chiropractic-technique-bergmann-thomas

497 Pages·2013·42.64 MB·English

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ccttrr00006655
Third EdiTion
Chiropractic
Technique
Principles and Procedures
Thomas F.
Bergmann,
dC, FiCC
Professor, Chiropractic methods department
Clinic Faculty, Campus Clinic
northwestern health sciences University
Bloomington, minnesota
david h.
Peterson,
dC
Professor,
Division of Chiropractic Sciences
Western States Chiropractic College
Portland, Oregon
with 1340 illustrations
i
BBEERRGGMMAANNNN,, 997788--00--332233--0044996699--66
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Chiropractic Technique Principles and Procedures 978-0-323-04969-6
Copyright © 2011, 2002, 1993 by Mosby, Inc., an affiliate of Elsevier Inc.
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Notice
Knowledge and best practice in this field are constantly changing. As new research and experience broaden our
knowledge, changes in practice, treatment and drug therapy may become necessary or appropriate. Readers are
advised to check the most current information provided (i) on procedures featured or (ii) by the manufacturer
of each product to be administered, to verify the recommended dose or formula, the method and duration of
administration, and contraindications. It is the responsibility of the practitioner, relying on their own experience
and knowledge of the patient, to make diagnoses, to determine dosages and the best treatment for each
individual patient, and to take all appropriate safety precautions. To the fullest extent of the law, neither the
Publisher nor the [Editors/Authors] [delete as appropriate] assumes any liability for any injury and/or damage
to persons or property arising out of or related to any use of the material contained in this book.
The Publisher
Library of Congress Cataloging-in-Publication Data
Bergmann, Thomas F.
Chiropractic technique: principles and procedures / Thomas F.
Bergmann, David H. Peterson. – 3rd ed.
p. ; cm.
Peterson’s name appears first on the earlier edition.
Includes bibliographical references and index.
ISBN 978-0-323-04969-6 (hardcover : alk. paper)
1. Chiropractic. 2. Manipulation (Therapeutics) I. Peterson, David H., 1952- II. Title.
[DNLM: 1. Manipulation, Chiropractic–methods. 2. Chiropractic–methods. WB 905.9 B499c 2011]
RZ255.B47 2011
615.5'34–dc22 Proudly sourced and uploaded by [StormR2G01]0 004358
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Printed in the United States of America
Last digit is the print number: 9 8 7 6 5 4 3 2 1

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for0080
F
oreword
A h! Where to begin? I’ve written books, chapters, papers, our refinement) of these procedures is based on modern sciences
and editorials, but I think that writing a foreword can be such as biomechanics and kinesiology, engineering, and diagnos-
the most challenging task. On the one hand so great is tic imaging. Elements of manipulative technique such as the idea
my admiration of this Third Edition of Dr. Tom Bergmann’s and of “pre-stressing” an articulation have acquired a new importance
Dr. Dave Peterson’s Chiropractic Technique that I have to restrain and allow for the first significant refinements of some manipulative
myself from writing what may substitute for an introductory techniques in many years. Staying abreast of such developments
chapter. On the other hand I’ve been given a rare opportunity to is the professional responsibility of every practicing chiropractor.
introduce readers to an extraordinary textbook, and I want to use This textbook provides a comprehensive reference for maintaining
my space wisely. currency in the art and science of our field.
First, the traditional and well-deserved laudatory comments: In adding my final comment about this new textbook, perhaps
this third edition of a now legendary chiropractic textbook offers I will be a little controversial myself. In Chapter 3, the authors
old and new readers an encyclopedic treatise of chiropractic man- state that the concept of subluxation serves as a defining prin-
ual methods (Principles and Procedures as described in the subtitle) ciple as well as the source of contentious debate and disagreement
referenced with the most up-to-date evidence, lavishly illustrated, within the profession. I agree with this statement and I think that
occasionally controversial but always rational, and true-to-form many modern and scientifically based chiropractors recognize the
for these experienced authors, eminently readable. The most valu- significance of this statement and the nature of the double-edged
able addition is the availability of the text in electronic format sword of this phenomenon we have historically known as the sub-
(e-book), and the access to the Evolve website with video dem- luxation. Another double-edged sword is the great variety of chi-
onstrations of all assessment procedures and adjustive techniques. ropractic professional approaches and practices that are observed
I can only imagine how valuable such an aid might have been around the world today. Many have added to our diversity and
during my own chiropractic education in the early 1970s. At sparked debate and the development of better, more effective care.
