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Animal Chiropractic Technique Manual

Canine

Sacropelvic Adjustments

©ABPA 2018

revised 2006, 2007, 2008, 2015, 2016

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CONTENTS

KEY TO TECHNIQUE CHARTS workshop

Sacroiliac Joint - Flexion Restriction, Tuber Ischii Contact 5

Sacroiliac Joint - Flexion Restriction, Tuber Ischii Contact, interlaced fingers 7

Sacroiliac Joint – Flexion Restriction- Standing Flywheel 6

Sacroiliac Joint - Flexion Restriction, Dual Ventral Cranial Iliac Spine and Tuber Ischii Contact

7

Sacroiliac Joint - Extension Restriction, Tuber Sacrale Contact 5

Sacroiliac Joint - Extension Restriction, Tuber Sacrale Contact, Interlaced fingers 6

Sacroiliac Joint – Extension Restriction- Standing Flywheel 6

Sacroiliac Joint – Extension restriction – lateral recumbency 7

Sacrum- Lateral Flexion Restriction, Lateral Sacral Apex Contact, Push 5

Sacrum- Lateral Flexion Restriction, Lateral Sacral Apex Contact, Pull 5

Lumbosacral Joint - Flexion Restriction, Sacral Apex Contact 5

Lumbosacral Joint - Extension Restriction, Sacral Base Contact 5

Lumbosacral Joint - Extension Restriction, Lumbar 7 Spinous Contact 6

Sacral Base Right /Left Rotation Restriction 7

This technique chart has been produced by incorporating previous charts and reviews by Ian Bidstrup, Kate Haines, Susan Tselepis, Marcus McDonald and others. Material has also been incorporated from Willoughby Workbooks. Photographs have been a collective effort from various members of the AVCA. Special thanks to one of Kim's clients for helping to take nearly all the canine photographs. A special thanks to her greyhound 'Mouse' who put up with all the photographs even though she wanted to go home. Thanks also to Julia Kline and her horse. We would like to thanks everyone for their input. Editors Kim Lim and Heidi Douglas (2006) Kim Lim and Susan Tselepis (2007) Kim Lim and Bernard Nadolny (2015)

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KEY TO TECHNIQUE CHARTS

Motion Star

SPATIAL TERMS

ANIMAL HUMAN

(D)Dorsal Posterior

(V)Ventral Anterior

(Cr)Cranial Superior

(Cd)Caudal Inferior

(L)Lateral Lateral

(M)Medial Medial

Depicts left or right sacroiliac joint motion restrictions. Eg. Right Sacroiliac extension restriction shown. Can be used also for coxofemoral joint restrictions (left & right rotation bars not shown here).

Depicts motion restrictions at Occiput-Cervical-Thoracic-Lumbar-Lumbosacral joints. Accordingly, the specific motor unit displaying the restriction is identified, eg L2/3, C3/4 etc. Throughout this manual, photographs depicting body positioning and contact points are used. The arrows correspond to the direction of the Line of Correction.

flexion

extension

rightlateralflexion

leftlateralflexion

leftrotation

rightrotation

restriction

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KEY TO TABLES

Joint Motion segment where motion restriction is detected. All positions are relative to the side of the joint restriction.

Motion restriction Direction of motion restriction

Doctor position Ipsilateral/contralateral used in reference to the side of restriction. Fencer’s stance - with legs balanced to give maximal stability and balance. The doctor’s centre of gravity, gluteals and shoulder of adjusting hand should be behind the adjusting hand. Body Drop - uses the weight of the doctor's body to provide force for the downward thrust through the L.O.C. The doctor's arms and shoulders are locked and the drop is performed by flexing at the knees and/or ankles.

Handler position At the patient's head and always the same side as the doctor in horses unless otherwise indicated

Animal position Animal posture to maximize stability for adjustments. Stabilization is often inherent in the standing horse.

