of subluxation with the lateral index taking tissue slack
inferiorly from the occiput to the posterior TP of the atlas.
Lateral index contact on the occiput (slide up on the SCM)
Supine with head piece elevated.
Stand at the head of the table facing inferior.
Patient is supine and doctor is standing at the head of the table. Turn head to side opposite subluxation and
apply your non-adjusting hand. Turn patient’s head so that the subluxation is now up and apply the
adjusting hand. Laterally flex the head toward the side of subluxation while rotating it to the opposite side.
Apply pressure to the contact against the atlas, toward the anterior while exerting counterforce against the
occiput. At the point of maximum tissue resistance, deliver your thrust.
Quick impulse thrust; anteriorly and slightly superior. Hold. Thrust is similar to turning a door knob.
Posterior Atlas: Seated *
Hand nearest the anterior of the patient; reach around to the opposite side, using chiropractic index finger to
contact on the posterior aspects of the atlas transverse process to take tissue slack from inferior to the atlas
transverse process.
Hand-heel contact on the mastoid process with fingers directed superiorly, cupping the patient’s ear.
Seated
Stand facing the patient at 45° on opposite side of atlas laterality/posteriority.
Patient is seated and doctor at 45° on side opposite of atlas posteriority. Take adjusting hand and reach
around to the opposite side using chiropractic index finger to contact the atlas TP. Take tissue slack from
inferior. Place non-adjusting hand-heel contact on mastoid process directing fingers superiorly making sure
to cup ear. Drop head to adjusting hand by laterally flexing head. Apply increasing pressure to the atlas to
pull it toward the anterior while resisting rotation with supporting hand. Quick impulse thrust with anterior
and slightly superior LOD and hold.
Quick impulse thrust; anterior and slightly superior. Hold.
Dr. Wittmer
5/12/2017
Tri 5 Diversified IV
Rob-Rice.com
Other
Anterior Atlas
Name
Adjusting Hand
Non-adjusting Hand
Patient Position
Doctor Position
Procedure
Thrust / LOD
Other
Posterior Occiput
Name
Adjusting Hand
Non-adjusting Hand
Patient Position
Doctor Position
Procedure
Thrust / LOD
Other
Name
Adjusting Hand
Non-adjusting Hand
Patient Position
Doctor Position
Procedure
Thrust / LOD
Other
Anterior Occiput
Name
Adjusting Hand
Non-adjusting Hand
Patient Position
Doctor Position
Procedure
Thrust / LOD
Other
Name
Upper Cervicals
Page 2 of 6
Stand on side opposite of subluxation. All other seated atlas moves require the doc to stand on same side.
Anterior Atlas: Supine *
Lateral index contact on TP side of anteriority
Lateral index contact on the occiput opposite anteriority
Supine
Head of the table, facing the inferior on the side of anteriority.
Place patient supine and stand at head of table; stand toward side of anteriority. Apply non-adjusting hand
then apply adjusting hand. The head can be rotated with the anterior TP up or down. Thrust
The direction of the line of correction is posterior with the adjusting hand, stabilizing the occiput with the
non-adjusting hand. Quick thrust and hold.
Doctor’s preference on whether the head is rotated with anterior TP up or down. LOD and thrust will be the
same in relation to the subluxation.
Posterior Occiput: Supine *
Hand-heel contact to the zygomatic arch with the fingers anterior.
Contact side opposite of posteriority with index and chiropractic index fingers by tractioning superiorly
along the SCM to the mastoid process.
Supine. HP slightly elevated. AP locked. FP lowered.
Head of table facing inferiorly.
Set up patient and doctor position. Apply the non-adjusting contact then rotate patient’s head. Apply
adjusting contact. Turn your body slightly to face into the direction of the thrust, forearm depicting the line
of correction toward the anterior. Exert a slight traction with both hand contacts, avoiding undue rotation of
the lower neck. Thrust after maximum tissue resistance has been obtained
Quick impulse thrust with the adjusting hand in the anterior line of correction and hold.
