Thumb and Finger (T&F) Technic.
The purpose of this technic, developed by a Dr. Dillon, is to
determine the best direction of thrust to relieve perivertebral
pain and tenderness. For example, a tender site is located in
muscles lateral to the vertebral column. A vertebra is selected
in this region and pressure applied by thumb and finger on the
spinous process of this vertebra in varying directions to find a
direction in which when pressure is applied to the spinous
process relief from pain or tenderness is achieved.
Once this direction has been determined, pressure is
maintained until sufficient relaxation of the musculature
exhibits. Following the relaxation of spasticity, a leverage or
recoil adjustment is made on an optional contact point with the
direction of drive as that determined to relieve the pain and
Key Vertebra (K-V) Technic
The purpose of this technic is to relieve tender areas on the
surface of the body (contributory) that did not have a recent
history of trauma. The key vertebra was C3. Tender perispinal and
peripheral areas on the body are isolated and marked with a skin
pencil. Pressure is applied on the spinous process or lamina of
C3 in varying directions until a sensitive area marked is
Once this direction for relief is determined, C3 is manually
vibrated lightly several times for 5--15 seconds in the direction
previously determined to provide relief. These bouts of vibration
are separated by "test" pressures over a marked tender area until
tenderness has been eliminated or greatly reduced. The procedure
is repeated for remaining sites of tenderness, usually starting
with the most acute site and progressing to less sensitive sites.
The Damon and Damon Technic is a modification in which tender
sites are not marked and no test procedures are used. The lamina
of C3 is vibrated at a point 1/2 inch lateral to the spinous
process and 1/4 inch cephalad. Ten 3--5 second bouts of vibration
Focal Myospasm Technic.
The goal of this reflex is to relieve focal muscle spasms (eg,
trigger-like points) lateral to the spine before or after
articular adjustment of a medially adjacent vertebra or its
perivertebral tissues (eg, muscle fixation).
A sensitive myospasm is found, characterized as a small, firm,
deep knot of hypersensitive muscle. It may be located anywhere
from the suboccipital area to the iliac musculature. Firm
thumbtip pressure just below the patient's pain threshold is
directed medially. The knot and its hypersensitivity should be
relieved in 30--60 seconds. The contact is held for several
additional seconds to assure resolution.
Three-Phase Gluteal Technic.
This reflex consists of three successive contact phases
designed primarily for the relief of pain in acute sacroiliac and
a. With the patient prone, the doctor stands on the opposite
side of involvement facing obliquely cephalad. The thumbpad of
the doctor's lateral hand is placed against the side of the L5
spinous process opposite the side of involvement, and steady
pressure is directed laterally toward the side of involvement.
The doctor's other thumbpad (medial hand) is placed over the
sciatic notch on the side of involvement and directed
ventromedially. These firm nonpainful pressures are applied
simultaneously with both thumbs for about a minute.
b. The second phase immediately follows this 1-minute
duration. The L5 spinous process contact pressure remains the
same. The notch contact is replaced with a thumbpad contact
against the tensor fascia lata at a point midway between the
iliac crest and greater trochanter. Here, pressure is directed
medially. And again, these firm nonpainful pressures are applied
simultaneously with both thumbs for about a minute.
c. The third phase immediately follows the 1-minute duration
of the second phase. Again, the L5 spinous process contact
pressure remains the same. The fascia lata contact is replaced
with a thumbpad contact just below the midpoint of the gluteal
rim. Pressure is directed anterosuperiorly. Again, these firm
nonpainful pressures are applied simultaneously with both thumbs
for 1 minute.
The goal of this technic is to reduce regionalized
perivertebral tension and pain. With the patient supine, the
doctor (usually sitting, facing obliquely cephalad) places the
tip of his/her flexed thumb (medial hand) against the center of
the patient's perineum, the thumb is then straightened, and
moderate pressure is directed obliquely ventral and cephalad.
With the perineal pressure sustained, the doctor's free hand
(lateral), palm upward, is inserted under the patient and
palpation is made for relaxation of the predetermined
perivertebral tension and pain. Once optimal relaxation has been
achieved, the technic concludes.
This reflex technic is used primarily for the reduction of
suboccipital tension headaches. With the patient prone and the
headrest lowered, the doctor assumes an oblique cephalad sitting
position on either side of the patient's cervical spine.
A pisiform contact of the doctor's hand nearest the patient
(medial) is placed against the superior aspect of the patient's
vertebra prominens. The doctor's free hand (lateral) applies
axial tension (palm heel) on the patient's occiput, causing the
upper cervical area to flex. The doctor's thumb and forefinger
are then moved to behind the patient's mastoid processes, and
pressure against the vertebra prominens is relaxed. Contact is
held until palpable suboccipital tension is relieved.
The goal of this reflex technic is to relieve piriformis
muscle spasm. The patient is placed prone, with the abdominal and
pelvic supports moderately tented.
