19/08/2019 Foot Levelers Education Resource Center | The Sacral Adjustment on the Segmental Drop Table

The Sacral Adjustment on the Segmental Drop Table

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Adjustment on the Segmental Drop Table

The Sacral Adjustment on the Segmental Drop Table

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By: Wayne Henry Zemelka, DC

(http://www.footlevelerseducation.com/wp-
content/uploads/2015/09/se222-Zemelka-sacral-
adjustment-segment-Fig-1.jpg)It is important to
understand that the Sacral Analysis or “Leg Lift” is an
integral part of the second phase of the Deri eld-
Thompson analysis system. The Protocol must be
adhered to in that the Sacral Analysis is done after
adjustment of the ndings of the LLI (Leg Length
Inequality) tests, including the cervical syndrome and
bilateral cervical syndrome.

As an example: If you nd a Negative Deri eld with a

Cervical Syndrome, adjustment of the cervical syndrome
is rst, followed by a post leg check to see if the pelvic
subluxation is cleared. If so, then proceed to the Sacral
Analysis to check if the adjustment cleared the Ilio-Sacral problem. Never ever bypass the negative or
positive Deri eld to go direct to the sacral leg raiser (Z’s rule 201).

The Apex of the sacrum is the subluxations reference point to determine which side is the segmental
contact point (SCP). Thompson always used the sacral apex, while others referred to the base of the
sacrum. Both were right, and the only difference is the methodology used in accomplishing the adjusting
procedure.
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19/08/2019 Foot Levelers Education Resource Center | The Sacral Adjustment on the Segmental Drop Table

(http://www.footlevelerseducation.com/wp-
content/uploads/2015/09/se222-Zemelka-sacral-
adjustment-segment-Fig-2.jpg)Analysis
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With the patient in the prone position have the patient
lock the knee and raise each leg one at a time,
comparing the height that is achieved by each leg
(keeping in mind that any difference is indicative of
imbalance in the pelvis). The patient should be
instructed to not raise the pelvis off the table, and the
doctor should hold down the sacral base with his/her
superior hand with the ngers pointing toward the feet
(as noted in Fig. 1).

You will be comparing how high the patient raises each

leg and noting the difference (Fig. 2). A variation as little as one inch is indicative of an imbalance and
should be adjusted. The Sacral Apex always points to the leg that comes up the highest and is adjusted
towards the involved leg, which does not come up as high (Fig. 3). The doctor notes the effort and ease
demonstrated by the patient in doing the test. Restriction to movement is indicative of a problem existing
and generally correlates to the sacral subluxations. After the adjustment the patient is able to raise the
legs to the same height with ease.

(http://www.footlevelerseducation.com/wp-
content/uploads/2015/09/se222-Zemelka-sacral-
adjustment-segment-Fig-3.jpg)Adjustment

The best way to adjust the sacral apex is to stand

superior and on the side to which the apex points. If you
have an elevation table such as the Lloyd 900HS it will
be easier to not have to lean over to accomplish this
move. Place the pisiform along side of the sacral apex
with the stabilization hand contacting the PSIS on the
same side (Figs. 4 & 5). The involved leg is crossed over
the other leg to help open up the joint spaces on that
side. Thrust is lateral to medial three or four times along
a horizontal line with a slight torque and the drop of the
table.

Rationale

Interestingly enough, the sacrum (treated as a simple entity in this demonstration) is also involved with
subluxations in the –D and +D to some degree, and may contribute to other instability problems of the
spine, producing subluxations, lateral curvatures, scoliosis, and muscle imbalance. Keep in mind that
changes in the functionality of the joints of the pelvis—especially relating to the sacrum—contribute to the
instability of the entire spine, and more speci cally in the lumbar region.