Posterior Occiput: Seated *
Reach around the front of the patient and place a lateral index contact on the posterior occiput.
Hand-heel contact on the mastoid process, cupping the patient’s ear and directing the fingers to the superior.
Seated
Stand on the side opposite of posteriority, facing the patient at 45°.
Set up doctor and patient position. Apply the non-adjusting hand then reach around with the adjusting hand
and contact the posterior occiput. Apply slight medial pressure with both hands while tractioning
superiorly. Rotate the head slightly toward you to the point of maximum tissue resistance. Apply thrust
Quick pull thrust from the shoulder in an inferior line of correction and hold
Anterior Occiput: Prone *
Cup patient’s chin and place the forearm across the occiput.
Hand-heel contact on the patient’s trapezius on the side of anteriority to hold shoulder stationary.
Prone. HP level or lowered. AP locked. FP raised.
Head of the table, facing inferiorly.
Set up doctor and patient position. Turn patient’s head so that the anterior occiput is up. Apply nonadjusting hand. Apply adjusting hand. Apply posterior traction to the occiput while applying counterforce
to the trapezius. Thrust at maximum tissue resistance
Quick pull thrust with adjusting hand in a posterior line of drive and hold
Mind the patient’s chin to assure you are not applying pressure.
Anterior Occiput: Seated *
Dr. Wittmer
5/12/2017
Tri 5 Diversified IV
Rob-Rice.com
Adjusting Hand
Non-adjusting Hand
Patient Position
Doctor Position
Procedure
Thrust / LOD
Other
Inferior Occiput
Name
Adjusting Hand
Non-adjusting Hand
Patient Position
Doctor Position
Procedure
Thrust / LOD
Other
Name
Adjusting Hand
Non-adjusting Hand
Patient Position
Doctor Position
Procedure
Thrust / LOD
Other
Name
Adjusting Hand
Non-adjusting Hand
Patient Position
Doctor Position
Procedure
Thrust / LOD
Other
Pollicis contact behind the patient’s ear above the mastoid process on the side of anteriority.
Reach around the front of the patient and place a lateral index contact on the occiput
Seated
Facing the patient at a 45° angle, straddling the patient's leg on the side of subluxation.
Set up doctor and patient position. Apply the non-adjusting hand and laterally flex head away from the side
of anteriority and rest it in the non-adjusting hand. Apply the adjusting contact. Apply a gentle pressure in
a medial superior direction until maximum tissue resistance is met. Deliver your thrust
Short impulse thrust with the adjusting hand in a posterior line of correction and hold
(According to Wittmer, do not straddle. Clarify this with your instructor)
Inferior Occiput: Prone *
Cup the patient’s chin and place the forearm across the occiput.
Hand-heel contact on the patient’s trapezius on the side of inferiority to hold shoulder stationary.
Prone. HP level or lowered. AP locked. FP raised.
At the head of the table facing toward the inferior.
Set up doctor and patient. Rotate the patient's head so that the inferior occiput is up. Set up non-adjusting
hand. Set up adjusting hand and apply superior traction to the occiput while you apply counterforce to the
trapezius. Thrust
Quick pull thrust superiorly with adjusting hand and hold
Make sure you don’t apply force to the chin. Ouch
Inferior Occiput: Supine *
On the side of inferior occiput, use the index and chiropractic index fingers of the adjusting hand to traction
along the SCM in a superior direction and contact the mastoid process. Apply superior traction.
Hand-heel contact on the zygomatic arch with the fingers directed inferiorly. Apply inferior traction.
Supine. HP slightly elevated, AP locked; FP down
Head of the table facing toward the inferior.
Set up doctor and patient. Set up the adjusting hand then rotate the head so that the inferior occiput is
down. Set up the non-adjusting hand. Apply the appropriate tractions. Deliver your thrust
Quick pull thrust in a superior line of direction and hold.
