Chiropractic Techniques

exercises), repositioning and correcting the weighted spine and posture relative to gravity.

Some of the key differences in The Pettibon System include seated x-rays, targeted therapies to prepare the spine for the adjusting force, and rehab post-adjustment to change the spine structurally. Pettibon teaches three distinct phases of care with different procedures unique to each phase.

Seated x-rays are often seen in upper cervical techniques. Pettibon uses seated x-rays for full spine sectional films. The concept is to load the spine to see its failure point. Sitting increases intradiscal pressure 30% over standing and 50% over supine. To equalize lumbar flexor and extensor groups, the patient’s thighs must be 30 degrees below horizontal (120 degrees to the trunk). This is important as many patients are diagnosed with lumbar hyperlordosis but they really have hypertonic lumbar paraspinals that when removed from the equation reveal a very different picture. Obviously, this can drastically alter the treatment.

Pre-adjustment includes modalities and therapies designed around reducing muscle

spasm and preparing the hard white tissues (ligaments and discs) to better tolerate the adjustments. This includes the Wobble Chair™ and Repetitive Cervical Traction™. These are based on ligament properties like creep and hysteresis. These are not static processes but are dynamic therapies based on sound research. Loading and unloading cycles are extremely effective in healing both disc and joint injuries by “imbibition and osmosis” of fluid and

adjusting easier for both the patient and chiropractor.

After adjusting, posture correcting therapies are more specific to the “red tissue.” We all know that we have slow-twitch, postural fibers and fast-twitch, phasic fibers but can you utilize specific therapies to target each type? The differences in these tissue types must be understood for spinal structural correction. For example,

“The nervous system always wants us to hold our heads upright. The nervous system will do this at the expense of causing muscles to subluxate the lower spine, or correct it if it is displaced for the same reasons.”

—Dr. Burl Pettibon

nutrients and elimination of metabolic waste from avascular tissue. Following Wobble and Traction, the Pettibon Tendon Ligament Muscle Stimulator (PTLMS™) relieves spasm and pain. This makes

Left: Neutral Lateral C-Spine

Right: Weighted Lateral C-Spine

when a phasic muscle fatigues it becomes flaccid. When a postural muscle fatigues it goes into spasm. Additionally, fast twitch are primarily volitionally controlled (pyramidal motor pathway) while slow twitch are primarily extra-pyramidal. This means our ability to target the slow- twitch fibers is most effectively done using reflex-stimulating modalities. This is the primary basis for the Pettibon Weighting System.

The Pettibon System is not what it was 20 years ago. It is a dynamic system that is constantly looking at the best way to care for the patient and advance the practice of chiropractic.

References: 1. JMPT, Vol. 19, 3, March/April, 1996 Lasting Changes in Passive Range of Motion After Spinal Manipulations.” 2. Kapandji IA. The Physiology of the Joints, Vol 3: The Trunk and Vertebral Column. 1974 Churchill Livingstone 3. Bernini PA, Wiesel SW, Rothman RH. The Aging Lumbar Spine. 1982 WB Saunders Philadelphia, PA 4. Guyton Arthur C, Textbook of Medical Physiology, Philadelphia: WB Saunders Company, 2000 5. Saunders S, D.C., D. Woggon, D.C., Cohen C, D.C., and D. H. Robinson, PhD. J. Vertebral Subluxation Res., May 2003

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