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

Scroll down to learn about each aspect 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