S.C.P Segmental Contact Point - anatomical landmark through which thrust vector is applied

1o C.P. Primary Contact Point - Doctor’s primary anatomical structure through which thrust force is applied to the patient. Eg. Pisiform, calcaneal

2o C.P Secondary Contact Point - Location of supporting arm/hand during adjustment procedure. This may be to 1. Stabilize adjacent joints to the adjustment

or 2. To support and protect the doctor’s own adjusting hand if stabilization is already inherent in the animal eg. Toggle Position - the pisiform of the indifferent hand is placed in the snuff box of the primary hand. There should be an imaginary line running from the doctor’s sternal notch, through the primary contact point, continuing through segment being adjusted in the LOC. Supported Wrist Position - the indifferent hand grasps the wrist of the thrusting hand to prevent hyperextension of the primary wrist. This is primarily used with the Body Drop.

L.O.C. Line Of Correction - direction through which the thrust’s force vector is applied usually along line/s of joint planes.

Thrust Style of adjustment thrust (high velocity, low amplitude thrusts) 1.High Velocity, Low Amplitude Thrust (HVLA)- hands stay at end-point position after adjustment, the segment maintains its position, there is no recoil. 2.Recoil - hands are quickly removed from vertebra following the adjustment. This allows the segment to recoil and find its own level.

Notes Additional comments

.

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Sacroiliac Joint - Flexion Restriction, Tuber Ischii Contact (source – modified Willoughby 92)

Joint sacroiliac joint

Motion restriction Flexion of ilium on sacrum

Doctor position Contralateral, slightly dorsal and lateral to patient

Animal position Standing square or with ipsilateral hind leg slightly cranial

S.C.P Ipsilateral Tuber Ischii, dorsal aspect

1o C.P Protected thumb, calcaneal, thenar

2o C.P Cranial forearm under patient's caudal abdomen, stabilizing lift

L.O.C D→V, slight Cd→Cr, M→L

Thrust HVLA

Notes Doctor must bring patient in close for stability. Leg position and

2o C.P aim to bring the sacroiliac joint to tension and reduce the thrust force though the coxofemoral joint

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Sacroiliac Joint - Flexion Restriction, Tuber Ischii Contact, interlaced fingers

Joint Sacroiliac

Motion restriction Flexion of the ilium on the sacrum

Doctor position Contralateral, facing across and cranial

Animal position Standing square or with ipsilateral hind leg slightly cranial

S.C.P Ipsilateral Tuber Ischii, dorsal aspect

1o C.P pisiform

2o C.P Cranial forearm under patient abdomen, webbed fingers, stabilizing lift

L.O.C D→V, slight Cd→Cr, M→L

Thrust HVLA

Notes Doctor must bring patient in close for stability. Leg position and

2o C.P aim to bring the sacroiliac joint to tension and reduce the thrust force though the coxofemoral joint. Lightly interlace fingers of cranial hand with that of primary adjusting hand.

Interlacing fingers stabilizes 1o C.P.

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Sacroiliac Joint – Flexion Restriction- Standing Flywheel (Jim Johnson 2004, adapted from

Willoughby 92)

Joint Sacroiliac joint

Motion restriction Flexion of the ilium on the sacrum

Doctor position Kneeling on the contralateral side

Animal position Standing with ipsilateral hindleg placed slightly forward

S.C.P 1. Ipsilateral Ventral Cranial Iliac Spine (Tuber Coxae) and

2. Dorsal aspect of ipsilateral tuber ischii

1o C.P 1.Calcaneal or thenar of cranial hand

2.Calcaneal or thenar of caudal hand

2o C.P Cranial forearm under patient's caudal abdomen, stabilizing lift

L.O.C 1.V→D, slight Cr→Cd, L→M, through sacroiliac joint plane

2. D→V

Thrust Steering wheel type adjustment with a thrust through the tuber ischii and a lift

through the ventral cranial iliac spine

Notes Beware, often very tender at ventral tuber coxae contact. It is important that the

joint is taken to tension via flexing the ipsilateral leg forward, suitable for larger

hands or smaller, skinnier dog

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Sacroiliac Joint - Flexion Restriction, Dual Ventral Cranial Iliac Spine and Tuber Ischii

Contact (Jim Johnson 2004, adapted from Willoughby 92)

Joint Sacroiliac joint

Motion restriction Flexion of the ilium on the sacrum

Doctor position Standing over ipsilateral pelvis, ventral to pelvis and in front of hindlegs

Animal position Lateral recumbency on an adjusting table. Ipsilateral hindleg flexed forward

and held there by doctor’s own thigh.

