4/1/2019

An Introduction to Upper Cervical

Overview
Technique (Hole-in-One) *

By
John Hart, DC, MHSc
Private Practice
Greenville, South Carolina

* Adapted from the author’s presentation on this topic at Image from: easynotecards.com
the National Subluxation Conference, held at Life-West
Chiropractic College, Dec 7-8, 2002

1 2

• Early text: Palmer BJ. Subluxation

Specific, Adjustment Specific. The
• Introduced as a technique In 1930 by B.J.
Palmer Palmer School of Chiropractic.
• First called hole-in-one (HIO) Davenport, IA. 1934.
• 1946 re-named upper cervical specific (1).
Reference

1. A new era for PSC. International Review of

Chiropractic. February 1956, p. 4.

3 4

Later text books More recent publications

• Remier PA. Modern X-ray Practice and Spinography. • Bolton PS, Bolton SP. Acute cervical torticollis and Palmer upper
The Palmer School of Chiropractic. Davenport, IA, cervical specific technique: a report of three cases. Chiropractic
1957, pp. 312-378. Journal of Australia 1996;26(3):89-93. and
• Amalu W, Tiscareno LH. HIO: old problems, new solutions.
• Remier PA. System of spinographic analysis. In: Palmer
Today's Chiropractic 1997;26(6):24-34).
BJ. Answers. W.B. Conkey Co. Hammond, Indiana.
• Hyman C. The Upper Cervical Technique. Enchantment
1952, pp. 1-25.
Publishing. 1996.
• Remier PA. Spinographic analysis. International Review • Strazewski J. The Essentials of Toggle Recoil. 1998.
of Chiropractic (ICA). February 1955, pp. 7-8, 32.
• Remier PA. Analysing the axis and atlas. International
Review of Chiropractic (ICA). August 1955, pp. 6-10, 29.

5 6

1
 4/1/2019

Analysis Adjustment

• Paraspinal thermal pattern analysis • Consists of toggle-recoil

• Leg length inequality assessment • Side-posture
• Upper cervical x-ray • Knee-chest position.

7 8

History

9 10
Courtesy Palmer College Archives

Video of BJ Palmer providing UC care:

https://www.youtube.com/watch?v=1zfZM3QpGY8

Courtesy Palmer College Archives 11 12

2
 4/1/2019

13 14

Courtesy Palmer College Archives

Courtesy Palmer College Archives

15 16

Courtesy Palmer College Archives Courtesy Palmer College Archives

17 18

3
 4/1/2019

19 20

Analysis: Instrumentation

21 22

The first chiropractic

temperature instrument –
the neurocalometer,
1924, PSC.

Courtesy Palmer College Archives

23 From: myovision.com 24

4
 4/1/2019

Chirometer

Conclusion: This study found a poor correlation between the AFTD and
the laterality of the atlas misalignment seen on the Blair radiograph.

25 26

Courtesy Palmer College Archives

27 28

From pickclick.ca 29 30

5
 4/1/2019

Analagraph
Nervoscope

31 32

Oct 1988
Tytron

F: 92.5 – 92.3 = 0.2

C: 33.6 – 33.5 = 0.1

F: 92.5 – 92.2 = 0.3

C: 33.6 – 33.4 = 0.2 From: http://chiropractorvictoria.com/wp-content/uploads/2011/05/thermal-scan-on-
patient1.jpg
33 34

From Hart et al, JCCA 2007 35

From Hart et al, JCCA 2007 36

6
 4/1/2019

J. Vertebral Subluxation Res., 3(4), 1999-2000

37 38

39 From Hart et al, JCCA 2007 40

JCCA 2015; 59(2)

41 42

7
 4/1/2019

43 44

Annals of Vertebral Subluxation Research

45 46

47 48

8
 4/1/2019

Thermofocus Analysis: X-ray

• AP open mouth
• Base posterior
• Lateral neutral

49 50

Atlas 12 Atlas listings

• Compared to occipital condyles
ASL ASLA ASLP
• Lateral view: Tilt ASR ASRA ASRP
• A-P Open Mouth view: Mainly for laterality AIL AILA AILP
and secondarily for rotation
AIR AIRA AIRP
• Base Posterior view: Mainly for rotation and
secondarily for laterality

