Central Concern:

Supine Thoracic adjustments – hands versus tools

What is the real problem? Do I have the skills/Knowledge to address the
central concern?
The central concern is not something which is bothering me right now, it is however
an issue for future practice. When performing Supine Thoracic adjustments to
correct Extension restrictions (AI static listing) and/or rotation restrictions (LP or RP
static listing) using varied hand positions see Figure 5-147 (Bergmann and Peterson,
2011) on multiple patients per hour/day/week. The stress load will build significantly
as time goes on with and increased risk of a Repetitive Stress Injury occurring.
It would be very easy to become lax with hand protection when tired or overconfident
leading to injury.
I have found some tools which can be used specifically to help practitioners avoid
this issue (The Guardian, 2019).
What I am concerned about is if you rely on a tool to do the adjustment for you, your
psychomotor skills would diminish over time and you could potentially position the
tool inappropriately before HVLA that would injure your patient.
Real argument here; Protection of practitioner’s hands over time vs. reduction in
psychomotor skill and increased risk to patient.
Where do I find the information I need? Can I trust the new information
source?
The manufacturer has multiple testimonials from various Chiropractors in the U.S
(The Guardian, 2019) which state that it has protected their hands and they have no
issue with the product. I would however like to have a conversation with some of my
own lecturers and mentors in relation to this and have they had any issue over the
years of treating.
I also noted that the product can only help with Extension restrictions not rotational
by design. So realistically it is highly specific for quite a bit of money.
Do I need a team approach to this? Who do I recruit into my management
team?
Lecturers and Mentors to gain insight as to how big an issue these Thoracic
adjustments can impact the hands and whether it is worth the monetary investment.
How can I be sure this new approach has addressed the central concern or
resulted in a positive change - outcomes...
This will be subjective to differing opinions and adjustment styles of practitioners. At
the end of the day it is not something which affects me now, but I intend to be in this
industry for the rest of my life and my hands are my tools, so I need to protect them
as best I can.
Apply my renewed approach next time around.
Until I find out which is the ‘smarter not harder’ approach I will continue to develop
my psychomotor skills, hand positioning, body position and overall technique. And
then decide.
References:
Bergmann, T. and Peterson, D. (2011). Chiropractic technique. 3rd ed. St. Louis,
Mo.: Mosby/Elsevier, p.203.
The Guardian. (2019). The Guardian. [online] Available at:
https://www.anterioradjusting.com/#about [Accessed 15 Sep. 2019].