that time we mostly learned from inconsistent personal instruc- In my view, however, this has also contributed to an often dog-
tion and crude drawings of static positioning. However, by using matically based divisiveness, a lack of clear consensus on scope
this wonderful reference work the next generation of chiroprac- of practice and professional standards. It is my sincere hope and
tors promises a whole new standard of consistency of care, not to expectation that this textbook will contribute to a more visible
mention the opportunity for instructors to design authentic and consistency of approach to care in future generations of chiro-
consistent assessment of their learners. Each of the chiropractic practors, not forgetting those currently in practice with many
manual and manipulative procedures has been named to concur years of practice remaining. Such a consistency of our professional
with common practice and especially the nomenclature used by approach to patient care is absolutely essential if we are to assume
the National Board of Chiropractic Examiners, which adds to the a rightful role in our nation’s health care system. Were it in my
utility of this text for all students. power, I would insist that every single chiropractor and chiroprac-
Chiropractic history is a special interest of mine, and I can tic student own and study this book and put into practice what
admit to the fact that many common manipulative procedures are Bergmann and Peterson have so masterfully described.
founded on a long tradition of empirical evidence, some dating
back centuries. This said, our current understanding (and hence, Michael R. Wiles, DC, Med
v
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pre0085
P
reface
T he third edition of Chiropractic Technique thoroughly practic manipulable lesion historically labeled as subluxation and
discusses the use of the manual therapies with emphasis also commonly referred to as joint dysfunction. Clearly this topic
on thrust techniques in an unbiased and rational man- is one of passion and contention. We have attempted to discuss
ner, based on and supported by current evidence, and continues issues including definitions and theoretical models that have sup-
its focus on teaching students of chiropractic and manual therapy. portive evidence. Moreover, we discuss and describe the vari-
It is a practical and comprehensive presentation of the fundamen- ous evaluative procedures used to identify the presence of joint
tal and advanced skills necessary to evaluate joint function and to dysfunction with a corresponding Appendix demonstrating the
deliver thrust and nonthrust techniques. As such it should help known reliability and validity of the procedures.
standardize the teaching and application of these procedures. Chapter 4 reviews the current understanding of manipulative
The third edition is also available as an electronic text. This mechanics, providing insight into current research and theoretical
feature allows for the addition of video demonstrations for the models of effects, or what happens when various forms of manual
evaluative and adjustive procedures. From the inception of this therapy are applied. We believe this chapter is very important to
text the authors have realized the enormous teaching value of hav- anyone seeking to become a user of thrust manipulation as it pres-
ing video clips to accompany the evaluation and treatment proce- ents information relating to adjustive vectors, forces, and which
dures. This feature provides the visual content that is so important joints and tissue may receive the majority of applied force. It sug-
for the development of manual skills and self-directed learning. gests that what we say we have been doing and what we really are
Also new to the third edition is the naming of each of the adjus- doing may be two entirely different things.
tive procedures. It is necessary to assign a clear and specific name to Chapters 5 and 6 have been updated with some new proce-
each technique procedure for teaching and testing purposes. The dures, and other procedures have been modified. However, the
adjustive techniques have been given names that are based on the significant change is in the layout of these two chapters. They are
involved joint/region, patient position, contact used by the clini- designed as a practical manual with technique descriptions that
cian, body part contacted, and any necessary additional informa- are closely associated with the illustrations and grouped by patient
tion (i.e., push, pull, with distraction, etc.), as well as the induced position. The names are changed to reflect the U.S. National
joint movement. These names follow the patterns used by the U.S. Board of Chiropractice Examiners format.