S.C.P 1. Ipsilateral Ventral Cranial Iliac Spine (Tuber Coxae) and

2. Dorsal aspect of ipsilateral tuber ischii

1o C.P 1.Calcaneal or thenar of cranial hand

2.Calcaneal or thenar of caudal hand

2o C.P Doctors thigh against popliteal region of dogs ipsilateral hindleg

L.O.C 1.V→D, slight Cr→Cd, L→M, through sacroiliac joint plane

2. D→V

Thrust Steering wheel type adjustment with a thrust through the tuber coxae and a

pull move through the tuber ischii

Notes Beware, often very tender at ventral tuber coxae contact. It is important that

the joint is taken to tension via flexing the ipsilateral leg forward.

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Sacroiliac Joint - Extension Restriction, Tuber Sacrale Contact (Willoughby 92)

Do sacrum first

Joint sacroiliac

Motion restriction Extensionof the ilium on the sacrum

Doctor position Contralateral, facing across and cranial

Animal position Standing square or with ipsilateral hind leg slightly caudal

S.C.P Ipsilateral cranial dorsal iliac spine (tuber sacrale)

1o C.P Protected thumb, calcaneal, thenar

2o C.P Cranial forearm under patient abdomen, stabilizing lift

L.O.C D→V, M→L (20 degrees off vertical), Cd→Cr, through sacroiliac joint plane

Thrust HVLA

Notes Doctor must bring patient in close for stability. Leg position and

2o C.P aim to bring the sacroiliac joint to tension and reduce the thrust force though the coxofemoral joint. Keep the adjustment amplitude small to avoid hyperextension of the LS joint

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Sacroiliac Joint - Extension Restriction, Tuber Sacrale Contact, Interlaced fingers (Modified Willoughby – Hauler modification)

Joint Sacroiliac

Motion restriction Extension of the ilium on the sacrum

Doctor position Contralateral, facing across and cranial

Animal position Standing square

S.C.P Ipsilateral, cranial dorsal iliac spine, (tuber sacrale)

1o C.P Calcaneal, hypothenar, thenar

2o C.P Cranial forearm under patient abdomen, webbed fingers, stabilizing lift

L.O.C D→V, M→L, Cd→Cr

Thrust HVLA

Notes Lightly interlace fingers of cranial hand with that of primary adjusting hand.Thrust may be assisted by a pulling motion of the cranial hand.

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Sacroiliac Joint – Extension Restriction- Standing Flywheel (Jim Johnson 2004, adapted from Willoughby 92)

Joint Sacroiliac joint

Motion restriction Extension of the ilium on the sacrum

Doctor position Kneeling on the contralateral side

Animal position Standing with ipsilateral hind leg placed slightly backwards or lateral recumbency with ipsilateral hind leg uppermost and extended back as much as possible

S.C.P 1. Ipsilateral Cranial Dorsal Iliac Spine (Tuber Sacrale) and 2. Ventral aspect of ipsilateral Tuber Ischii

1o C.P 1.Groove of fingers at proximal interphalangeal joints of cranial hand 2.Calcaneal or thenar of caudal hand

2o C.P Cranial forearm under patient's caudal abdomen, stabilizing lift

L.O.C 1. D→V 2. V→D, slight Cr→Cd, L→M, through sacroiliac joint plane

Thrust Steering wheel type adjustment with a thrust through the tuber ischii and a pull through the cranial dorsal iliac spine

Notes It is important that the joint is taken to tension via extending the ipsilateral leg backwards, suitable for larger hands or smaller, skinnier dog

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Sacroiliac Joint- Extension Restriction – Lateral Recumbency

Joint Sacroiliac joint

Motion restriction Extension of the ilium on the sacrum

Doctor position Standing over ipsilateral pelvis, ventral to pelvis

Animal position Lateral recumbency. Ipsilateral hind leg extended backwards and held there by doctor’s own knee

S.C.P 1. Ipsilateral Cranial Dorsal Iliac Spine (Tuber Sacrale)

1o C.P Calcaneal or thenar of cranial hand

2o C.P Doctor’s knee to stabilize hind leg in extension, secondary hand on cranial femur or greater trochanter to stabilize coxofemoral joint

