Webster

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Websters Technique

• Dr. Larry Webster

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 Websters Technique

• Also known as
• Webster's In-Utero Constraint Technique
• Webster's Breech Turning Technique
• Developed in 1978
• Chiropractic technique gt Intrauterine constraint

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Intrauterine Constraint

• any forces external to the developing fetus
  that obstructs the normal movement of the fetus
• Ohm (2000), ICPA

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Intrauterine Constraint

• May prevent the baby from moving into a vertex
  position
• Breech C-section

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Websters Technique

• Classically, used when the baby has not moved
  into a vertex position by 34 weeks
• increased baby size
• decreased fluid

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• Why wait until something has gone wrong?

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Clinically...

• Doctors report that patients monitored throughout
  their pregnancy dont have as many breech
  presentations

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Research...

• If you wait until 34 weeks, not 100 successful
• 82-92
• re-call bias, retrospective studies
• Many DCs have begun to start monitoring
  Websters in the 7th month

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Websters Technique

• Patient lies prone (neutral posture)
• Flex both heals to buttocks feeling for side of
  higher resistance
• stand square to the patient
• can close eyes
• Clinical Note may not be accurate if the
  patient has had knee surgery

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Websters Technique

• According to Dr. Websters work...
• The side of increased resistance is the side of
  posterior sacral rotation
• so, increased resistance on the right indicates a
  P-R sacrum

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Websters Technique

• Correct the posterior sacral subluxation
• tension of the drop should be set at its
  lightest
• Dr. Webster did not recommend side posture

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• Chiropractors have reported success using
• prone Diversified
• Gonstead side-posture
• Thompson drop adjusting
• Activator
• SOT
• It seems that the important thing is to correct
  the side of posterior sacral rotation...

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Websters Technique

• Recheck legs for equalization of resistance
• Once the legs are balanced...
• Patient lies supine
• Palpate to find the trigger point on the side
  opposite the sacral posteriority
• if adjusted P-R, soft tissue work on the left

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Websters Technique

• From the ASIS, draw a line 45 degrees
  inferior-medially and from the umbilicus, draw a
  line 45 degrees inferior-laterally
• Where the two lines bisect should be the trigger
  point of the rectus abdominus
• overlying the broad ligament of the uterus

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Websters Technique

• Using light pressure (3-6 oz.) hold an I-S
  contact over the trigger point
• this is usually tender for the patient
• Rotate your thumb 5 degrees in either direction
  (challenge the tissue) and feel which direction
  the tension is felt

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Websters Technique

• Hold that contact for
• 1-2 minutes
• Feel for the hypertonicity to relax
• melt under your contact

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STOP!

• Do NOT adjust any additional segments that day
• Perform Websters every 2-3 days
• other segments can be adjusted on days in between
• It may take multiple visits before the baby
  shifts positions

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Conditions that might prevent the fetus from
turning

• Oligohydramnios
• Placenta previa
• Short umbilical cord
• Twins
• Uterine anomolies
• bicornate uterus

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References

• Anrig Plaugher. Pediatric Chiropractic.
  Baltimore, MD Lippincott Williams Wilkins,
  1998.
• Anrig-Howe C. Scientific Ramifications for
  Providing Pre-natal and Neonate Chiropractic
  Care. The American Chiropractor, 1993 May/June
  20-26.
• Fallon. Textbook on Chiropractic and Pregnancy.
  Arlington, VA International Chiropractors
  Association, 1994.
• Forrester J. Chiropractic Management of Third
  Trimester In-utero Constraint. Canadian
  Chiropractor, 1997 2(3) 8-13.
• Fysh. Chiropractic Care for the Pediatric
  Patient. Arlington VA ICACCP, 2002.
• Kunau P. Application of the Webster In-utero
  Constraint Technique A Case Series. Journal of
  Clinical Chiropractic Pediatrics, 1998 3(1)
  211-6.
• McMullen M. Assessing upper Cervical
  Subluxations in Infants Under Six Months. ICA
  International Review of Chiropractic, 1990
  March/April 39-41
• Pistoles R. The Webster Technique A Chiropractic
  Technique with Obstetric Implications. JMPT,
  2002 25(6).
• Webster L. Chiropractic Care During Pregnancy.
  Todays Chiropractic, 1982 Sept/Oct 20-22.