IS DROP TABLE ADJUSTING MORE EFFECTIVE THAN MANUAL ADJUSTING?
In last month’s blog, we gave a detailed overview of what chiropractic is and discussed the benefits to overall health. At one point, we mentioned that there are over 200 different chiropractic techniques in the profession. Most chiropractors will utilize 1 to 5 different techniques in practice. It would be difficult to learn and master 200 different techniques because first, it would take an entire lifetime and second, utilizing too many techniques could conflict with patient care and treatment may be prolonged.
Most new patients that walk into our doors are used to manual spinal manipulation. In this month’s blog, we will introduce the primary technique we utilize in our office and compare our technique versus manual adjusting.
The Build Up
Before we dive into our chiropractic technique, we must first start with the building steps that created it. The technique we utilize is a combination of three different chiropractic techniques that are taught at different chiropractic institutions worldwide.
Toggle Recoil
Toggle recoil, also known as the Hole-In-One (HIO) technique, was developed by BJ Palmer, the son of DD Palmer, the founder of chiropractic. Toggle was designed to be an upper cervical technique that involves a quick thrust using a specialized hand movement. A special table and a specific series of x-rays are used to determine accuracy and efficiency in patient care.
Logan Basic
Logan Basic was developed by Hugh Logan, DC in the mid-1920s. The technique uses light, sustained force applied against a specific contact point on the sacrum at the base of the spine. This method uses the muscular structure that surrounds the sacrum as a lever system for balancing the complete structure of the spine. Chiropractors that utilize Logan Basic as their primary technique use posture analysis and sometimes x-rays as their diagnostic tools.
Thompson Drop Table
The Thompson Drop Table technique was introduced by Clay Thompson, DC in the 1950s. Do you ever notice that when you’re lying on a chiropractic table that every chiropractor checks your feet? You can thank Dr. Thompson as one of the contributors. It is called a leg length analysis, and it is used to determine an imbalance to the pelvis.
The scientific principle behind the Thompson Drop Table technique is that the table segments give way to gravity, which helps assist the adjustment and requires less energy. Potential energy of a patient laying down on an elevated drop piece can be transferred to another object if all its energy is converted to kinetic energy.
The Pierce Results System
Dr. W. Vernon Pierce of Dravosburg, PA was a 1955 Palmer graduate. He operated the Pierce Chiropractic Clinic and We Care Chiropractic Clinics, Research and Education until his untimely death in 1993.
Until the 1960s, Dr. Pierce adjusted patients with the techniques taught at Palmer College. One day, an active patient returned to his facility after several months on hiatus due to a stroke. Dr. Pierce was distraught, feeling that he somehow had done a disservice to the patient. The patient was left with numbness on one side and weakness.
At the time, no chiropractor would dare touch a stroke patient let alone perform a cervical adjustment. The patient fully trusted Dr. Pierce and wanted some sort of relief. Respecting the patient’s wishes, Dr. Pierce found a subluxation at C5 and said to the patient that he was going to use a drop piece on his neck and apply a lot of force.
BOOM! The room fell silent, and the patient said nothing. Dr. Pierce dropped to his knees and asked the patient if he was okay. The patient’s response was, “For the first time in months, I can feel my arm.” In that instant, The Pierce Results System (PRS) was born.
From that moment forward, Dr. Pierce developed, perfected and taught his technique across the world. Utilizing what he learned at Palmer, he used the quick thrust that was performed in a toggle recoil adjustment. Although typically performed in the upper cervical, the quick thrust can be utilized anywhere in the spine.
Dr. Pierce befriended Dr. Thompson and worked alongside him to perfect the drop technique and properly utilize leg analysis. Not directly utilizing Logan Basic, Dr. Pierce used trigger point therapy to help reduce muscle tension and increase blood flow to affected areas. Increased blood flow helps to promote the healing process and remove the body of inflammation and toxins, ultimately, removing nerve interference.
With a technique in place, Dr. Pierce developed his own analysis system and coined it The Pierce Results System (PRS). To be a Pierce adjuster, a chiropractor should have access to x-rays, thermography, a chiropractic drop table and a video fluoroscopy device. Dr. Pierce perfected the Thompson table and designed his own along with being the first chiropractor to utilize video fluoroscopy in patient diagnostics. Video fluoroscopy is a moving x-ray used on the cervical spine to show patients the curvature, degenerative changes, range of motion and most specifically, restricted points needing adjusted.
