GONSTEAD

PRONE
ADJUSTMENTS
KNEE CHEST and
PELVIC TABLE

PATIENT PROTOCOL FOR KNEE

CHEST:
GETTING ON
1) One foot forward to the side of lower platform.
2) Kneel on opposite knee.
3) Bring other knee on platform.
4) When balanced, grasp chest support with either hand.
5) Bring hand and chest on the slotted support.
6) Bring both hands over hand rest for complete relaxation.
GETTING OFF
1) Pushing away from chest support.
2) When balanced on knees, place one foot to the side.
3) With forward leg push up to raise and stand on both feet.

DOCTOR’S CONTACT HAND:

1) Ask patient to drop their belly and relax (some times you can ask the patient to lift their
bottom up to the ceiling). Never thrust into resistance.
2) Thrust: body drop + arm extension, quick, controlled depth, torque to close the wedge if
any, set & hold 2 ‘’

SP CONTACTS:
Soft Pisiform contact: Dr. on side of spinous laterality, fingers at 45º,facing patient
at 90º.
Double Thumb contact: for very small SP; C3, C4, C5, or T10, T11, T12, L5 on small person,
children…
 Dr. 45º cephalad (fencer), slightly behind vertebra to adjust. Distal phalanges of thumbs
over SP on top of each other. A very quick thrust with both thumbs simultaneously and HOLD.
In case of cervicals, fingers are wrapped around the trapezius muscles.

TVP CONTACTS:
Soft Pisiform contact: facing patient at 90º.
 Dr. on side of SP laterality: fingers at 45º
 Dr. opposite side of SP laterality: fingers // to spine
Pisiform-Thumb contact: for deep TVP processes; T9, T10, T12
Doctor facing patient at 90º on side of SP laterality, thumb of inferior hand contacts the TVP with
remaining fingers wrapping around thorax. Pisiform tops the thumb’s distal phalanx. Thrust is
given by both the pisiform and the thumb. This allows deeper and more specific adjustment.

Double Thenar contact: Dr. 45º cephalad (fencer),slightly behind vertebra to adjust. Dr. Stands on TVP
side, shoulders // to patient’s shoulders, first thenar placed over the TVP, thumbs // to the spine and
remaining fingers wrapping thorax, then other thenar is placed the same way. No thrust is given with the
stabilization hand unless there is a straight P-A listing.

MAMMILARY CONTACTS:
Soft Pisiform contact:
 Dr. on side of SP laterality: fingers at 45º
 Dr. on opposite side of SP laterality: fingers // to spine

Double Thenar contact: Dr. 45º cephalad (fencer), slightly behind vertebra to adjust. Dr. Stands on
Mammilary side, shoulders // to patient’s shoulders, first thenar placed over the Mammilary, thumbs //
to the spine and remaining fingers resting over the skin, then the other Thenar is placed. No thrust is
made with the stabilization hand. Torque is performed when needed with contact hand.
LAMINA CONTACTS:
Soft Pisiform contact with slight forearm supination: Dr. on side of SP laterality; P-A & medialward
thrust, torque to close the wedge.(C7, C6)

Double Thumb contact: Dr. 45º cephalad (fencer), slightly behind vertebra to adjust. Dr. Stands on
lamina side, shoulders // to patient’s shoulders. Contact thumb is placed over the lamina,
stabilization thumb is placed over the opposite lamina, the fingers resting over the trapezius. No thrust is
made with the stabilization hand. Torque is performed when needed with contact hand.

A double lamina contact can be used to adjust a spinous listing, in this case, the thrust is made by
both thumbs on both lamina simultaneously. This thrust needs to be very quick, since it doesn’t have the
same leverage as a direct spinous contact. Thrust and hold.

ATLAS PRONE ADJUSTING:

Patient positioning:

1). Patient positioned as usual for Knee-Chest, but can be done on hilo prone.

2). Patient turns head towards side of Atlas laterality.

3). Hand on side of laterality resting on the headpiece.

Doctor’s positioning:

4). Doctor in fencer stance on side of laterality

5). Palpation with inferior hand, Thumb over anterior TVP.

 6). Pisiform of Sup. Hand over thumb, remove thumb.

7). Stabilization Hand over wrist of contact hand.

8). Adapt angle of Forearm to match with LOC required.

ASLA/AILA:
LOC: Inf. & Post., Episternal notch 2-3 inch Ant. to External Accoustic Meatus

- ASLA (CCW torque)

- AILA (CW torque)

ASLP/AILP:
LOC: Inf. & Post., Episternal notch above to EAM

- ASLP (CCW torque)

- AILP (CW torque)

For ASL LISTINGS the sitting position is to be preferred