The chiropractic adjustment isn’t just one thing: Part II

In the previous blog post, I began to describe different forms of chiropractic adjustments. Now, I’ll deal in a form of adjusting entirely different from flexion distraction called a drop piece. This is a table section that can be raised independently, and released abruptly when a certain amount of pressure is reached. Drop pieces utilize a physics principle known as impulse, which is best illustrated by pulling the tablecloth out from under the dishes without moving them. Drop pieces allow chiropractors to move a specific vertebra a very short distance very rapidly, in a very non-invasive fashion. Again, this may look nothing like what the public pictures of chiropractors.

Drop pieces were developed by a chiropractor named Clay Thompson. When he was first in practice, he could only afford a table with a slightly broken headpiece that moved if he adjusted someone. When he became more successful, he bought a new table, but his patients requested to be adjusted on the broken one because they felt better. This prompted him to investigate, and led to him developing a full spine drop table technique, and an algorithm to determine where to adjust. Both were major innovations and contributions to the art and science of chiropractic.

Most importantly for the sake of this discussion, while drop pieces can be of use in disc conditions, they shine the most when dealing with what is referred to as “joint dysfunction”. In the most current understanding, this is when soft tissue space holders within the joint become caught in the joint surfaces. I have written about this elsewhere, so I’ll direct you to that. Regardless, drop pieces allow us to comfortably open the joint and release that entrapment.

Of course, I should also deal with the kind of adjustment the public expects. What people often refer to as “getting cracked” is technically referred to as high velocity, low amplitude, or osseous adjusting. This means we move the joint a very short distance, very quickly. This is a highly skilled procedure that takes years to learn, and a great deal of practice to perform effectively. Just because someone can crack their knuckles doesn’t mean they understand this. It is also important to point out that just because a spine surgeon understands the spine doesn’t mean they have the faintest understanding of spinal manipulation.

People sometimes have concerns with the safety of this procedure, perhaps because of misconceptions from social media. An important indicator of safety is malpractice insurance rates. Like the average chiropractor in New Hampshire, I pay about $2500 a year in malpractice premiums. The average orthopedic surgeon pays six figures. Insurance companies understand risk very well, and what they charge for malpractice insurance clearly demonstrates the safety of chiropractic.