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19/08/2019 Foot Levelers Education Resource Center | The Sacral Adjustment on the Segmental Drop Table

(http://www.footlevelerseducation.com/wp-
content/uploads/2015/09/se222-Zemelka-sacral-
adjustment-segment-Fig-4.jpg)A base posterior sacrum
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will also affect the leg raiser test, in that the patient
cannot raise either leg off the relaxer bar more than a
few inches. When this occurs consideration should be
given to the possibility of the base posterior as the prime
factor in restriction of movement in the pelvic region,
and that more than likely lumbar subluxations are
contributing to the problem of raising the legs. When this
condition presents itself then place the heel of the hand
over the base of the sacrum, and with an S to I motion
adjust the sacrum inferior ward following the plane line
of the 5L disc. (Note: Avoid contacting the spinous of the
4th and 5th Lumbar.)

If during the course of the leg raiser examination you note a bending of the knee, the possibility of lumbar
subluxations is likely. The bent knee is in response to a possible sciatic nerve involvement. Adjustment of
the lumbar subluxations should remove this problem and can be checked immediately by doing the leg
analysis again.

After adjusting the sacrum proceed to palpate and locate the lumbar subluxations and adjust where
necessary, and then do a post leg raiser examination. If the legs can be raised higher than the initial
examination, it shows that you have handled the problem in a proper manner. Follow-up on future visits is
recommended.

(http://www.footlevelerseducation.com/wp-
content/uploads/2015/09/se222-Zemelka-sacral-
adjustment-segment-Fig-5.jpg)Some base posterior
sacral problems may take several visits to clear, but if the
patient shows marked improvement at the onset, you
can be assured that continued monitoring and
conservative Chiropractic adjustments will be bene cial
for the patient.

When you have a condition such as a subluxation of the

Sacrum keep in mind that you should also have the
patient do some speci c exercises for the pelvis, to
include lying on his/her back and doing leg raisers with
a scissors motion, abdominal crunches, and bringing the
knees up to the chest while back lying.

Another cause of instability in the pelvic region that can affect the tilting of the sacrum is lack of support
to the arches of the feet. Such a lack contributes to the instability within the Kinetic Chain. Flat feet,
plastic deformation of the tendons of the arches (reducing the support for the arches), pronation, and—
above all—poorly tting shoes with poor support of the arches will contribute to this system deterioration.
If arch support is necessary, custom orthotics from a reliable orthotics lab should be recommended.

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19/08/2019 Foot Levelers Education Resource Center | The Sacral Adjustment on the Segmental Drop Table

Consider doing a complete lower extremity examination on your patient with these problems, especially
when you nd an ongoing problem of sacral instability. Incorporate an examination of the lower
extremities—especially the feet—and a gait study as you observe the patient walking down the hall. If you
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don’t have a hall, take him or her out to the parking lot. Who knows—this may attract new patients!

About the Author

Dr. Wayne Henry Zemelka is a 1975 graduate of Palmer College of Chiropractic. He was Faculty President
for six years in the 1980’s, during which time he built and operated the Media Production Department for
Television and Video and was instrumental in production of classroom instruction videos and operation of
the Printing Department. “Dr. Z” also taught in the Technique Department, Business Management and
Continuing Education. In 1997 he was elected once more as Faculty President. He retired from Palmer in
1998.

Dr. Zemelka, who is now regarded as the Thompson Technique Specialist, worked with Dr. Thompson for
years, beginning in the late Seventies. In early 1980 he convinced Dr. Thompson to make a video series
showing the analysis and adjusting techniques. This turned out to be a very good idea, and thus was born a
teaching concept that has brought the Thompson Technique to the forefront of Chiropractic adjusting
worldwide.

Dr. Zemelka presently operates the Zemelka Family Chiropractic Clinic on Lillie Avenue in Bettendorf, IA,
“next to but not in Simoniz Car Wash on Kimberly Road.” He writes for several national magazines and
journals, and recently nished production on a new Thompson Technique Video which can be seen in the
Palmer Library. His Thompson Manual is available from the Palmer Bookstore. Dr. Zemelka is Certi ed in
Video uoroscopy and is presently working on a video series of instructional tapes for the Chiropractic
profession.

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