Chiropractic Philosophy The human body is endowed with certain inherent qualities that provide for the protection, maintenance, and restoration of health, of which the normal function of the nervous system is a major integrating force. It is reasoned that when normal transmission and expression of nerve energy is interfered with, particularly in the spine, pathophysiologic processes may develop.

Chiropractic is a health care discipline which emphacizes the inherent recuperative power of the body to heal itself without the use of drugs or surgery.

Chiropractic Science Chiropractic science is concerned with the relationship between structure, primarily the spine, and function, primarily the nervous system, of the body as that relationship may affect the restoration and preservation of health.

Subluxation A.C.C. (Association of Chiropractic Colleges) definition of a subluxation: A subluxation is a complex of functional and/or structural and/or pathological articular changes that compromise neural integrity and may influence organ system function and general health.

Causes of Subluxation Trauma Toxins Thoughts

Vertebral Subluxation Complex Kinesiopathophysiology Neuropathophysiology Myopathophysiology Histopathophysiology Biochemical Changes

Fixation Any physical, functional, or psychic mechanism that produces a loss of segmental mobility within its normal physiologic range of motion

Springy End Feel Joint play refers to a small amount of movement which can be produced by the doctor at the end of passive range of motion on any normal joint. It is also called “end play,” “springy end feel,” “or the “elastic barrier of resistance.” It is this joint play that we look for in our diagnostic motion palpation procedures. Lack of joint play at the end of the active range of motion indicates a fixation or hypomobility, which we may correct with a manipulation.

Picture of ROm

Active Movement Refers to movement which is patient produced.

Refers to movement which is produced by the doctor. Passive Movement.

Paraphysiological Space The part of joint motion entered into when an adjustive thrust has resulted in an articular click. This click indicates that a cavitation phenomenon has occurred. Studies have shown that the joint space is now maximally sparated until the bubble of gas is reasbsorbed within the synovial capsule. The gas content of synovium in the MCP joint was found to be 80% carbon dioxide.

Limit of Anatomical Integrity Represents the limit of joint movement allowable before injury to that joint occurs. Forcefully moving a joint beyond the limit will result in a sprain/strain injury to that joint.

Joint Play That degree of end movement or distention in a joint allowed passively that cannot be achieved through voluntary effort.

Total joint movement is the voluntary range of movement plus or minus the joint play present Voluntary action depends on normal joint play, but voluntary motion and exercise cannot produce or restore joint play. The presence or absence of joint play can only be demonstrated by an examiner, i.e. passively.

Loss of joint play produces pain on testing, i.e. whenever that direction of joint play is challenged. When restricted joint play is restored by adjustment, the related pain abates. Muscles that move a joint with joint dysfunction become hypertonic in response to the pain from irritation; therefore, the active range of motion is also restricted.

Prevention Regular motion palpation examinations to discover early aberrant motion, especially fixations, to prevent the subluxation complex from developing.

Prognosis Depends on the reversibility of the pathology, the restoration of normal function, and the ability to keep the joints free of subluxation-fixations and other causes of malfunction.

Joint play can only be restored by a mobilizing force (adjustment)delivered satisfactorily i.e. in line with the plane of articulation and against the motion resistance (fixation).

YZ Plane Sagittal Plane XY Plane Coronal Plane XZ Plane Transverse Plane

Curves of the Spine –Posterior deviations from the Y-axis Kyphosis –Anterior deviations from the Y-axis Lordosis –Lateral deviations from the Y-axis –Scoliosis

Functional Spinal Unit Two adjacent vertebrae and the ligamentous and soft tissue elements that connect them.

Translation Movement such that all particles in the body at a given time have the same direction of motion relative to a fixed point.

Rotation Movement such that all particles in the body have zero velocity relative to a fixed point. Angular displacement about some axis.

Movement about the x axis and through the sagittal plane Flexion and extension Movement about the y axis and through the transverse plane Rotation Movement about the z axis and through the coronal plane Lateral flexion Six Degrees of Freedom

Six Degrees of Freedom Flexion +  X Extension -  X Rotation +/-  Y Lateral Flexion +/-  Z

Cervical Spine Flexion 30° - 45° Extension 40° - 55° Rotation 70° - 80° Lateral Flexion 40 ° - 45°

Misalignment

Misalignment = Malposition Malposition = Fixation

Fixation = Malposition Diminished = Restricted

Fixation is where the vertebral body is stuck. Restriction is where the vertebral body cannot go.

Right rotational fixation Right rotational malposition

Left rotational restriction Right rotational malposition

Left lateral flexion fixation Right lateral flexion restriction

Left lateral flexion and right rotational fixation fixation Right lateral flexion restriction and left rotational restriction

Left lateral flexion fixation and left rotational fixation Right lateral flexion restriction and right rotational restriction

Flexion Malposition

Extension Malposition

Rotational Malposition

Lateral Flexion Malposition

Occiput Up to six letter listing separated by dashes PS/AS (+/- theta X) PS - RS/LS (+/- theta Z) PS – RS – RA/RP (+/- theta Y) PS – LS – LA/LP (+/- theta Y)

Anterior Glide

Lateral Flexion

Rotation

Atlas Up to four letter listing A S/I R/L A/P ASR ASL ASRA/ASRP ASLA/ASLP

Laterality

Rotation

Original Atlas Listings by B.J. Palmer L LA LP LS LI LAS LAI LPS LPI R RA RP RS RI RAS RAI RPS RPI A P

Listings Point of reference TVP’s: LP/RP Vertebral Body: BL/BR Spinous Process: PR/PL Orthogonal: +/-  X,Y, or Z

C2 – C7 Flexion/Extension Rotation Lateral masses 1” lateral Lateral Flexion

Rotation Head rotation in one direction causes the spinous processes to rotate towards the opposite direction down to about L2

Coupling Motion in which rotation or translation of a body about or along one axis is consistently associated with simultaneous rotation or translation about another axis.

Lateral Flexion causes the spinous processes to rotate...

From C2 to T6, the spinous processes will tend to rotate away from the direction of lateral flexion (toward the convexity) From T6 on down, the spinous processes will tend to rotate towards the direction of lateral flexion (toward the concavity)

T1-T6 Flexion/Extension Rotation T1-T4 up 1 sp out 1” T5 – T6 up 2 interspinous spaces out 1” Lateral Flexion Spinous process towards convexity

T6 – T12 Flexion/Extension Rotation T6 – T8 up 2 interspinous spaces out 1” T9 – T12 up 1 sp out 1” Lateral Flexion Spinous process towards concavity

T6 – T12 Flexion/Extension Rotation T6 – T8 up 2 interspinous spaces out 1” T9 – T12 up 1 sp out 1” Lateral Flexion Spinous process towards concavity

Modified Gillet’s Test PSIS PSIS – S2

Quick Scan Proper patient position Proper doctor position SI Sacrum Lumbar Thoracic Cervical

Ribs 1st rib Extend Laterally flex towards Rotate away Patient position Hand on shoulder Turn, tuck, flex Doctor position Arm in front 1” lateral to TVP