Clinic Entrance - Gonstead

Front 1

Base Posterior (sacrum)

Back 1

3 findings:
1) Misalignment is superior/posterior
2) Edematous triangle on the sacral base
3) Gluteal pain
Pt Position: side posture in any side
Dr Stance: face Pt @ 45
Dr Fingers: 45 away from
Dr Contact Hand: inferior
Dr Contact point: pisiform
Pt Segmental Contact: Sacral base (1st sacral
tubercle)
Tissue Pull: I

Front 2

PL/PR
PI-L/PI-R
(Involved side up)

Back 2

(sacrum)
Pt Positon: Involved side up
Dr Stance: face Pt @ 45
Dr Contact Hand: inferior
Dr Fingers: 90 towards table (away from Dr) fingers down
straight to avoid PSIS. Tips to floor
Dr Contact point: pisiform
Pt Segmental Contact: sacral ala (b/t 2nd tubercle & PSIS)
Tissue Pull: M

Front 3

PL/PR
PI-L/PI-R
(Involved side down)

Back 3

(sacrum)
Pt Positon: involved side down
Dr Stance: face Pt @ 45
Dr Contact Hand: inferior
Dr Fingers: 0 or parallel to spine. Fingers across
spine. Elbow out more
Dr Contact point: pisiform
Pt Segmental Contact: sacral ala, b/t 2nd tubercle &
PSIS
Tissue Pull: M

Front 4

PL/PR
PI-l/PI-R
Thenar Alternative

Back 4

(involved side is always up)
(sacrum)
Pt Positon: involve side is always up
Dr Stance: face Pt @45
Dr Contact Hand: inferior
Dr Fingers: 45 away from Dr
Dr Contact point: thenar eminence
Pt Segmental Contact: sacral ala, b/t 2nd tubercle &
PSIS
Tissue Pull: M

Front 5

PI (L/R)

Back 5

(Ilium)
3 findings:
1) X-ray: Longer femur head, obturator foramen is longer diagonally,
increased lumber lordosis
2) + derefield test, seated/standing gillet, lat. flex (w/thumb on top of
PSIS)
3) Static palpation-edema
Pt Positon: side posture, push move
Dr Stance: face Pt @ 45
Dr Stabilization: superior hand traction top-front shoulder
Dr Contact Hand: inferior
Dr Fingers: point up the spine
Dr Contact point: pisiform
Pt Segmental Contact: inferior border of PSIS
Tissue Pull: I

Front 6

PIIn

Back 6

(Ilium)
Pt Positon: involve side up
Dr Stance: face Pt @ 45
Dr Stabilization: superior hand traction top-front shoulder
Dr Contact Hand: inferior
Dr Fingers: point 45towards Dr.
Dr Contact point: pisiform
Pt Segmental Contact: inferior-medial PSIS
Tissue Pull: I

Front 7

In

Back 7

(Ilium)
3 findings:
1) Pt w/ external toe flare “toe out”
2) Groin pain
3) Obturator foramen more narrow, increase width of ilium
Pt Positon: involve side up
Dr Stance: face Pt @ 45
Dr Stabilization: superior hand traction top-front shoulder
Dr Contact Hand: inferior
Dr Fingers: point 90 towards Dr
Dr Contact point: pisiform
Pt Segmental Contact: medial PSIS
Tissue Pull: M

Front 8

ASIn

Back 8

(ilium)
3 findings:
1) Pain on medial knee, coccyx pain
2) acetabular pain
3) DJD on x-ray
Pt Positon: involve side up
Dr Stance: face Pt @ 45
Dr Stablilization: superior hand traction top-front shoulder
Dr Contact Hand: inferior
Dr Fingers: point 45 towards Dr
Dr Contact point: pisiform
Pt Segmental Contact: acetabular ridge
Tissue Pull: S

Front 9

AS

Back 9

(ilium)
3 findings:
1) High gluteal fold
2) Pt prone to hamstring strains/pull
3) Decrease lumber lordosis, obturator foramen decreases, short femur
head
Pt Positon: involve side up
Dr Stance: face Pt @ 45
Dr Stabilization: superior hand traction top-front
shoulder
Dr Contact Hand: inferior
Dr Fingers: point 15 towards Dr
Dr Contact point: pisiform
Pt Segmental Contact: acetabular ridge
Tissue Pull: S

