The following article is a result of a cooperative effort among The American Chiropractor, Dr. Alan Creed and leading authorities on the techniques featured What Is a Technique? A technique is an operating system with established protocols for evaluation, treatment, and assessment of a patient's infirmities. Over the years, my approach for practicing the art, science and philosophy of chiropractic has been the creation of a "Chiropractic Bridge of Techniques, Styles and Technologies". I adjust with my hands, instruments and equipment, both manual and electric, in order to achieve mechanical advantages that comfortably correct aberrant issues, with extraordinary outcomes for the patient. Whv Does a Patient Seek Care? A person seeks care for one of two reasons: some part of their body isn't functioning at a level they perceive to be "normal"; or, for the most part, because they are in pain and discomfort. In assessing a technique, there arc three points of view to consider. 1. The doctor's viewpoint: How hard is this technique on the doctor's body, patient after patient, day after day, year after year— wrists, elbows, hands and thumbs, neck, low back, knees'? What is the comfort level as it pertains to the doctor's skills, abilities, and results within that particular modality? 2. The patient's viewpoint: What is the patient's experience of the adjustment; i.e., comments to the doctor, other patients and staff members? Are the patients able to participate with the doctor's style of treatment, and do they feel it addresses their needs? Is the patient hearing more of a philosophical viewpoint as to their potential progress versus experiencing their progress? Do the patients comply with the treatment program and stay in care? 3. Technical viewpoint: Is the technique relevant to the patient's condition? Are pain and function addressed at the same time? What are the short-term needs and outcomes? What are the long-term effects and benefits for the patient? These questions should be paramount in the doctor's mind always. By utilizing a multi-technique approach with patients, it is possible to provide the patient with rapid relief from pain and improved function. Once an adjustment is performed, changes occur. Therefore, when applying the forces that make the changes, posture, range of motion, proprioception, balancing hemispheres, cerebellum communication, and functional activity need to be taken into consideration. By employing a global assessment of a patient, the doctor has a greater opportunity to address the spinal biomechanics, neurophysiology and organ system relationships. The application of combining techniques in the treatment protocol may be performed in an expedient fashion, from 1-10 minutes, depending on the doctor's style of practice. And, by judiciously combining techniques, the doctor is able to customize a treatment approach for each patient. My experience of the patient's outcome from a multi-technique approach has been their joyous appreciation for their care and a practice exclusively based on referrals and cash. I utilize a variety of the following 10 techniques in my own "multi-technique", so feel free to give me a ring at 305-365-3818, if you'd like to learn more about combining techniques. The following are (alphabetized) descriptions of several chiropractic techniques, with brief discussions of their evolution, theories, and applications. ] The Access Technique The Access Workshop promotes an "un-tcchnique" approach. The approach evolved from the observation that many existing techniques were created by practitioners who were exceptionally perceptive. Unfortunately, these individuals were not able to teach others how to perceive the same subtle information they did. As a result, technique protocols were created to indirectly get other practitioners "into the ballpark". In the past, exceptional perception skills were difficult to teach and generally required (many) years to cultivate. New findings emerging from the neurosciences have recently changed this. Some important findings include: 1. The nervous system's sensitivity extends far beyond conscious awareness. 2. The nervous system produces specific (involuntary) autonomic and central nervous system responses when it detects stimuli outside of conscious awareness. 3. If awareness of these specific responses is enhanced, an individual can learn to "sense" information that is too subtle to be perceived directly through the five senses. The Access Workshop blends cutting edge research with the use of specialized "enhancing tools" to greatly accelerate *• the development of exceptional perception skills. In most cases, participants can begin applying these skills following a single weekend of training. High level perceptual abilities enable a practitioner to significantly increase the specificity of their techniques. This, in turn, increases certainty, results and patient satisfaction. As an individual's perception/awareness increases, technique guidelines can be superceded. The practitioner can then proceed using an "un-technique" approach. l For further information about the Access Workshop, call Dr. Wiegand at 215-674-9108, or visit www.accessworkshop.com. Activator Methods Chiropractic Technique (AMCT) Activator Methods International, Ltd., has been providing patient-based care founded on the principles of clinical research for over 30 years. Activator Methods' co-founder. Dr. Arlan W. Fuhr, D.C., has over 40 years of experience in clinical research and private practice. He has received many awards, including Chiropractor of the Year for the state of Arizona (1993) and the Daniel David Palmer Scientific Award (1993). He was also a Governor's appointee to the Commission on Sports Health and Physical Fitness. Dr. Fuhr