What is an adjustment?

Chiropractors are unique among health professionals and physicians in extensively studying, addressing and identifying the relationship between improper spinal joint function and mechanics, and improper nerve function as it affects the various body systems. We have named this complex the subluxation.

We are also unique as a profession in providing a direct, effective, natural and non-invasive treatment by hand, the adjustment.  An adjustment can be applied in many different methods. Physician experience and physical ability, the condition treated, and patient attributes such as size, bone density, presence of complicating factors, pain tolerance, patient preference and ability to relax all dictate what technique can be safely utilized.

Before performing any patient treatment your average Chiropractor has spent hundreds of hours with hands on supervised practice in specialized educational institutions and clinics. Some further expand their education and expertise through post-graduate course study.

Chiropractic is safe and effective. Professionals that need to have and can choose amongst the best health care possible use chiropractic. Many professional sports teams have chiropractors on staff because it has profound effects in improving function and health.

The most commonly applied adjustment is the Diversified Technique:
      • The problematic joint is located (part of exam process).
      • Differentiation is made between too much or not enough movement.          
        (Too much movement addressed differently).
      • The direction of restriction is determined.
      • The part of the body is positioned safely within anatomical limits(picture below).
      • A hand contact is made over the problem joint.
      • Skin slack is gently accounted for by gentle skin traction.
      • Further gentle movement towards restriction is made until ligament and              other soft tissue tension is reached (This also determines tolerance to              procedure before it commences).
      • A quick, controlled, shallow thrust (less than half an inch) is made in the
        direction of restriction.
      • Most of the time a cracking sound can be heard (gas release from joint
        similar to popping a cap of a bottle of juice ).
      • It is common to feel relaxation, or warmth or tingly at the area of correction.
      • The technique can be modified without cracking when not appropriate for         condition or not tolerated / preferred by the patient.

Diversified Manipulation of the Neck

Top Image:

You can turn your neck this much.

Bottom Image:
Adjustment position involves much less rotation / movement.
Adjustment is made within
half an inch
of movement.

Sometimes patients new to Chiropractic worry about neck manipulation. They assume a much more dramatic procedure than is actually implemented. The images to the left clarify that misconception.

A thorough examination is always performed to rule out complicating factors.

Joints are always positioned well-within safe anatomical ranges minimizing risk of complications.

In our office treatment always starts gentle and only what can be comfortably tolerated. We progress treatment as your body adapts to the corrections.

Sometimes patient preference or complications make it necessary to use even gentler techniques. The following is a brief explanation of several other techniques available:

Cox Technique / Flexion Distraction
scroll over image to see
flexion- distraction
Flexion Distraction is a gentle and safe way to treat the lumbar spine. It utilizes a table with a moveable mid section.

Great for safely reducing pressure on nerves from disc herniations, bone spurs or stenosis.
Sacral Occipital Technique with Blocks
Before: Rotation of the pelvis
creates shorter leg.
SOT block treatment
for the pelvis.
(patient face down)

SOT_blocksAfter: Leg lengths equal.

Sacro-Occipital Technique is a system based on the connection of the head base or Occiput, and the tail bone Sacrum through the spinal cord sheath.

It uses gentle pressure and positional techniques that treat muscle imbalance and faulty reflex patterns.

A common tool are 2 wedges or blocks used under the pelvis. They let gravity to level out imbalances.

Cranio-Sacral therapy is a related technique that uses gentle pressures to mobilize the cranial bones.

It can be very effective for headaches, dizziness, and sinus problems.

The Activator is a hand held tool with a soft tip. The physician can pin-point the contact, and easily adjust the direction of correction or the force generated.

A trigger activates a spring-loaded device which clicks (sounds like a stapler).

It relies on speed and specificity as opposed to force and joint movement to correct reflexes in the nervous system.

Thompson Drop Technique
PatientTreatedWithThompsonDropscroll over image to see
drop activated
The "drop" is a spring-loaded section that changes height about an inch. The body segment is positioned over the raised section. The doctor directs the correction by hand position and arm angle. A shallow thrust is aimed towards the floor.

The controlled thrust "drops" the raised section. The adjustable tension of the spring precisely controls the force at a minimum.
Webster Technique
Webster Technique: This technique is a particular method of Chiropractic analysis and treatment that may be applied to anyone with sacral / pelvic joint dysfunction. The goal is to improve neural and mechanical function of the pelvis. Dr. Webster during his clinical experience developed the technique due to the observation / association between difficult birth or poor baby presentaion and improper pelvic mechanics. During the development and the subsequent practice of the technique there has been a very high observed rate of breach presentaion babies turning or towards optimal presentation. You may read more here:
Impulse Instrument Adjusting
Impulse Instrument Adjusting: This technique in an improvement of existing spring loaded low force devices ( the activator device that sounds like a stapler). The concept is similar in providing a very localized and controled / adjustable force to the spinal joints faster than they can tighten up or guard. The very fast muscle and ligament stretch resets the spinal reflex. The result is a reflex muscle relaxation of the small muscles that normally guard or spasm and restrict motion.

The improvement over the older technology is that the new electrically powered device is able to deliver a rapid-fire series of impulses (sounds like a woodpecker) in a specific frequency that has been shown to decrease tissue stiffness. The device is more effective and more efficient to administer.

You may read more here:

Personal Care Chiropractic & Massage, P.C.
© copyright Nicholas Stamoulos, D.C. 2008. All rights reserved.
104 Massachusetts Avenue
Arlington, MA 02474
781 641 4482 fax 781 641 4483