Front 10

Ex

Back 10

(Ilium)
3 findings:
1) Pt w/ internal toe flare-“toe in”
2) Heel pain/Achilles tendon pain
3) Decrease width of ilium, obturator foramen increase width @ base
Pt Positon: involve side down
Dr Stance: Dr inferior leg parallel to Pt flexed top leg
Dr Stabilization: superior hand traction top-front
shoulder
Dr Contact Hand: inferior
Dr Contact point: fingers w/ pisiform
Pt Segmental Contact: lateral border of PSIS
Tissue Pull: L

Front 11

Ex-In

Back 11

(Ilium)
Pt Positon: Ex side down
Dr Stance: Dr inferior leg parallel to Pt flexed top leg
Dr Stabilization: superior hand traction top-front
shoulder
Dr Contact Hand: inferior
Dr Contact point: fingers w/ pisiform
Pt Segmental Contact: lateral PSIS on Ex side
medial PSIS on In side
Tissue Pull: L

Front 12

PIEx

Back 12

(Ilium)
3 findings:
1) Pain in lateral heel
2) low iliac crest, short leg on involve side
Pt Positon: involve side (PIEx) down
Dr Stance: Dr inferior leg parallel to Pt flexed top leg
Dr Stabilization: superior hand traction top-front
shoulder
Dr Contact Hand: inferior
Dr Contact point: fingers w/ pisiform
Pt Segmental Contact: inferior-lateral border of PSIS
Tissue Pull: L

Front 13

ASEx

Back 13

(Ilium)
Pt Positon: involve side (ASEx) down
Dr Stance: Dr inferior leg parallel to Pt flexed top leg
Dr Stabilization: superior hand traction top-front
shoulder
Dr Contact Hand: inferior
Dr Contact point: fingers w/ pisiform
Pt Segmental Contact: acetabular ridge
Tissue Pull: L

Front 14

PL/PR
PLS/PRS

Back 14

Pisi push, Simple Listing
(Lumber)
3 findings for L5 disc:
1) Motion visualization: common pain when going from sitting to
standing
2) Static visualization: edema in the sacrum
3) Static palp: edema, tenderness, muscle spasm
4) Motion palp: fixation on extension
5) Go-Scope: spikes in go-scope
6) X-ray: break in george’s line
Pt Positon: SP up
Dr Stance: facing Pt
Dr Contact Hand & Contact Point: inferior pisiform
Dr Fingers: 45 away from Dr
Pt Segmental Contact: lateral-posterior tip of SP
Tissue Pull: L

Front 15

PL-m/PR-m
PLI-m/PRI-m

Back 15

Pisi push, Rotatory Listing
(Lumber)
Pt Positon: SP down
Dr Stance: facing Pt
Dr Contact Hand & Contact Point: inferior pisiform
Dr Fingers: 0 or parallel to spine
Pt Segmental Contact: mamillary process
Tissue Pull: M

Front 16

P
PL/PR
PLS/PRS
Finger-Pull
(Lumber)

Back 16

Pt Positon: SP down
Dr Stance: facing Pt
Dr Contact Hand: inferior
Dr Contact point: “the claw”
Pt Segmental Contact: lateral-posterior tip of SP & oppo. mamillary
w/ rat hole
Tissue Pull: L

Front 17

P
PL-m/PR-m
PLI-m/PRI-m
Finger-Pull
(Lumber)

Back 17

Pt Positon: SP down
Dr Stance: facing Pt
Dr Contact Hand: inferior
Dr Contact point: “the claw”
Pt Segmental Contact: lateral-posterior tip of SP & oppo. mamillary
w/ rat hole
Tissue Pull: M

Front 18

PRI-sp

Back 18

( L-5 special listing)
Pt Position: L side down
Dr Stance: facing Pt
Dr Contact Hand and Contact point: Inferior pisiform
Dr Fingers: 45 away from Dr
Pt Segmental Contact: R inferior tip of SP
Tissue Pull: L