is currently a member of The International Society For The Study of the Lumbar Spine. He is the only chiropractor that does not hold dual degrees that has been accepted into this prestigious organization. Activator Methods has published clinical and scientific peer reviewed papers beyond that of most specifically-chiropractic diagnostic treatment procedures. AMCT has developed a mechanical force manually assisted adjusting instrument that is recognized and covered by Medicare. The number of licensed professionals using AMCT has grown to approximately 50,000 worldwide; making it the most widely used low force technique in the world. Due to the aging baby boomer generation, Activator Methods has positioned its chiropractic technique to aid the future demand of geriatric patients. AMCT provides gentle low force methods of chiropractic care that all chiropractic patients seek. Activator Methods has recently been involved in a large observational geriatric study in cooperation with Palmer University in Davenport, Iowa, in which over fifty AMCT instructors volunteered to collect data. Each year, AMCT offers more than thirty-six technique seminars around the world to provide instruction and certification opportunities. Doctors can achieve and maintain Basic or Advanced Proficiency Ratings and become part of the Referral Service of Proficiency Rated Doctors through these seminars. AMCT has published more than 105 abstracts and manuscripts on the Activator Technique with the support of the National Institute of Chiropractic Research. These abstracts and manuscripts have been a valuable tool in enabling the practitioner to treat problems of the spine. For more information, please visit Activator Methods' website at www, activator.com. Applied Kinesiology (AK) The origin of contemporary .Applied Kinesiology is traced to I l)M. w hen George G. Goodhcart, Jr., D.C., first observed that, in the absence of congenital or pathologic anomaly, postural distortion is often associated with muscles that fail to meet the demands of muscle tests designed to maximally isolate specific muscles. He observed that tender nodules were frequently palpable within the origin and/or insertion of the tested muscle. Digital manipulation of these areas of apparent muscle dysfunction improved both postural balance and the outcome of manual muscle tests. Goodheart and others have since observed that many conservative treatment methods improve neuromuseular function as perceived by manual muscle testing. These treatment methods have become the fundamental Applied Kinesiology approach to therapy. Included in the AK approach are specific joint manipulation or mobilization, various myofascial therapies, cranial techniques, meridian therapy, clinical nutrition, dietary management, and various reflex procedures. AK uses functional assessment measures, such as posture and gait analysis, manual muscle testing as functional neurologic evaluation, range of motion, static palpation, and motion analysis. These assessments are used in conjunction with standard methods of diagnosis, such as clinical history, physical examination findings, laboratory tests, and instrumentation, to develop a clinical impression of the unique physiologic condition of each patient, including an impression of the patient's functional physiologic status. When appropriate, this clinical impression is used as a guide to the application of conservative physiologic therapeutics. The practice of Applied Kinesiology requires that it be used in conjunction with other standard diagnostic methods by professionals trained in clinical diagnosis. As such, the use of Applied Kinesiology, or its component assessment procedures, is appropriate only to individuals licensed to perform those procedures. For more information, contact the International College of Applied Kinesiology-U.S.A. at 6405 Metccilf Ave., Suite 503, S/iawnee Mission. KS M2O2-3')2'l (<JI3) 3*4-5336. The Morter Bio Energetic Synchronization Technique (B.E.S.T.^ In 1974, Dr. M. T. Morter, Jr., began development of a new chiropractic adjustment procedure he later termed the Bio Energetic Synchronization Technique (B.E.ST.). The technique was developed when Dr. Morter found, after years of clinical practice and literary research in the field, that the traditional chiropractic method of spinal adjusting and re-positioning of vertebra to relieve nerve pressure was excellent for many standard cases of physically-induced trauma to the patient, but sometimes lacked the ability to locate or permanently correct the effects of the trauma. Nowhere had this become more evident than in Dr. Morter's own life. Following an accident, Dr. Morter was left with a severe neck injury, which was treated for years by traditional chiropractic methods. Although his condition improved, his frustration at never being able to completely heal his neck led him to investigate how to utilize his own body's life force to balance his nervous system and allow the muscles to reposition the bony structures. This "balancing" of the body through use of the body's own energy (the body's life force) led to the development of this technique and. for Dr. Morter. was the solution for which he had been searching to correct his own neck injury. The Morter B.E.S.T. Technique offers methods of searching for, identifying, and removing interferences that foster an environment in which subluxations can occur or be retained. The basic clinical procedure of the technique centers around light pressure applied by hand to strategic points on the spine, as well as other areas of the body. These points are revealed through palpation of the tender areas of the body that are indicated, by response to testing for variations in leg length and/or arm strength, to