Technique Toolbox: September 2010

John Minardi
August 31, 2010
Written by John Minardi
  TT1
  Picture 1. Webster Coronal Suture Analysis. Measure the hemi-cranium from the anterior fontanelle to the EOP.
  TT2
  Picture 2. Measure the hemi-cranium on the opposiste side
  TT3
  Picture 3. When the large hemi-cranium is on the same side as a low medial canthus, use a bilateral pinkie contact on both sides of the coronal suture.
  TT4
  Picture 4. Gently distract both contacts away from each other, througout the entire length of the coronal suture.

Sample Case
A few months ago, a husband and wife presented to the clinic with headaches and back pain respectively. Following a six-week regime of chiropractic adjustments to correct for subluxations that were detected upon examination, both husband and wife became pain-free. In the initial examination and report of findings with these patients, the doctor informed the couple that chiropractic care could certainly help alleviate their symptoms but it could also serve to optimize their health and well being, even after the pain dissipates. The couple were so pleased with the results of chiropractic care in relieving their respective complaints, that they were happy to continue with chiropractic care in order to optimize their health. On a subsequent visit, the couple inquisitively asked the chiropractor if their three year old son should have his spine checked, even though they indicated that their son seemed to be pain-free. The doctor pondered for a moment and then replied, “Well, if he seems fine, then he is probably OK and there’s no need to bring him in.”

Has this type of situation ever happened in your office? Have you ever assisted someone out of a pain, educated them on the importance of continued chiropractic care, only to overlook their child’s spine because the child was seemingly pain- free? Is this a congruent message being sent to the patient?

Avoiding mixed messages
Regardless of what your chiropractic philosophy is, your chiropractic treatment regime must be congruent with your philosophy, or you will always send mixed messages to your patients. For example, the chiropractic philosophy of certain individuals is to adjust a patient only when they are in pain. Therefore, they assess an individual who is in pain, treat the individual until they are pain- free, and then discharge the patient. If this is your philosophy, that is totally fine, because how you treat your patients is congruent with what you believe in. However, if your philosophy is to assess and adjust a patient regardless of whether symptoms are present or not, then you must carry that philosophy and treatment regime to all patients, regardless of age, in order to be congruent.

Allow me to share an example with you. I was recently contacted by a doctor who wanted to care for more children in his practice. I asked the doctor if he assessed many of the children of his existing patients. He replied that he did not, as they seemed to be “OK”. I asked him to clarify if “OK” meant that the children seemed pain-free. The doctor replied yes, the children were pain-free, so he did not assess them. I then followed up by asking if the doctor would adjust one of his existing patients, who did not have symptoms, provided that he found a subluxation in his assessment. The doctor quickly answered that he would, indeed. So I asked the doctor, why was his treatment philosophy different for a pain-free child. He did not have an answer for this. Furthermore, he realized that his treatment philosophy was not congruent for everyone in his practice, and was probably the biggest reason that he was not seeing more kids. When a doctor’s message is not congruent with his/her actions, patients become confused.

In our sample case, I would indicate to the couple that it is extremely important to assess their child’s spine. I would explain that the assessment may indicate that the child is subluxation-free, and may not require any adjustments, but that I would need to perform a proper assessment in order to confirm this. I would further explain that the child may be symptom-free, but subluxations could still be present that would indicate the need for an adjustment to prevent problems later on.

In this edition of Technique Toolbox, I will discuss one such subluxation that can present without symptoms, namely a cranial subluxation, and will go on to discuss Webster’s Coronal Suture adjustment to correct for the subluxation.

History
The Webster coronal suture analysis and adjustment was developed by Dr. Larry Webster, as an assessment and correction of potential intra-cranial subluxations that may be present in a child. As founder of the International Chiropractic Pediatric Association (ICPA), Dr. Webster was a visionary, a technique developer and teacher, and was intensely passionate about conveying the necessity of chiropractic care for children. In the last years of his life, Dr. Webster became involved in supporting ongoing chiropractic research for children, a goal which has become a reality today, as the ICPA supports a large full-time pediatric research foundation.1

The technique
Step One – Cranial Analysis: (See Pictures 1 and 2)
  • Using a soft measuring tape, the doctor measures the hemi-cranium from the anterior fontanel to the external occipital protuberance. This is performed bilaterally.
  • Normally, the hemi-cranium measurements will be the same on both sides.
  • When a coronal suture subluxation is present, one hemi-cranium will measure larger than the other.
  • The doctor will then observe the presence of a low medial canthus, ipsilateral to the larger hemi-cranium measurement.
  • Dr. Webster found that when a low medial canthus and an enlarged hemi-cranium are ipsilateral, this indicates that a dysfunction is present at the ipsilateral coronal suture.
  • The coronal suture is an irregularly shaped suture located between the frontal and parietal bones. It is the irregularity of the suture that allows it to subluxate in an elevated position, resulting in an enlarged measurement of that hemi-cranium.
  • Step Two - Correction: Webster’s Coronal Suture Adjustment: (See Pictures 3 and 4)
  • Patient: Supine.
  • Doctor: Standing on either side.
  • Contact: Pinkie tips along the suture’s border.
  • LOC: Gentle distraction or scissor motion. Repeat three to four times.

The doctor should note that within a few minutes, the previously observed abnormalities will be markedly decreased.

As usual, I have only scratched the surface of pediatric cranial assessment and corrections. If you would like to learn more about chiropractic care for children, please go to www.icpa4kids.com. And, remember, what we believe in and how we practice should always be congruent. It will eliminate confusion with patients, and ultimately, provide you with a more fulfilling practice. If you have any comments, please contact me at This e-mail address is being protected from spambots. You need JavaScript enabled to view it . Until next time…adjust with confidence. •

References:
  1. http://www.icpa4kids.com/about/LarryWebster.htm

Dr. John Minardi is a 2001 graduate of Canadian Memorial Chiropractic College. A Thompson-certified practitioner and instructor, he is the creator of the Thompson Technique Seminar Series and author of The Complete Thompson Textbook – Minardi Integrated Systems. In addition to his busy lecture schedule, Dr. Minardi operates a successful private practice in Oakville, Ontario. E-mail This e-mail address is being protected from spambots. You need JavaScript enabled to view it , or visit www.ThompsonChiropracticTechnique.com .

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