Here we shall describe the fundamental types of contact, contact points and their options, securing the contact hand and direction of drive. The type of contact used in applying a chiropractic adjustment is optional in most situations. The broadest contact that is efficient should be used, because the force will be directed through a larger surface area. For example, a force applied by a fairly open palm against the skin is perceived by the patient far differently than a force applied by a pointed finger against the skin. There are times, however, when a pisiform or thumb contract on a spinous process is necessary to get the job done quickly and efficiently.
All contact points are optional at some time.
Thus, the choice of selecting a transverse process, a spinous process or a lamina contact is a matter of clinical judgment. A mobilizing force directed against any of these structures will induce articular separation, tissue stretching, and the effected segmental motion, although one contact may be more efficient and less painful to the patient than another, depending on the situation at hand. Most classic adjustive technics apply contact on the spinous process or transverse process for greater leverage. Whenever possible, a laminal contact would allow the force to be directed against the strongest aspect of the posterior portion of the vertebra. Some leverage is lost with a laminal contact, but added safety is gained.