The doctor inserts a gloved index finger into the patient's
rectum and applies moderate pressure, just below patient's pain
threshold, on the side of involvement along the anterolateral
aspect of the sacral apex for a duration of 1--2 minutes. The
spasm should abate within this time.
This technic is often used to quiet severe muscle spasms and
visceral (autonomic) hyperactivity. The patient is placed relaxed
prone, with the pelvic support raised moderately. The anal circle
is viewed as a cross section of the body. Moderate middle finger
pressure is placed on the anal circle (site clock for contact
point) corresponding to the site of the organ being treated; eg,
heart, 1:30; liver, 9:00; spleen, 3:00; stomach, low 12:00;
rectum, 5:00; urogenital, 6:00; etc.
With this contact held, sites of perispinal tenderness or
spasm are lightly massaged with the middle finger of the free
hand. Typical session duration is about 5 minutes. Excellent
results have been achieved with migraine, hypertension, petite
mal, anxiety states, and PMS. Why? Completely beyond my
comprehension. Because the anus is so richly innervated, an
effect similar as that achieved in Logan Basic reflexes may be
evoked. A Dr. Watkns published several papers on this technic in
the JNCA (1950s).
With the eyelids closed, pressure upon the eyeballs normally
causes moderate cardiac inhibition, slowing pulse rate from 5--10
beats. In paroxysmal tachycardia and sometimes with persistent
hiccoughs, it may be possible to slow the rate by ocular pressure
or direct vagal pressure. If ocular pressure accelerates heart
rate, the reflex is said to be inverted. The cause of inversion
is unknown to the author.
Besides the above, many pioneer chiropractors utilized reflex
technics developed by osteopaths (eg, Chapman's reflexes),
naturopaths, and naprapaths. If interested, please refer to the
literature of these professions.
Recruiting the Mind/body Connection
A colleague recently asked how I recruited a patient's subconscious faculties to be in harmony with my case management plan. If we consider a patient more than flesh and bone, then it would be logical to have both psychic and physical forces working
toward the same goal. Below is my response. It is one broad
example similar to that used in pioneer chiropractic. The labels
have changed with time; the process has not.
"By the time the physician (any type) has spurred an
in-depth history, gathered facts from appropriate physical,
neuro, ortho, lab, and radiated imaging studies, he/she should
have a working logical perception of the patient's
pathophysiologic status. This is what I call my basic 'clinical
image.' As I further examine the patient (eg, palpate an acute
area), I form a mental image of what is under my fingertips; ie,
current state of fascia, muscles, tendons, ligaments, vessels,
nerves, and bone --healthy function vs dysfunctional/pathologic
"I'm thus refining my mental picture --my image. If, for example,
a patient may say, "It hurts when I turn this way but not that
way, Doc," I ask myself "Why?" The dialogue continues with many
questions, many "Whys." My image becomes clearer, more detailed.
The patient may say, "I've sprained this several times like this
before." "No you haven't," I reply. "The first time you sprained
healthy ligaments. The succeeding times you also tore poorly
nourished scar tissue." This, again, refines my image of what
actually is beneath my fingertips. I see this in my "mind's eye"
just as I would view an illustration in a book.
"The same thing occurs with my adjustments. I visualize how
things are, what I'm going to do in detail, why I am going to do
it, what the patient will likely "feel," and what my logical
incremental expectations are. I then explain this in lay terms to
the patient --actually transferring my mental image to the
patient's mind. If logical in substance and sequence to the
patient, it will be accepted. Nothing I do will be a surprise to
the patient. The doctor and patient are in harmony, en
rapport. This, in general, is how I engage the Mind/Body
"The patient has thus been exposed to multisensory communication
--my words, the tone of my voice, my emphasis, my touch, my
gestures, my sincerity, my gentle-firmness --all unpretentiously
expressing deductively from my image. If doctor-patient rapport
has been firmly established and I have the patient's optimal
attention, a mind/body template has been created --like an artist
visualizing a painting from start to finish on blank canvas
before he grasps the first brush or a sculptor envisioning a
figure within a crude block of marble before he chips away the
For further study, the reader is referred to the many hundreds
of noteworthy university studies regarding psychoneuroimmunology.
Your interest will be well rewarded.
I am neither scientist nor scholar. I am a clinician. My
priority concern has never been what other chiropractors did or
thought. I have no interest in self-serving dogmatic chiropractic
philosophy. I did not develop textbooks to benefit my colleagues.
I developed them to benefit their patients. I am and always have
been 100% patient oriented.
It is my belief that to approach chiropractic by a strict
mechanical viewpoint is to yield a cesspool of often
confusing/contradictory inhumane data. Alert health care cannot
be practiced solely from the head. Alert health care cannot be
practiced solely from the heart. Alert health care must be
practiced from both cultured places simultaneously, in harmony.
I hope these notes and recollections will benefit your
patients. If so, this, likely my last paper, has not been in
vain. So mote it be. --RCS
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