Dr. Christopher Lannon - Personalizing conservative healthcare for a better experience.
Joint Manipulation Techniques
     
      There are various types of techniques for joint manipulation.  Most doctors will manipulate any joint in the body ranging from the spine, feet, legs, hips, shoulders, arms, hands, etc.  The individual doctor's school of thought and education typically dictate the approach he/she may take.  Historically, manipulation has been what separates my profession from other forms of healthcare.  This has been changing over the years, many physical therapists are now being trained in manipulation techniques while in school.  Additionally, osteopaths are going back to their roots and implementing manipulation into their practice once again.  Furthermore,  chiropractors are trained in many additional forms of healthcare for a comprehensive approach.
    The techniques are so diversified that a patient may have two entirely different experiences if treated by different doctors for the same problem.  Each individual will respond more or less favorably to a technique based on health, age and body type.  Most doctors will become proficient in more than one form of manipulation in order to provide options to their patients, and some techniques are more hands-on than others. 
    Manipulation is easily the most controversial portion of conservative healthcare.  This is unfortunate because it is extremely safe and effective if administered properly.  There is always an inherent risk with any form of healthcare, but chiropractic manipulation is one of the safest.  Risk of bodily harm is greater from taking basic over the counter pain medication than from an adjustment.  Unfortunately for my profession, any mishap will make the news.  Manipulation can often provide that "miracle" cure for certain disorders, giving immediate relief.  I do not manipulate any joint unless I have the patient's permission.  In addition, all patient's receive a thorough examination to determine if they are a candidate.  I have never had a bad experience in my office.  Obviously millions of people have enjoyed the effects of an adjustment as chiropractors have remained busy for over 100 years treating entire families!
      The average chiropractic patient lives a healthier life!  Typically people who seek out chiropractic treatment eat better and exercise more.  Most chiropractors live the life they preach and do everything they can to keep themselves and their patients off of medicine.  I always consider medicine and surgery as a last resort.  However, I have a number of doctors I work with regularly in the area to assist me when conservative care is not enough.  Unfortunately, surgery and medicine are sometimes necessary. 
    Some technique terms you may find published are diversified, activator, graston, gonstead, AK, thompson drop, toggle, SOT, mobilization, pro-adjuster, and more.  I primarily use a diversified, mobilization or thompson drop approach.  I will occasionally use an activator tool or SOT blocks.  A brief description is given below for the techniques I practice in my office.   
 
 
 
  Diversified and mobilization are used on at least 80% of my patients that desire joint manipulation as a part of their care.

Diversified:
Possibly the most widely used technique in the chiropractic profession, diversified manipulation is a term used to describe a type of manipulation in which a small quick movement is used to restore normal movement to a restricted joint. This type of manipulation is often associated with a clicking or popping sound, as the joint quickly moves, although this sound is not required for the manipulation to be effective.


Mobilization:
    The term "mobilization", in this context, refers to a technique in which the therapist or physician gently guides the restricted joint through its normal range of motion, usually with slow, oscillatory movements. With this technique, there is usually no quick movement or "crack" required.
Less frequently used techniques in my office.
 
Thompson Drop:  The Thompson Technique utilizes a “Segmental Drop Table” to enhance the motion of the segment or area to be adjusted, most commonly the mid-back, low back and pelvic area. Leg length checks, palpation, X-rays and other appropriate tests may be used by the Thompson practitioner in determining where to adjust.
     There is usually no “popping or cracking” with a Thompson Drop Table Adjustment – unless you are hearing the “pop” or “crack” of the table!  I use this technique often for the low back, hips and pelvis.
 
 Activator: The Activator Adjusting Instrument is a tool some doctors choose to deliver a low-force chiropractic adjustment. This unique hand-held instrument has been studied extensively with results published in hundreds of peer-reviewed research papers, and was designed to give patients a specific and gentle adjustment.  I use it primarily for the very young, very old or those seeking a more gentle (but less effective in my opinion) technique.
 
SOT: Wedge shaped blocks are used to adjust the sacrum (base of the spine) where it attaches to the hip bones. This is done by placing 2 blocks in very specific locations under the low back/pelvis. The blocks act as a fulcrum which uses gravity and respiration as the force. This creates a very gentle, yet very effective adjustment.  I often will do this simultaneously while treating with another modality (ultrasound, e-stim, cold laser).