Wikis > Physical Therapies > Manual Therapy > Manipulation/’Adjustment’


Sudden movement or thrust of small amplitude performed at high speed
Risky if performed inappropriately
Takes time to develop proficiency.

- Do ‘joint play’ assessment first  assess the qualitative ‘feel’ of the elastic barrier at the end range of motion of the joint – move joint through a plane of movement that is not under voluntary control and compare to the contralateral side or with what could be considered ‘normal’ .

“The Subluxation”/Chiropractic Adjustment:
This concept is at core of the chiropractic profession – use of term is subject to some controversy due to its definition:
1) an incomplete dislocation (‘orthopaedic subluxation’)
2) the alteration of the normal dynamics, anatomical or physiological relationships of contiguous articular structures
3) a motion segment in which alignment, movement and integrity, and/or physiologic function are altered though contact between the joint surfaces remain intact
Core concept is that the subluxation is presumed to alter the normal neurophysiologic balance

“The Adjustment”:
• Used for ‘fixations’ – see Passive Motion Palpation in chapter x.

Activator/Impact Tool:
Applies an “impact” to bones for the adjustment

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