Download Thumb pollicus

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Thoracic adjusting procedures CHART pp: 209 –
Listing
NOTE: Table position/Patient position :
- pt in prone position, head piece level, or lower, pelvic piece level with greater trochanter, abdominal piece unlocked.
- NAH = non adjusting hand: AH = adjusting hand
Doctor position
Patient position (if different
Osseous contact
Manual contact
LOD (adjusting hand
from normal)
1) type of thrust
LOD (NAH or AH 2)
Rotatory
Malposition
Sp Recoil
90 d: on side of sp
laterality
Prone with head towards side
of sp laterality.
Sp
T1-6- inf pisiform
T7-12- sup pisiform
AM / recoil
Support adjusting hand
Thumb Move
(T1-3)
On the side of sp
rotation (45) OR at the
head of the table. (90)
*can also do on opp.
side of sp rotation.
Same: make sure shoulders
are backed away from head
piece to allow room for
adjusting hand
AH – thumb on side of
sp laterality
NAH – over ear and
lateral flex and rotate
head towards side of sp
rotation
AH – distal thumb,
with palm of hand
facing superiorly.
Dorsum of AH against
trap ms.
Medial – note keep
elbow down and
deliver /body lunge
thrust.
NAH – lat. Flex and
rotate head to same
side of sp laterality.
Superior
Transverse (T13)
Stands at head of the
table on opposite side
of sp rotation.
Same: traction head sup and
lat rotate towards high tvp
TVP
Flat thumb on high
Tvp
Anterior and slightly
inferior / body lunge
thrust with shoulder
and hold; elbows in
NAH – cup pt ear,
traction superior, and
lat. rotate head (index
on mastoid process)
Single
Transverse (T112)
45: fencer stance on
side of high tvp.
Same: turn head towards the
side of High TVp.
TVP
Pisiform on high tvp
(always use inferior
hand on side of high
tvp)
Anterior in plane of
thoracic curve /straight
arm lunge thrust, held
for 4-5 seconds
Support adjusting hand
Pisiform
Crossover (T14) + P-P, T-P
bimanual
contacts
Counter
Rotations
Doublee pollicus
Stands at head of table
facing inferior (90)
Same: but laterally flex and
traction pt head to opposite
side of high Tvp (leg piece
raised) side of sp
TVP
Pisiform on high tvp
With opposite hand
AI along plane of
thoracic kyphosis /
impulse thrust and
hold.
For stabilization only:
cup pt’s mastoid
process laterally,
flexing and tractioning
pt head to resistance.
Either side of table,
facing superior
Same:
Bilateral TVP of
motion segment
Pollicus
Inf hand: ASL in plane
of curve
Sup hand: ASL in
plane
Double Pisiform
Fencer stance on side
of high tvp of inferior
vertebrae.
Same:
Bilateral TVP of
motion segment with
inferior hand on lowest
high tvp
Pisiform
Inf hand: ASL/ lunge
and hold thrust
Sup hand: ASL (note:
place inferior hand
contact first).
Listing
Doctor position
Patient position (if different
from normal)
Osseous contact
Manual contact
LOD (adjusting hand
1) type of thrust
LOD (NAH or AH 2)
Thumb pollicus
(T1-T3)
Fencer (45) stance on
side of OW (disc
bulge)
Same: (for best results have
pt drop hands to the floor)
IVF (superior hand)
Superior hand: thumb
Inferior hand: pollicus
Superior hand – AM
(into OW) / lunge
thrust and hold.
Inf hand:
typical: AS on tvp
Atypical: MS on sp.
PollicusPisiform
(T3-T12)
Fencer stance (45) on
side of OW
Same:
IVD space (superior
hand)
Other: typical: high tvp
of sup vertebrae:
Atypical: sp
Superior
hand:modified pollicus
Inferior hand: pisiform
Same:
Same:
Pisiform/pollicus
(T3-12)
Fencer stance (45) on
side of OW
Same:
Same:
Sup hand: pisiform
Inf hand: pollicus
Same:
Same:
Thumb Pisiform
(T4-T12)
Same:
Same:
Same:
Sup hand: thumb
Inf hand: pisiform
Same:
Same:
Fencer stance (45)
facing superior on
either side!!
Same:
Bilateral spinous
laminar junction,
tractioning the skin
inferiorly
Double pollicus
Anterior through the
disc plane
Anterior through the
disc plane
Same:
Same:
Bilateral Spinallaminar junction
tractioning skin
superior.
Double pollicus
AS / lunge thrust and
hold
AS / lunge thrust and
hold
Same:
Same:
HH: spinous
DKE : spinal laminar
junctionl.
Hand heel and double
knife edge.
HH: AS
DKE: AS
Bilateral
posterior disc
Double Pollicus
Retrolishthesis/
extension
malposition
Double Pollicus
Hand
heel/double
knife edge.
Rib Moves
Single Pisiform J
move:
On side of lesion
facing superior (45)
Same:
Inferior hand: angle of
the rib (inferior traction
– J) with continued SM
to rib tubercle:
Double pollicus
Can stand on either
Same:
AH: Angle of rib
(better for lower side of the table.
NAH: sp of same level
thoracics- T1012 w/o ribs.
