THORACIC VERTEBAE - there are 12, numbered from the top T1, T2 etc. Each has 2 transverse processes which are attached to their corresponding ribs. Each also has a spinous process in the centre which is the part that you can see down the centre of a person’s back. Each vertebra also has two attaching points to join to the vertebra above, and two more to join to the vertebra below. Person can lie face down or sit. Discrepancies are easier to see when the patient is sitting, however, adjustments are often easier for you to do when the person is lying down. Since it is trying and sometimes painful for the patient to get up and down, I try to do it in the position that is the more comfortable or relaxed for them.
  1. Check the transverse processes of T1.
  2. See if there is a twist (one side will stand proud).
  3. Adjust by squeezing in gently as the person breathes out.
  4. Check T2……and so on, to T12 where it is very narrow.
All these adjustments should be in consultation with the person. You need to know how they feel as you touch each vertebra. Tell them your findings and see how sensitive each one is before you do adjustments. Often pain is experienced on the vertebra above or below the one that needs to be adjusted. If you are finding it difficult to check for the twist and the patient is not feeling any improvement, check down the spinous processes (the centre of the spine) to see if they follow one below the other. When you touch the spinous process, the patient will feel if there is something wrong as it will feel extra sensitive. Having discovered this, you need to find the transverse processes of that vertebra which will be above it. (The transverse processes of the vertebra below will be parallel to the one you are touching.) Sometimes it helps to measure the part of the vertebra either side of the spinous process (superior articular process and the inferior articular facet) to be even more precise if this is needed. It is normally of little consequence if you know exactly which number vertebra you are checking, it is really only important that you and the person find the ones that need adjusting to relieve their pain or tension. Normally, correcting the twist is sufficient, but occasionally there is a tilt in a vertebra; if this is the case, there may be more than one to be adjusted as they may have moved with one another. As before, work with the person’s pain/sensitivity, especially by checking the spinous processes (in the centre.)
  1. Check the transverse processes to see if there is a tilt.
  2. Start with T1 and work down to T12.
  3. See if one is higher than the other (nearer the patient’s shoulders)
  4. Adjust by easing up the lower and down the higher.
  5. If you have difficulty, ask the patient to bend forward with a rounded back.
  6. Check the height of the ribs that attach to each side of that vertebra.
LUMBAR VERTEBRAE - between the lowest rib and the iliac crest. There are 5. The tranverse processes are much longer and are not attached to other bones. This appears to be a vulnerable part of the back as there are no ribs or pelvis to support it, however but the longer processes strengthen it considerably. When these vertebrae need adjusting, people often have pain in their sacrum, in their rib cage or even at the base of their neck. The person can either lie face down or sit.
  1. Check the transverse processes – these get wider and wider as you descend.
  2. Check for a twist.
  3. It is easier to find L5 and work up to L1 (L5 is slightly lower than the iliac crest).
  4. Adjust by pressing in the one that stands proud, let the person twist with you.
  5. If this is difficult, ask the person to bend forward to open up the gaps between a bit
    6. and press again.
  6. Check for a tilt.
  7. Adjust by pressing down and up appropriately.
  8. If this is difficult, try with the person bending forward, or on their hands and knees.
  9. As with most adjustments, immediate relief can be felt.

STERNUM, MANUBRIUM AND RIBS. The breast bone has the first seven ribs attached to it. The ribs are attached by costal cartilage. At the top, the manubrium is attached to the clavicles and the first ribs. Then the sternum is attached to the second, third, fourth, fifth, sixth and seventh ribs. The eighth, ninth and tenth ribs are attached with cartilage to the cartilage of the seventh rib. The eleventh and twelfth ribs are not attached in the front; they are called floating ribs. At the back, all the ribs are attached to the thoracic vertebrae. The first rib is attached to T1, the second rib to T2, and so on. They have two attachments : 1. to the body of the vertebra and 2. to the transverse process. To check the MANUBRIUM and STERNUM : The person sits, measure from the front.

  1. Check the points of the ends of the collar bones.
  2. Check the level of the top of the manubrium.
  3. Adjust by gently pushing down the side that is higher.
  4. Check below the ends of the collar bones and see if there is a twist.
  5. This is where the first rib joins the manubrium.
  6. Check each pair of ribs where they join onto the sternum down to the seventh.
  7. You now have a picture of any twist of the sternum and manubrium.
  8. Adjust appropriately.
  9. If necessary, bring the whole rib cage forward on the opposite side.
  10. If only one rib is awry, adjust that one only.
  RIBS. If the ribs have been corrected at both ends, they may sort themselves out, but not always. Sometimes the whole rib cage is lopsided . To measure this : The person sits or lies on their back or their front.
  1. Check the lowest ribs in the front, at the side and at the back to see if they are level.
  2. To adjust, put the higher side down and lower side up.
  3. Ask the patient to lean over sideways to help you to push the lower side up.
Occasionally, individual ribs are out of place. Person sits. Examine from behind to start with.
  1. Compare the heights of ribs at the sides of the body from the lowest to under the arms.
  2. Continue up the ribs in front.
  3. Adjustments can be made by pushing a rib up or down.
  4. If it is easier, ask the person to lie down on the side that does not need adjusting.
  5. Be aware that ribs may be odd because of past breaks.
Only usually adjust when there is discomfort. To check if one side of the rib cage is more forward than the other, the person lies on their back and it is clear to see, or you can look over their shoulders. Adjust in the sitting position or lying down, preferably with your hands spread out. Let them move with you and use the out-breath.   RESULTS TO EXPECT. Sometimes the bones do not seem to move. Sometimes they move a little. Rely on the person to tell you if they are in the position that is the most comfortable for them, or at least feeling better than before. They usually continue to feel easier over the next few days as the associated muscles relax. You need to explain this so that they know what to expect. During and after a session, I expect the pain to be less than when the session started, although it is unlikely to have disappeared completely; sometimes, however, people say it has vanished altogether.