51 52

Axis 14 Axis listings

• Also compared to the occiput condyles ESL ESR
BPSL BPSR
• A-P Open Mouth view: Laterality, noting SPBL SPBR
position of dens and spinous ESL-SL ESR-SR
ESL-BL ESR-BR
• Lateral neutral: Anteriority – posteriority CPBL CPBR
relative to C3 PLI PRI

53 54

9
 4/1/2019

Lateral cervical neutral set-up

Courtesy John Strazewski, SC, M.S.Ed Courtesy John Strazewski, SC, M.S.Ed
The Essentials of Toggle Recoil, 2015 The Essentials of Toggle Recoil, 2015
55 56

From Hart, JVSR 2006

J. Vertebral Subluxation Res. Oct. 25, 2006

57 58

A-P Open Mouth X-ray Set-Up

L
Courtesy John Strazewski, SC, M.S.Ed
From Wikipedia.com The Essentials of Toggle Recoil, 2015
59 60

10
 4/1/2019

Courtesy John Strazewski, SC, M.S.Ed

61 The Essentials of Toggle Recoil, 2015 62

From Hart, in
JMPT 2004

Courtesy John Strazewski, SC, M.S.Ed

63 64
The Essentials of Toggle Recoil, 2015

From Hart, JVSR 2006

L
65 From sunshinethroughlaughter.com 66

11
 4/1/2019

Nasium

From Hart
in JVSR 2006

L
From radiopedia.com 67 68

Base Posterior X-ray Set-Up

Courtesy John Strazewski, SC, M.S.Ed Courtesy John Strazewski, SC, M.S.Ed
The Essentials of Toggle Recoil, 2015 69 The Essentials of Toggle Recoil, 2015 70

Courtesy John Strazewski, SC, M.S.Ed

The Essentials of Toggle Recoil, 2015

Courtesy John Strazewski, SC, M.S.Ed

71 The Essentials of Toggle Recoil, 2015 72

12
 4/1/2019

From Hart, JVSR 2006

73 74

Vertex
Nasium

75 76

Adjustment
• Toggle-recoil
• Side-posture
Adjustment • Knee-chest position

77 78

13
 4/1/2019

Courtesy John Strazewski, SC, M.S.Ed Courtesy John Strazewski, SC, M.S.Ed
The Essentials of Toggle Recoil, 2015 The Essentials of Toggle Recoil, 2015

79 80

Courtesy John Strazewski, SC, M.S.Ed

The Essentials of Toggle Recoil, 2015
Courtesy John Strazewski, SC, M.S.Ed
81 82
The Essentials of Toggle Recoil, 2015

HIO Research

Courtesy John Strazewski, SC, M.S.Ed

The Essentials of Toggle Recoil, 2015
83 84

14
 4/1/2019

85 86

87 88

ACUTE CERVICAL TORTICOLLIS AND

PALMER UPPER CERVICAL SPECIFIC
TECHNIQUE: A REPORT OF THREE
CASES
Chiropr J Aust: Sep 1996(26:3): 89-93
By Drs. Bolton & Bolton

89 90

15
 4/1/2019

Chiropractic care in the treatment of

asthma

By LZ Killinger, DC

Palmer Jnl Res. 1995 Sep;2(3):74-77

Journal of Vertebral Subluxation Research

91 92

93 94

Some of the speaker’s related

literature and research

Annals of Vertebral Subluxation Research. March 3, 2014

95 96

16
 4/1/2019

97 98

99 100

101 102

17
 4/1/2019

JOURNAL OF VERTEBRAL SUBLUXATION RESEARCH, VOL. 1, NO. 4, 1997

103 104

105 106

Thank you for your attention !

Speaker's email: jhartdc@yahoo.com

Hart JF. Manipulation-induced subluxation and
associated cardiac arrhythmia. Digest of
Chiropractic Economics 1991(33:1) 68-69.

107 108

18