Over the next 30 years until his death, Dr. Pierce traveled the world and visiting different chiropractic schools teaching his technique, analysis and philosophy. I never met Dr. Pierce, but Dr. Wilkins was one of his beloved mentees and my grandfather was his best friend. From the stories both Dr. Wilkins and my family share with me, he was a down-to-earth individual, and he was truly dedicated to the chiropractic profession.
Drop Table Adjusting VS Manual Adjusting
When DD Palmer, the founder of chiropractic, and his son BJ Palmer, the developer of chiropractic first started our profession, it began with a manual adjusting technique called diversified. BJ Palmer believed that upper cervical adjusting is more effective and developed toggle recoil. A few decades later, a gentleman by the name of Clarence Gonestead, DC developed his infamous technique that includer cervical adjusting in a chair and a lumbar side posture adjustment. The Gonestead technique is mainly taught at Palmer college, but diversified adjusting is taught at all accredited chiropractic colleges globally.
First and foremost, what is manual adjusting? Manual adjusting techniques such as diversified or Gonestead are high-velocity, low-amplitude adjustments that bring a restricted joint to full tension. Once full tension is obtained, a thrust with proper direction and line of drive is performed that usually results in an audible sound that patients may hear and feel.
In last month’s blog, we talked about a misconception that we would like to revisit. The misconception is that the cracking sound that is heard means the bone is fractured. This is false information. That popping sound comes from little gas bubbles trapped in joint spaces that make an audible sound when the joint reaches its range of motion limitations.
Additionally, if a popping sound is not felt or heard after an adjustment, that doesn’t mean that the adjustment was unsuccessful. What patients may feel versus what the chiropractor feels for proper alignment are two totally different things.
Drop table adjusting techniques such as Thompson or Pierce include a high-velocity, low-amplitude adjustment without rotating a joint, but rather, applying a thrust straight down. In most cases, drop table adjusting doesn’t usually result in a popping sound, however, it can sometimes which is not an alarming issue.
As we stated earlier, the scientific principle behind the drop table is that the table segments give way to gravity, which helps assist the adjustment and requires less energy. Potential energy of a patient laying down on an elevated drop piece can be transferred to another object if all its energy is converted to kinetic energy.
The Wrap Up
Because we use drop tables, does that mean we are against manual adjusting? Absolutely not. Neither Dr. Wilkins or I have anything against manual adjusting or chiropractors who choose them as their choice of treatment. From time to time, Dr. Wilkins and I will perform a manual adjustment if we feel a different technique may better suit patient needs. Even Dr. Pierce performed the occasional manual adjustment. Why do we choose this technique over any other? I can speak for both myself and Dr. Wilkins.
When Dr. Wilkins was in chiropractic school, he was a Gonestead adjuster. He forged a friendship with a fellow chiropractor who introduced him to Dr. Pierce. After witnessing outstanding results, it was hard to look back. After Dr. Pierce’s untimely passing, this friend took over and currently runs the Pierce Clinic in Dravosburg.
I have had experience with the Pierce technique since I was a baby. When I was at Palmer and first graduated, I was a diversified adjuster. The results I got were good, but they were not great. When I teamed up with Dr. Wilkins, I’ve experienced nothing but great results.
Another reason why we chose this as our primary technique is because it’s not just a technique; it’s also a system, hence the reason why it’s called the Pierce Results System and not the Pierce technique.
Many chiropractors choose only to adjust and don’t offer any other services such as x-rays, neurological examinations, therapies, etc. To be a Pierce adjuster, x-rays (and if readily available, video fluoroscopy) are a must because we use patients’ x-rays to determine the directions we need to adjust our patients. Neurological examinations and instrumentation tools such as surface EMGs are not required but help further confirm our diagnosis.
The difference between drop table adjusting and manual adjusting is one of the most asked questions we receive in the office, so we decided to explain the differences in a blog. It was a lot of information, but we hoped we answered your questions.
In next month’s blog, we are going to shift gears and start talking about our non-surgical spinal decompression therapy. If you have any questions about drop table adjusting vs. manual adjusting, please call us at (724) 547-3377 and check out our website at www.laurelmountainchiro.com for more content.
Yours In Health,
Brian M. Steinert, DC