Note that the subluxation is down.
Inferior Occiput: Seated *
Hand-heel or pisiform contact on the mastoid process with the fingers directed superiorly.
Reach around the front of the patient and place an index or chiropractic index contact on the occiput
opposite the side of subluxation.
Seated
Stand on side of the inferior occiput, facing the patient at 90°
Establish doctor and patient position. Apply your non-adjusting contact. Laterally flex the head and rest it
into the non-adjusting hand. Apply your adjusting contact. Apply medial pressure and superior traction
bilaterally until max tissue resistance is reached. Thrust
Quick impulse thrust and hold.
Ensure you are standing at 90°
ATLAS/AXIS ADJUSTMENTS
I’m taking a break. I’ll have the rest of these this weekend  Good times.
Counter Rotation – Hold C1 / Adjust C2
Name
Counter Rotation – Hold C1 / Adjust C2: Prone *
Adjusting Hand
Non-adjusting Hand
Patient Position
Upper Cervicals
Page 3 of 6
Dr. Wittmer
5/12/2017
Tri 5 Diversified IV
Rob-Rice.com
Doctor Position
Procedure
Thrust / LOD
Other
Name
Adjusting Hand
Non-adjusting Hand
Patient Position
Doctor Position
Procedure
Thrust / LOD
Other
Counter Rotation – Hold C1 / Adjust C2: Supine *
Count Rotation – Hold C1 / Adjust C2: Prone
Name
Counter Rotation – Hold C2 / Adjust C1: Prone *
Adjusting Hand
Non-adjusting Hand
Patient Position
Doctor Position
Procedure
Thrust / LOD
Other
Name
Adjusting Hand
Non-adjusting Hand
Patient Position
Doctor Position
Procedure
Thrust / LOD
Other
Counter Rotation – Hold C2 / Adjust C1: Supine *
Counter Rotation – Hold Occiput / Adjust C1 or C2
Name
Counter Rotation – Hold Occiput / Adjust C1: Prone *
Adjusting Hand
Non-adjusting Hand
Patient Position
Doctor Position
Procedure
Thrust / LOD
Other
Name
Adjusting Hand
Non-adjusting Hand
Patient Position
Doctor Position
Upper Cervicals
Page 4 of 6
Counter Rotation – Hold Occiput / Adjust C1 or C2: Seated *
Dr. Wittmer
5/12/2017
Tri 5 Diversified IV
Rob-Rice.com
Procedure
Thrust / LOD
Other
OCCIPUT / AXIS ADJUSTMENTS
C2 Rotation – Hold Occiput / Adjust C2
Name
C2 Rotation – Hold Occiput / Adjust C2: Prone *
Adjusting Hand
Non-adjusting Hand
Patient Position
Doctor Position
Procedure
Thrust / LOD
Other
Name
Adjusting Hand
Non-adjusting Hand
Patient Position
Doctor Position
Procedure
Thrust / LOD
Other
C2 Rotation – Hold Occiput / Adjust C2: Supine *
Name
Adjusting Hand
Non-adjusting Hand
Patient Position
Doctor Position
Procedure
Thrust / LOD
Other
C2 Rotation – Hold Occiput / Adjust C2: Seated *
Upper Cervicals
Page 5 of 6
Dr. Wittmer
5/12/2017
Tri 5 Diversified IV
Rob-Rice.com
Drawing by Rob Rice
If I have missed something or if I am incorrect in any way, please alert [email protected].
Work Cited / References:
* The information used to compile this insert came from the following text:
“Spinal Biomechanics and Specific Adjusting”; by Otto Reinert, D.C., F.I.C.C. revised and edited by
Drs. Alden, Barrale, Filson, and Gatto.
Upper Cervicals
Page 6 of 6
Dr. Wittmer
5/12/2017
Tri 5 Diversified IV
Rob-Rice.com