National Board of Chiropractic Examiners and are designed to be Chapter 7 presents information on the application of mobiliza-
helpful in the teaching and testing for competence. tion, traction, and soft tissue procedures. Clearly, the High Veloc-
The organization of the third edition remains the same with ity, Low Amplitude (HVLA) form of manual procedure is not
each chapter able to stand on its own. It is not necessary to read indicated or tolerated by all patients and other forms of manual
the information in one chapter to understand the material in therapy should be applied. This chapter provides the rationale and
another. description for many of nonthrust techniques.
Chapter 1 provides an updated look at the past, present, and We continue to believe that the text’s distinguishing strong
future aspects of the profession of chiropractic. It also draws atten- point is its comprehensive and extensively researched rational
tion to other professions that incorporate manipulative therapy approach to the application of chiropractic adjustive techniques.
and includes expanded information on the philosophical roots of The breadth of the topics covered makes it ideally suited as both a
the chiropractic profession. core teaching text for chiropractic students and a reference text for
Chapter 2 presents the musculoskeletal anatomy and basic bio- anyone using manual and manipulative therapy.
mechanical principles necessary to understand and apply chiro- We are very pleased with the adoption of this text at a number
practic adjustive procedures. It has been updated with additional of national and international chiropractic institutions and that the
information on the effects of loads on all forms of connective tis- U.S. National Board of Chiropractic Examiners lists it as a refer-
sue as well as the relationship between forces applied to the body ence for tests on chiropractic practice. Our goal for this text is to
and the consequences of those forces on human motion. Chapters have it be a comprehensive source to assist in the standardization
3 and 4 have been revised and supported with current references. of teaching chiropractic diagnostic and adjustive methods.
Chapter 3 is a comprehensive discussion of the basis for eval-
uation of joint dysfunction identifying important, relevant, and Thomas F. Bergmann, DC., FICC
defensible concepts for the role that the musculoskeletal system David H. Peterson, DC
plays in health and disease. It takes a critical look at the chiro-
vii
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ack0090
A
cknowledgments
A third edition of a textbook can only occur through contin- Kristen Rogney, Haj Soufi, Kory Wahl, and Pler Yang for serving
ued acceptance and use. Thanks must therefore go to all as models in the Third Edition.
of the students, faculty, and practitioners who have found Appreciation and gratitude goes to Dr. Stacy Thornhill and
Chiropractic Technique a valuable educational resource. Dr. Joe Cimino for their expertise in differentiating and defin-
We wish to acknowledge the roles of many individuals in the pro- ing the various soft tissue techniques, to Dr. Tom Davis for the
duction of this edition: the photographic talents of Glen Gumaer concepts of distractive and motion-assisted procedures, and to
on the First Edition, Arne Krogsven on the Second Edition, and Dr. Bill Defoyd for his insight and suggestions concerning
Greg Steinke on the Third Edition; Nick Lang for the graphic McKenzie methods.
artwork in the First Edition and Jeanne Roberts in the Second Finally, we would like to express sincere gratitude to all of the
Edition; Dr. Janice Justice, Dr. Fred Rhead, Dr. Janet Preckel, Dr. individuals at Elsevier, Inc., who have maintained faith in us and
Lolin Fletcher, and Dr. Andrew Baca for serving as models in the this book to see it through to a third edition. Specifically, we thank
First Edition; Dr. Stacy Thornhill, Dr. Sarah Macchi, Dr. Torbin Kellie White, Kelly Milford, and Sara Alsup.
Jensen, Dr. Arin Grinde, and Brian Hansen for serving as models
in the Second Edition; Andrea Albertson, Lindsey Baillie, Matt D.P. and T. B.
Christenson, Ayman Hassen, David Landry, Christine Rankin,
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