Originally Published in The American Chiropractor June 2017
The Pelvic Imperative
All chiropractic techniques must comply with the laws of physics and principles of biomechanical engineering in order to make successful spinal corrections.
Just as a strong and level foundation is an absolute requirement for the structural and functional integrity of any building, a strong and balanced pelvis is necessary to provide a stable foundation for biped man walking upright against the force of gravity. This is where the similarity begins and ends, however.
Where the foundation of a building is solid and static, the human pelvis has three sets of paired articulations and one singular midline articulation for a total of seven joints, each with unique freedom of movement. While these seven joints function interactively, they must be evaluated and treated individually.
The most fundamental challenge facing any chiropractic technique is to provide analytical and corrective methodologies that allow the chiropractor to quickly and efficiently begin every correction with a strong and balanced pelvis capable of fulfilling its unique weight bearing and neurophysiologic functions.
It is this foundational joint system that allows a person the strength and stability to lift heavy weights. It also provides us with the flexibility and proprioceptive ability to navigate any terrain ranging from a smooth floor to the most impossibly convoluted and rugged mountain trails.
I have made a lifetime study of the major techniques used in the practice of chiropractic, but have found no single technique that adequately addresses the correction of all seven pelvic joints. Fortunately I have found the necessary individual components among the protocols of several well known and popular techniques.
Through the integration of specific components of several techniques and the use of the ArthroStim® and VibraCussor® hand held electronic adjusting instruments, I have found a high level of accuracy in the individual analysis and correction of the seven joints of the pelvis.
My analysis uses muscle testing and physical indicators to provide objective evidence of the functional state and relative strength of the paired joints. Just as importantly these same evaluative techniques are then used for post corrective testing.
This constitutes good evidence based chiropractic with the added benefit of clearly demonstrating improved function that the doctor and patient can see and feel through immediate comparison of pre and post correction findings.
These protocols provide a qualitative and quantitative functional analysis of the pelvic joints when performed by a doctor who is trained to evaluate the subtle differences which can be observed in the right and left sides of the paired joints.
It is through the doctor’s careful attention to and observation of the pre and post correction findings that a chiropractor can obtain the highest level of balance and integration of the components of the pelvic joint system.
The detailed evaluation of the seven pelvic joints would be of only academic value if not used in conjunction with corrective procedures that are equally detailed, specific and effective.
The corrective procedures I am advocating constitute a departure from traditional low back side-posture, drop table adjusting and mechanized spinal decompression protocols which constitute the mainstay of the low back and pelvic techniques used by most chiropractors.
While I would never deny the importance of these techniques and procedures in a chiropractor’s arsenal, what I am proposing are technique refinements employing the ArthroStim and VibraCussor handheld electronic adjusting instruments with aspects of Gonstead, SOT, Pettibon Biomechanical Engineering, Thompson, Quantum Neurology®, Gonzalez Rehabilitation Techniques®, Applied Kinesiology and Neuro Kinetic Reintegration Techniques.
While this approach is very technique intensive, once learned it quite easy and quick to implement. And since this approach is totally evidence based and very specific, it provides good medical/ legal justification for each procedure used.
Also, by utilizing the hand held instruments, this technique has the added benefit of being physically easy and comfortable for both the doctor and patient. The gentle and non threatening nature of instrument adjusting without the cracking and crunching sounds associated with most techniques allows for a greater degree of patient relaxation eliminating a primary source of resistance to seeking chiropractic care.
The ultimate correction of the pelvis requires that the seven individual joints function synchronously with normal range of motion and balanced right and left weight bearing.
This can only be accomplished via a technique approach that addresses the individual characteristics and function of joints of different classifications. The major pelvic joints and their classifications are:
- The 5L- S1 facets are synovial plane diarthrodial joints with opposing cartilage surfaces.
- The hip joints are multi axial diarthroses.
- The pubic joint is an ampiarthrosis.
- The sacroiliacs are weight transferal synovial plane diarthroidal syndesmosies.
The assumption that traditional diversified adjusting techniques will create a domino effect capable of making all of the corrections necessary to balance the seven joints of the pelvis is naïve at best.
Unless the pelvis is balanced, the cervical and lumbar spine will always resubluxate to compensate through the self righting reflex in order to provide the level horizon necessary to satisfy needs of the cranial nerves that provide vision, especially depth perception and equilibrium.
A balanced pelvis greatly facilitates correction of the full spine while reducing the time and number of visits required to do it. Let us never forget that results obtained better, faster and more economically is what put chiropractic on the map.
In a future issue of TAC I will fully describe the seven joint examination, analysis and correction of the pelvis.
© copyright Dr. William H. Koch all rights reserved