L.O.C D→V, slight Cd Cr, M L

Thrust Steering wheel type adjustment with a thrust through the tuber ischii while stabilizing or thrusting through coxofemoral joint

Notes It is important that the joint is taken to tension via extending the ipsilateral leg backwards, useful if both coxofemoral and sacroiliac joints cannot extend fully. Flexibility of doctor important as doctor’s position is set in line with patient, Patient may be placed on a table to elevate working area,

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Sacrum- Lateral Flexion Restriction, Lateral Sacral Apex Contact, Push (Modified Willoughby)

Joint Sacroiliac (& Lumbosacral)

Motion restriction Lateral flexion of Sacrum on the ilium

Doctor position Standing caudal to the dog, facing cranially or standing lateral to the dog and facing across

Animal position Standing square

S.C.P Contralateral, lateral surface of sacral apex (S3)

1o C.P Pisiform, thenar, protected thumb

2o C.P Cranial forearm under patient abdomen, stabilizing lift

L.O.C L→M, push

Thrust HVLA/ Recoil

Notes Take care to be on the sacrum and not on the coccygeal segments

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Sacrum- Lateral Flexion Restriction, Lateral Sacral Apex Contact, Pull (Modified Willoughby)

Joint Sacroiliac (& Lumbosacral)

Motion restriction Lateral flexion of Sacrum on the ilium

Doctor position Standing lateral to the dog, facing caudolateral

Animal position Standing square

S.C.P Contralateral, lateral surface of sacral apex (S3)

1o C.P Fingertips

2o C.P Cranial forearm under patient abdomen, stabilizing lift, doctor's body bracing ipsilateral side of the pelvis.

L.O.C L→M, pull

Thrust HVLA

Notes Take care to be on the sacrum and not on the coccygeal segments

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Lumbosacral Joint - Flexion Restriction, Sacral Apex Contact (Gleason 98)

Joint Lumbosacral

Motion restriction Flexion

Doctor position On one knee, facing across pelvis

Animal position Standing square

S.C.P Third sacral tubercle (sacral apex)

1o C.P Notched thumb

2o C.P Cranial forearm under patient's caudal abdomen, stabilizing lift to take lumbosacral joint to tension

L.O.C Perpendicular to dorsal sacral surface, D→V

Thrust HVLA/ Recoil

Notes Important to stabilize abdomen to avoid injury to coxofemoral joints

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Lumbosacral Joint - Extension Restriction, Sacral Base Contact (Modified Willoughby 92)

Joint Lumbosacral

Motion restriction Extension

Doctor position On one knee, facing across pelvis

Animal position Standing square

S.C.P First sacral tubercle (note its small size), (sacral base)

1o C.P Notched thumb

2o C.P Cranial forearm under patient abdomen, stabilizing lift

L.O.C Perpendicular to dorsal sacral surface, D→V

Thrust HVLA

Notes Important to stabilize abdomen to avoid injury to coxofemoral joints. Hindlegs may be drawn a little caudally to take lumbosacral joint to tension

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Lumbosacral Joint - Extension Restriction, Lumbar 7 Spinous Contact (Modified Willoughby 92 – I Bidstrup variation)

Joint Lumbosacral

Motion restriction Extension

Doctor position On one knee, facing across pelvis

Animal position Standing square

S.C.P Dorsal Spinous Process of L7

1o C.P Notched thumb

2o C.P Cranial forearm under patient abdomen, stabilizing lift

L.O.C Perpendicular to dorsal surface of the sacrum, D→V

Thrust HVLA

Notes An alternative to the sacral base technique if sacral base is tender. Important to stabilize abdomen to avoid injury to coxofemoral joints. Hindlegs may be drawn a little caudally to take lumbosacral joint to tension

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Sacral Base Right /Left Rotation Restriction (Willoughby 92)

Joint Lumbosacral and Sacroiliac

Motion restriction Rotation of sacrum

Doctor position On one knee, facing across

Animal position Standing square

S.C.P Ipsilateral, sacral lamina, lateral to spinous process of S1

1o C.P Protected thumb

2o C.P Cranial forearm under patient's caudal abdomen, stabilizing lift

L.O.C Perpendicular to dorsal sacral surface, D→V

Thrust HVLA

Notes Often used with Sacroiliac restrictions that are difficult to resolve