be priority centers of nerve interference. The subtle, yet precise, pressure that is applied removes blocked nerve energy, eliminates physiological interference that segments the body, paves the way for more balanced input of sensory signals to all levels of the central nervous system, and allows improvement in both vascular circulation and nerve impulse flow that mandate improved vertebral position. For more information on the B.E.S.T. Technique contact Morter Health System at 800-874-1478 or visit their website at www.morter.com. Charrette Extremity Adjusting My extremity adjusting education began with a weekend course taught by Dr. Gordon Hasick. while I was a student at Palmer College. I still use some of the procedures I learned in 1978. While attending Palmer. Dr. Monte Greenawalt's guidance and instruction greatly influenced my chiropractic career. Also. Dr. Ray Zindler. a huge chiropractic innovator with a unique technique, demonstrated the wrist-extension thrust to me. This technique, with its Russian bone-setting origins, is one of the most powerful procedures in obtaining knee stability that I have ever seen or used. The Charrette adjusting protocols were developed by combining efficiency, doctor/patient comfort, and ease of duplicating procedures. They are not technique-specific and can be used with virtually every chiropractic spinal technique. The most important thing is to follow the patterns. As long as the basic patterns are adhered to. the exact way that one adjusts is secondary. The protocols begin with adjusting the spine. After adjusting the spine (getting the legs as even as possible non-weight bearing), adjust the feet, knees, and hips. After that, adjust the wrists, elbows, and shoulders. 1 adjust from distal to proximal. This is important in the lower extremity, since it appears that some indicators in extremity joints can change when distal joints are adjusted/mobilized. These protocols are quite fast and easy to duplicate. This is one of the strong points of the protocols: Everyone can perform them easily and quickly. For more information about the Charette Adjusting Protocols, contact Dr. Mark N. Charrette at 702-254-2693 or e-mail wncik(a>Mol.coin, Diversified Technique Diversified Technique is one of the most frequently used chiropractic procedures and is taught at most of the chiropractic colleges. In fact. The National Board of Chiropractic Examiners reports that over 90% of chiropractors use diversified procedures, to some extent. However, the roots of diversified technique are hard to trace. It seems that the diversified approach to chiropractic technique began around 1927, apparently in response to the reductionistic approach of B.J. Palmer, and. truly, can be attributed to the concepts of a number of individuals who opposed B.J. Palmer's approach. In 1947, however, Joseph Janse's book. Principles anil Practice and Teclmic. was considered the first diversified text and, consequently, qualifies Janse to be recognized as the Father of Diversified Technique. In this text, he describes a wide scope of clinical chiropractic procedures, both diagnostic and therapeutic, in a generic nonproprictary manner. More recently, books by Otto Reinert (1962), States (1968) and Peterson and Bergmann (1993,2002), are also considered texts on diversified technique. Interestingly, diversified technique is not based upon any particular analytic system; rather, it can be used with any analytic system. However, reference is made to primarily static relationships between joint structures, with static palpation serving as the main evaluative tool. The influence of Gillct and Faye have moved the evaluation from a strictly static, structural model to include a more dynamic, functional model. Diversified adjustive procedures consist of high velocity, low amplitude thrusts applied specifically to a short lever, though long levers and, especially, combinations of long and short levers arc used. These techniques attempt to use the normal biomechanies of the spine and extremities in order to create motion at a vertebra or extremity joint, with the goal of restoring function and structure to the joint. Thus, its application becomes nearly universal, which may account for its widespread use within the chiropractic profession. For more information, contact Thomas F. Bergniann, D.C., F.l.C.C, Professor, Methods Department; Faculty Clinician; Northwestern Health Sciences University; 2501 West 84th Street; Bloomington. MN 55431. Phone; 952-888-4777; e-mail 2lbergni(inn(a!iiwhc'(tlth.e</ii. Gonstead Technique Thc Cionstcad Technique arose from the practice experience of Clarence S. Gonstead, D.C. (1898-1978), of Mt. Horeb. Wl. He developed a practice that, by patient referral, attracted patients from throughout the north central states. This resulted in other chiropractors" seeking out his system of care. These inquires led to the development of his seminar (1954) and a referral base that brought chiropractors and patients from around the world. In 1964, he built a large clinic in Mt. Horeb that soon developed an international reputation. The Gonstead Technique is a full spine technique. Examination of the patient includes complete patient history, static palpation, motion palpation, instrumentation of the spinal column, orthopedic and neurological testing. X-ray analysis and, if necessary, laboratory analysis. The location of sublux-ation is based on direct spinal examination. The specific Gonstead listing and adjusting system can be applied without X-rays, but is most efficaciously utilized by means of biomechanical interpretation using spinal X-rays, preferably full spine films, when indicated. The Gonstead adjustment is a very specific application of the widely validated and