Front 19

PLI-sp

Back 19

( L-5 special listing)
Pt Position: R side down
Dr Stance: facing Pt
Dr Contact Hand and Contact point: Inferior pisiform
Dr Fingers: 45 away from Dr
Pt Segmental Contact: L inferior tip of SP
Tissue Pull: L

Front 20

PRS-m

Back 20

( L-5 special listing)
Pt Position: R side down
Dr Stance: facing Pt
Dr Contact Hand and Contact point: Inferior pisiform
Dr Fingers: parallel to the spine
Pt Segmental Contact: L mamillary contact
Tissue Pull: M

Front 21

PLS-m

Back 21

( L-5 special listing)
Pt Position: L side down
Dr Stance: facing Pt
Dr Contact Hand and Contact point: Inferior pisiform
Dr Fingers: parallel to the spine
Pt Segmental Contact: R mamillary
Tissue Pull: M

Front 22

A-L/A-R

Back 22

(coccyx)
3 findings:
1) Hurts when sitting down, hurts to palpate, no motion finding
2) Broken/fx bone
Pt postion: prone
Dr stance: stand on side of laterality
Dr contact: cornu
LOD: P

Front 23

(occiput)
AS
AS-RS
AS-RS-RA
AS-RS-RP
AS-LS
AS-LS-LA
AS-LS-LP

Back 23

Pt Position: Pt seated on cervical chair. A condyle block is used to
stabilize cervical spine.
Dr Position: Standing behind Pt w/ feet parallel to Pt’s pelvis & stand
midline to Pt
Tissue Pull: the direction of correction
Dr Contact Pt: soft pisi of side of laterality
Segmental Contact Pt: The Glabella
LOD: the thrust is made S

Front 24

(occiput)
PS
PS-RS
PS-RS-RA
PS-RS-RP
PS-LS
PS-LS-LA
PS-LS-LP

Back 24

Pt Position: Pt is seated in cervical chair
Dr Position: stand behind Pt on side of laterality
Tissue pull: I

Front 25

(Atlas)
AIL/AIR
AILA/AIRA
AILP/AIRP

Back 25

Pt Position: Pt seated in cervical chair. The strap goes over the stabilizing
shoulder.
Dr Position: stand behind Pt to side of laterality
Tissue Pull: thumb contact from the mastoid to the contact on the atlas.
Dr Contact Point: hand is flat & horizontal, w/ the thumb held tight to the palm.
Contact is w/ the distal-lateral-palmer tip of the thumb.
Segmental Contact Point: lateral tip of C1 TP
LOD: the thrust is made L

Front 26

(Atlas)
ASL/ASR
ASLA/ASRA
ASLP/ASRP

Back 26

Pt Position: Pt seated in cervical chair. The strap goes over the stabilizing
shoulder.
Dr Position: stand behind Pt to side of laterality
Tissue Pull: thumb contact from the mastoid to the contact of Atlas
Dr Contact Point: hand is flat & horizontal, w/ thumb held tight to the palm.
Contact is the distal-lateral-palmer tip of the thumb
Segmental Contact Point: the lateral tip of C1
LOD: the thrust is made L

Front 27

PL/PR
PLS/PRS
(C2-C7)

Back 27

Pt Position: Pt seated on cervical Chair. Strap is over the stabilizing
shoulder
Dr Position: stand behind Pt to side of Laterality- L/R
Tissue Pull: I

Front 28

PLI-l /PRI-l
(C2-C7)

Back 28

Pt Position: Pt seated on cervical Chair. Strap is over the stabilizing
shoulder
Dr Position: stand behind Pt to side of Laterality- L/R
Tissue Pull: I

Front 29

PL/PR
PLS/PRS

Back 29

(Single-Hand, double thumb, double thenar, single thumb contact for
thoracic)
Pt Position: Prone on the knee-chest table
Dr Position: stand to side of laterality
Tissue Pull: depends on side of laterality, if “R”: R

Front 30

PL-t/PR-t
PLI-t/PRI-t

Back 30

(Single-Hand, double thumb, double thenar, single thumb contact for
thoracic)
Pt Position: prone on Knee chest table
Dr Position: stand on side of SP laterality, reached across to other side & contact
TP.
Tissue Pull: depends on side of laterality, if “R”: R