Topic 2 Cervical Adjustments

Approaching the conclusion my Bachelor of Chiropractic course has caused me to become reflective
of what I have learned until this point in time. I’m happy with how I have progressed in this short
time; however, I have identified that the area of my own personal skill that needs the most
improvement is cervical adjusting. Throughout my study of various chiropractic techniques, the
cervical spine has proven to be the most uncomfortable segmental region to adjust. The reason that
I find this adjustment type to be troublesome is because I am hesitant to perform the adjustment.
My skills at this point are developed enough to perform this type of adjustment, however, I lack
confidence and as a result I hesitate and stop before following through with the adjustment.

To address this concern, I need to perform research on the application of adjustments, how to
identify when they are necessary, as well as practice performing them more often. To begin, I will
strip back to basics and look at what an adjustment is. An adjustment is defined as “a specific form
of joint manipulation using … techniques with specific anatomic contacts. It is characterised by a low-
amplitude dynamic thrust of controlled velocity, amplitude, and direction.” (Bergmann & Peterson,
2011). This is a general definition of an adjustment and when selecting any area of the spine to
adjust, the anatomy differs, therefore cervical adjusting is performed specifically with cervical type
set-ups. By reiterating this fundamental knowledge, I can boost my confidence while setting up an
adjustment on a patient.

Preparing for a cervical adjustment is the next concern I need to investigate to determine how and
why an adjustment is performed. Several steps are taken to identify when an adjustment is required.
These steps include observation, static and motion palpation with emphasis on ranges of motion.
These steps will highlight any segments that are not moving correctly and as a clinician I should be
able to identify them to determine what type of adjustment is required based on the adjustments I
have learnt. Cervical spine adjustments are performed predominantly using the assisted method and
based on the segment restriction, the adjustment technique will be selected. There are several
different types of adjustments I can choose, however, personally I prefer performing supine
adjustments when possible rather than seated. Although seated adjustments will achieve the same
result as supine, personally I find them to be slightly more awkward to perform. With practice and
repetition, I can become more familiar with both techniques improving my confidence and ability.
Finally, before adjusting a patient and after a segment has been identified, an intended outcome
must be considered to justify why it is necessary to perform. Goals of performing an adjustment may
include “reducing pain, improving motion” (Yeomans, 2020).

A team approach will be beneficial to me. I can utilise my chiropractic lab on campus to practice
individually using a manikin, however, feedback from an observer and from a patient will be
invaluable. A manikin is useful as it has no risk of injury, but it can not provide feedback and there is
no underlying anatomy to feel. The opposite is true when practicing on a patient, there is a potential
risk of injury, however the benefits of feeling underlying anatomy and feedback outweigh the risk in
this situation.

Also attending external Chiropractic events outside of my course can be helpful as it will expose me
to new patients, new teachers, and techniques that I can use to further increase my confidence and
ability. Based on classmate feedback and their experiences attending external events, I feel that this
would be a productive use of time. Prior to this I have been hesitant to attend any events as I
wanted to focus on my core skills, but now I feel that I am able to absorb new information that will
compliment my foundation of knowledge.
By following the steps mentioned above, I can be sure that my cervical adjusting skills will improve
based on feedback, increased confidence and comfortability performing them. I do not believe that
shortcuts will benefit me in achieving my goal, I expect this to be a gradual process that will develop
over a relatively short time as I simply need to fine tune this skill rather than re-learn it.

Moving forward I am excited to apply these steps to improve my performance as a Chiropractic

student. I am convinced that by placing emphasis on this technique now, it will help to refine my
skill performing cervical adjustments.

Reference list

 Bergmann, T., & Peterson, D. (2011). Chiropractic technique (p. 85). Korea: Elsevier Korea.
 Yeomans, S. (2020). Chiropractic Manipulation for the Cervical Spine. Retrieved 12
September 2020, from https://www.spine-health.com/treatment/chiropractic/chiropractic-
manipulation-cervical-spine