established high velocity, low amplitude thaist, accompanied by cavitation. There are a variety of corrections using primarily four types of adjusting apparatus: the hylo table, pelvic table, knee chest table and cervical chair. It is a highly specific, repeatablc system approach, effective in dealing with severe cases. The technique also teaches extremity adjusting and nutrition as part of its whole health approach. Three of the staff that worked with Dr. Gonstead still practice at the Gonstead Clinic of Chiropractic in Mt. Horeb, Wl. To contact the clinic: (608) 437-5585 or P.O. Box 46. Mt. Horeb. Wl 53572. To contact the Gonstead Seminar, call 1-800-842-6852. Barrington, IL 60011 or go to www.gonsteadseminar.com. Total Body Modification Technique (TBM) TBM is an adjunct to all existing (remembered and forgotten) chiropractic philosophies used for the restoration and maintenance of the optimum health of our patients. In TBM, the doctor is able to test and correct most of the known body functions. The human body is an integrated unit, and it doesn't always fit the logic that we have been taught in school. Therefore, we have had to expand our thinking to accept the clinical responses that we achieve using TBM. We find that body functions, which we were taught were separate activities, in actuality, interact and communicate with each other in a myriad of complex pathways. Through the efforts and teachings of many of our health innovators, and through trial and error, we have been able to put together teachable, leamable and rcpcatable technical procedures to correct what we term iinhalances oj'functionalphysiology. We use a simple indicator muscle test and test points located throughout the body to determine the positive or negative function of that body. It has been taught for the last few decades that all of the body functions are controlled by the biological computer within the body. TBM has found that, by using the test points and an indicator muscle, we can test the various computer programs within the system. Then, using energetic and soft tissue corrections, we can re-align the function of specific computer programs, thereby restoring function and communication within the body. For more information about TBM, Dr. Victor Frank can he reached at HOI-571-2411. or you may e-mail healtlif&tbmseminurs.CQm or visit www.tbmseminaars.com. The Thompson Technique The Thompson Technique and the Deri Held Leg Analysis System have been around since the late 1940's. Dr. J. Clay Thompson designed and developed a drop headpiece while attending Palmer School of Chiropractic and learning how to do the Toggle Recoil on a solid headpiece on the knee chest table. He surmised that the resultant reflective force experienced by the doctor was not quite the way he imagined the adjustment should be done. After some experimentation on several side posture tables, he came up with a spring loaded drop piece that would allow for the head and neck to drop slightly transferring the force into the atlas with little reflective energy back into the doctor's arms. He based his theory on Newton's Second Principle. He took his invention before the United States Patent Office and was granted a process patent on his invention of the drop system of chiropractic adjusting. Dr. Clay then set about developing drop *■* pieces for the dorsal, lumbar and pelvic regions and, thus, began a new era in adjusting the spine in the chiropractic profession. i During this time he also was developing the Derifield-Thompson Analyses System with Dr. Romer Derifield of Detroit, Michigan, who originally came up with the Leg Length Inequality system. Over the years, the segmental drop method of adjusting has grown to become one of the top five adjusting techniques around the world. Wayne Henry Zemelka, D. C, was certified in the Thompson Technique by Dr. J. Clay Thompson, and teaches the Thompson 'Technique at seminars throughout the world. You may contact him at drwayne(3).netins.net or visit his website at http:// mvw.netins. Toggle Recoil Technique Have you questioned why you IInd virtually the same pattern of subluxations on patients, visit after visit, even though you have accepted that the body is a dynamic, self-healing and self-regulating organism? Are you creating a dependency practice, or is there a way to truly empower your patients to strive for greater and greater health and well being? These contradictions and others like them are artfully addressed by Dr. Steve Hoffman in his Mastering Chiropractic with Certainty (MC:) Seminar. Day one presents a tonal (physiology based assessment) model for upper cervical toggle recoil. MC: is an easy-to-understand and apply process, that is not dependent on X-ray, for determining atlas subluxation rotation, laterality, torque direction and the precise vector (line of drive) that the patient needs each visit. Leam where, when and when not to adjust, so that you will have true clinical certainty in your office immediately. Day two presents a simplified, full-spine prone analysis that is uniquely based on the patient's not being subluxated at C1. While all techniques are compatible with what Dr. Hoffman teaches, all other techniques leave the atlas subluxation as a variable component, whereas Dr. Hoffman eliminates it before doing any other evaluations. This approach is efficient, effective and elegant. Dr. Hoffman s approach is compatible with many other techniques, yet is non-duplicative of them. Discover why MC: has become the fastest growing technique seminar in chiropractic today. Dr. Hoffman can be reached for additional information, to register for one of his seminars or to schedule a seminar in your area, by calling 760-943-7040 or e-mail ing him at drstevehoffman(a)sbcelobal.net. \
