Adjusting Children Differs from Adjusting Adults


By Dr. Cynthia Horner

One could look at children’s spines as a miniature version of an adult’s spine, but there are some differences in how I assess and adjust children as to adults.

I perform a spinal assessment to look for early signs of instability in the nervous systems.  Most children who come to me do not have pain, or muscle spasms. This is because problems in motor (movement) show up before sensory (pain). Early signs of motor function show up as:

  • Weak, tight muscles
  • Postural distortions, one shoulder or hip higher, a foot flare, or altered walking gait
  • Balance problems when balance is challenged
  • Coordination problems when coordination is challenged
  • Inability to track smoothly with the eyes


Once I assess where the nervous system is unstable I begin to adjust. Adjusting the feet has the mildest effect on the brain, so I usually begin there, to avoid overstimulation.  Adjusting consists of short, quick movements of the joints by gentle pulling or pushing.  I do not adjust the child’s feet because a foot bone is misaligned but to generate a mild stimulus through their nervous system to their brain to change the frequency of firing of groups of nerve cells that work together.

Changing the frequency of firing of nerve cells stabilizes the cell membrane creating a healthier cell. When groups of nerve cells fire together they wire together and this increases speed of brain activity. Increased wiring is a good thing. Sometimes my intent is to create excitation or increase the input from brain to body, other times to create inhibition or a calming of a particular pathway to the body. I continue adjusting with the fingers, wrist, and elbow. Once the brain has received this sensory (touch) and motor (movement) stimulation from the extremities I begin adjusting the spine.

Adults may have experienced a popping noise as their spine was adjusted. This noise is created as air is released from the sealed joint capsule. Because children’s vertebrae are mostly flexible cartilage and the bands of tissue called ligaments that hold vertebrae together are very pliable a noise is not heard when adjusting infants and children three years and under.  With adults I use the side and heel of my hands to produce movement of a vertebrae, with children I use my index finger. My finger is smaller, less forceful and quicker. 

I often use a device called the Webster Child Toggle Piece to adjust children’s cervical or neck vertebrae. I wear it around my neck and it rests on my upper chest. The child’s ear is placed against the soft cushion of the toggle piece, which is set with a lever to pop up. With my finger (often my pinky) on the child’s neck vertebra I press lightly and the toggle piece releases about a half and inch creating a little give. This a much like a drop piece on a chiropractic table. At times I stand toddlers on my table and lift them up with my one arm under their arm pits and as their spine stretches and opens from head to tail I use my finger to adjust a vertebra in their mid-back.