On spinous recoil stand on side of spinous laterality.
On single Transvers stand on side or high Tvp.
Counter rotation: double pisiform: side of high TVP of inferior vertebrae.
Pisiform
Inferior traction of soft
tissue, to medial with J
motion, continue supmed to rib tubercle:
LOD = AS towards rib
head
Sup hand: supports
wrist of adjusting
hand.
Pollicus on rib,
modified pollicus
supporting sp of same
rib.
AH – AS
NAH for blocking
contact only, no
thrust!!
NOTE:
-
typically (towards) I am an ASs! LOD – AM into open wedge, and Anterior, superior on high TVP.
Atypically (away) I am a MeSs! LOD – AM into open wedge, and Medial superior on sp.
o Use Thumb, pollicus, Pollicus- pisiform, pisiform- pollicus, or thumb, pisiform. (or pisiform traction for T1-T3).
Cervical Adjusting Procedures (C3-C7) pp-230 - 241
Include:
-
-
-
-
Luscha trauma: a derangement of the encapsulating tissues of the luschka joint, usually on one side, causing a separation
of the articular surfaces. Superior vertebrae is tilted toward the opposite side, = sectional towering above. NOTE: thrust
and hold & instruct pt to relax and drop his head into the contact hand.
Capsular Trauma: derangement of the encapsulating tissues of the apophyseal joint, separates the articular surfaces. Body
of superior vertebrae rotates toward that side, while the sp process rotates toward the opposite side. Purpose of adjustment,
is to restore the zygapophyseal joint surfaced, when separated, to a closed and normal position. (rotary break)
Direct foraminal compression: (RETRO): extensive deragnemetn of the apophyseal capsules bilaterally, posterior
inferior movement of the superior vertebrae, causing foraminal compression. (bimanual, and thumb index (lift)) NOTE: use
cervical pillow to restore neck hyperlorodsis. No more than 15 minutes at a time.
All except retro, can be done in prone, supine and seated positions
Prone adjustments: head piece level or slightly down to pt comfort, abdominal piece unlocked, and foot piece raised. (note:
for direct formainal compression head piece is up for bilateral thrust).
Listing
Doctor position
Patient position (if
different from normal)
Osseous contact
Manual contact
LOD (adjusting hand
1) type of thrust
LOD (NAH or AH 2)
Opposite side of
subluxation, at 90 d
Seated straight up
AH: Lateral aspect of
neck (luska jt)
NAH: mastoid process
AH: Chiropractic index
finger
NAH: hand heel
Medial (towards doc)
Short pull thrust from
the shoulder and hold
Superior traction,
lateral bending of pt
neck.
Prone
Either side: but best
on side of sub. At 45.
or head of table(C6-7)
Prone: sup traction and
laterally flex head with
NAH.
AH: lateral aspect of
neck
NAH: opp side head
AH: Lateral index w
superior hand
NAH: Cup ear.
Medial (across spine
and hold) (* forearm
parallel to floor
Laterall flex, sup
traction head w/o
counterforce of AH.
Supine
At head of table,
toward inferior on
side of subluxation
Supine: abd piece
locked, foot piece down,
head piece raised
AH: Lateral side of cer
vical spine
NAH: occiput
AH: Lateral index at level
of subluxation
NAH: hand-heel
Medial (parallel to
floor) at pt of max
tissue resistance
Cup ear, laterally flex
towards side of sub.
Don’t lift head!
Opp side of
subluxation, at 45 d
Seated:
AH: Open facet
capsule, trction lat
medial NAH: occiput
AH: Chiropractic index
(middle finger)
NAH: hand heel occipt:
AH- anterior/inferior
through disc plane
(pull thrust)
Superior and slightly
posterior traction of
head to side of sub.
Either side, best on
side of sub at 45 d. Or
at head of table,C5-C7
Prone:
Open facet capsule
AH:Flat thumb, or lateral
index
NAH: thenar contact on
opp mastoid, cup ear
AH: anteroinferior line
through disc plane,
and hold
- Impulse thrust
NAH: apply
superiolateral traction,
avoid excess
rotation/extension
Supine (Less
specific than prone
Head of table, toward
inferior on side of
open facet capsule
Supine
AH: Open facet capsule
NAH: occiput
AH: lateral index
NAH: hand heel on occip.
- lifting
anteriorinferior
through disc plane and
hold.
NAH slight extension
and rotation, away
from open facet capsul
Bimanual recoil
(prone)
Facing superior on
Either side, below
level of subl with
shoulders squared to
pt at 45 d.
Same:
Prone: head piece
slightly elevated .
laminae and articular
processes on each side,
tissue slack inf sup
Lateral index of each
hand
AH: anteriosuperior,
Recoil (come off
contact immediately
Same; will extend head
when adjust
Bilateral open facet
capsules, cradle sp,
NAH: forehead
(tissue slack – I  sup
AH: Thumb-Index
NAH: palm of hand
AH: anterior, slightly
superior.
AH2: same:
NOTE: apply bilateral
thumb pressure after in
LOD to assist in tissue
accommodation.
NAH: exerts (extends
neck) counterforce to
hold head stationary.
Luscka Trauma
Seated
Capsular,Trauma
Seated
Prone
Thumb Index
adjustment