Patient Care Plan for the Pelvis

By: Wayne Henry Zemelka, DC

Needless to say, the pelvis is one of the main areas that we need to be cognizant about. Throughout you will find references made by Drs. Barge, Gonstead, Logan, and others concerning the proper alignment of the pelvic girdle to restore or hold the integrity of the spinal column (Fig. 1).

Figure 1. Pelvic adjustment.

Figure 1. Pelvic adjustment.

Getting the “Drop” on Misalignments

Having said that, I will add another name to the list of early Chiropractors. Dr. Clay Thompson introduced a method of adjusting that would be easier on the doctor and the patient. Drop mechanisms were added to the table in the early 1950s. This allowed the individual pieces to be controlled by cocking them for the specific area being adjusted, adding a slight “drop” to the table, thus making it easier in adjusting the Pelvis, Lumbar, Dorsal, and Cervical Regions.

Hundreds of people who have attended one or more of my seminars put on by Foot Levelers ask various questions about the pelvis. I’m finding they want to do hands on, but without the reflective force they feel in their wrists, elbows, and shoulders when adjusting. And I have to mention their backs and legs—which usually happens to us as we get older.

Adjustment Procedures

Adjusting the pelvis is quite easy when utilizing a Segmental Drop Table (Fig. 2), even when the patient weighs more than you. Keep in mind that proper Line of Drive (LOD) and Line of Correction (LOC) are important in the segmental drop table when doing the Thompson Technique. This Part 2 of the Negative Derifield has the doctor’s body over the Ileoinguinal Ligament, the Segmental Contact Point (SCP) of the left hand, the Contact Point (CP) thenar, and showing how this is all coming together with a torqueing of the contact hand and the stabilization of the right hand on the front of the leg to hold the other side of the pelvis stable.

Figure 2. Segmental drop table.

Figure 2. Segmental drop table.

I talk about people having an awareness of where they are as they prepare to do the thrust. It’s what is called “Situational Awareness” for the doctor, and knowing what position he or she is in, and the position of the patient at that moment in time with respect to the adjustive thrust and to where it is to be administered. Line of Correction and Line of Drive are but one part of the equation. The accomplishment of the adjustment is a combination of all the things we have laid out for you in this article.

The adaptation of the adjusting process (onto a table that has the capability of initiating a drop characteristic to add to the adjustive thrust) was novel at the time in the late forties and early fifties. There is another view to add to the operation taking into consideration the angle of the “Facets” of the vertebral units. By placing the patient on the table in a position (prone) that allows access to the motor units, we can now adjust more specifically the intended structure at the point of the subluxation (Fig. 3).

Now you are able to utilize the drop segments on the table to enhance the adjustments that may be used to remove or change the position of the vertebral unit. This affects not only the structure (bones) but also improves the capability for the movement of the muscles, resulting in improved motion for the body.

Figure 3. Accessing the motor units.

Figure 3. Accessing the motor units.

Lower Extremity Involvement

A major part that we also need to consider is to bring into focus what happens in the pelvic region when the legs are not functioning, to stabilize the muscular and structural parts that make up the feet, legs, and pelvic area. There must be a plan for you, the doctor, to recognize when the differences creating the initial instability of the pelvis point to the feet or knees as possible culprits.

So, what do you do? For one thing use the Postural Stability Indicator™ (PSI) Card to determine variations in the arches of both feet. I use the PSI card on the very first visit. I want to know right from the start if there may be a problem that contributes to instability of the patient. Do X-rays in the event there is some structural degeneration contributing to the problem. Most likely, the patient will need to be fitted for a pair of Foot Levelers functional orthotics that will help in establishing a stable basis for your patient.

Once we have taken into account all that is needed for the initial Patient Plan, be sure to have the patient do recommended exercises routinely. That means every day. I have found that when patients exercise regularly, they don’t need me to adjust them as much. It’s a happy day when patients are making appointments on their own and have been doing everything right – and they know what it’s like to feel well.

[For a free pack of Foot Levelers’ PSI cards, call 1-800-553-4860 (from Canada: 1-800-344-4860).]