Chiropractor

Truro

Cornwall

Michael Gillingham

DOCTOR OF CHIROPRACTIC

        Book an appointment:

01872 264040

6 Ferris Town, Truro

TR1 3JG

                  GCC Registered    |    Royal College of Chiropractors’ Member    |    BCA Member

 

A Chiropractic Examination


A traditional chiropractic examination is based on assessment procedures that take into

consideration both functional and structural alterations to the neuromusculoskeletal system.

Following a ‘look, feel, move & special tests’ approach.


This can consist of, but not limited to:


Patient Observation

    - Gait Evaluation

    - Postural Evaluation

    - Leg Length Evaluation


Range of Motion Assessment


Palpation

    - Bony Palpation

    - Soft Tissue Palpation

    - Motion Palpation


Muscle Testing


Orthopaedic Testing                                                                                                         Click here to learn about Spine Anatomy





Scroll down to learn about the various aspects of a chiropractic examination





Patient Observation


Gait Evaluation


    Alignment and symmetry of the head, shoulders

    and trunk is assessed.


    Movements are assessed looking for reciprocal

    and equal amplitude of movement.





Postural Evaluation


    Posterior to anterior and lateral plumb line evaluation of spinal posture.


    Lateral View


    The gravitational line should pass:

        - Through the ear lobe

        - Just anterior to the shoulder joint

        - Through the midline of the thorax

        - Through the centre of L3 vertebral body

        - Through the greater trochanter

        - Just anterior to the midline of the knee joint

        - Just anterior to the lateral malleolus


    Posterior to Anterior View


    The gravitational line should pass:

        - Through the midline of the skull

        - Through the spinous processes

        - Through the gluteal crease

        - Midway between the knees

        - Midway between the ankles


    The following landmarks should be evaluated for unleveling or asymmetry:

        - Gluteal folds

        - Gluteal contours

        - Iliac crests

        - Posterior Superior Iliac Spines

        - Rib cage

        - Inferior angles of the scapula

        - Vertebral borders of the scapula

        - Acromioclavicular joints

        - Ear lobes


Leg Length Evaluation


    Anatomical leg length discrepancy (LLD)


    Biomechanical dysfunction in the lumbopelvic region can result from both a ‘true’ leg length

    discrepancy, or structural discrepancy, where the femur or tibia are actually different lengths.

    This kind of difference in leg length is usually congenital and many people have slight

    differences of half a millimetre to an inch. Other causes of structural leg length discrepancies

    include surgery, accidents, or fractures. These structural LLDs can be addressed through the

    use of lifts in the shoe. However, using heel lifts to correct a leg length discrepancy that is

    causing back pain is not always advisable unless the LLD is truly structural.


    Functional leg length discrepancy


    A functional leg length discrepancy is one where the bones are actually the same (or very similar) lengths but postural problems

    have caused one leg to appear longer (or shorter) than the other. Tight muscles in the back can lead to functional leg length

    discrepancies, as can improper rotation of the pelvis. An examples is where a tight right quadratus lumborum muscle pulls the

    right side of the iliac crest (the hip) upwards. When a patient with this phenomenon is lying down it would look like the right leg

    was shorter although the bones may very well be of a similar length.



Range of Motion Assessment


    Measurement of joint mobility is a critical element in the evaluation of joint function. Significant limitation and asymmetry of

    movement are considered to be evidence of impairment and improvement in regional mobility may be a valuable outcome

    measure for assessing effectiveness of treatment.


      Neck (Cervical Spine) ROM                                                 Back (Thoracic & Lumbar Spine) ROM













Palpation


    Palpatory procedures are commonly divided into static and motion components. Static palpation is performed with the patient in a

    static position. Motion palpation is performed during active and passive joint movement and also involves the evaluation of

    accessory joint movements.


    Static palpation assessment











   

   

    Motion palpation assessment


    Mid-thoracic left rotation           Mid-thoracic P-A Glide        Lumbar lateral flexion












    Joint movement is tested by assessing how two bony joint partners and their soft tissues move in relation to each other.



Muscle testing


    Tests for muscle length and strength are an integral part of the examination process.









Orthopaedic testing


    The major purpose of orthopaedic testing is to locate the anatomic site responsible for producing the patient’s pain.


       Slump test and straight leg raise