Activator Method 1

ACTIVATOR METHOD BASIC SCAN - 2024

The entire Activator Method of analysis relies on a series of legs checks.

WHERE TO START THE ACTIVATOR ANALYSIS:

INITIAL LEG CHECK FOR POSSIBILITY 1, 2, 3

The first thing the Activator doctor wants to know is which of the three possible starting points is the

patient today. This is called the initial leg check and it is based on the leg check in position #1 (P#1)

where the legs are extended on the table and position #2 (P#2) where the legs are flexed at the knees to

no more than 90 degrees.

On the initial leg check if one sees a functional short leg (not an anatomical short leg), this is called the

Pelvic Deficient leg (PD leg), meaning the pelvis has moved in a direction to make one leg appear short.

When both legs are flexed to no more than 90 degrees (P#2) the examiner can determine if the PD leg

relatively lengthened or stayed just as short or shorter compared to P#1. The PD leg is also the reactive

leg.

If the PD leg is short in P#1 and relatively lengthens in P#2, this is called

Possibility 1

. The examiner

would start the Activator analysis by testing the medial and lateral knees for a subluxation.

If the PD leg is short in P#1 and in P#2 it stayed just as short or shorter, then this is called

Possibility 2

The examiner would start the Activator analysis by testing L4 for a subluxation.

If the legs are even in P#1 and even in P#2, this is called

Possibility 3

and the examiner would start the

Activator analysis by testing the pubic bone.

PATIENT PLACEMENT

To determine the prone leg length the Activator Method way requires a strict and specific way to place

the patient on the table.

The procedure of placing the patient prone will be explained and demonstrated in the lecture and lab.

POSITION #1 (P#1)

The patient first lays prone on the Activator table with their arms by their sides and the back of the

hands touching the table.

The examiner first simply looks at the prone legs in P#1 without touching the feet or legs. Look for

Inversion (pronation) or eversion (supination)

Toe in or toe out

If you wish to bring the legs/feet closer to each other, cup the lateral malleoli and bring the legs

together. This the only Activator approved way to bring the legs closer together.

Place a hand on each ankle/foot. The hands in a Six-Point Landing

Index fingers posterior to lateral malleoli (do NOT touch the Achilles tendon)

Middle fingers anterior to the lateral malleoli

Thumbs placed on the heel of the shoe.

Remove inversion/eversion

Gently remove any plantarflexion of the feet so the bottom of the feet is perpendicular to the floor

Flare the feet 10 degrees

Apply gentle headward pressure without moving the patient headward and the face paper doesn’t make

a sound

Look at the welt of the shoe (where the leather of the upper shoe meets the rubber of the heel) to

determine the PD leg

Remove the hands from the patient’s feet before moving to P#2

POSITION #2

Use the middle fingers to contact the dorsum of the foot at the metatarsal-phalangeal junction

Slowly lift the legs by raising the feet and flexing the knees to no more than 90 degrees (be careful the

feet do not touch each other through the whole procedure)

At 30 degrees, place the thumbs on the soles of the shoes on or near the ball of the feet and at 60

degrees place the index finger into the outer (lateral) welt of the shoe

When the knees are flexed to no more than 90 degrees, keep the feet a mirror image to each other.

Ideally the feet should be parallel to the floor, but never force the ankles/feet into this position. if the

examiner is tall, angle the feet to see better

Remove inversion/eversion

Flare feet 10 degrees and keep the heels from touching

Site an imaginary line from S2 to the EOP

Look at the medial welt of the heels to determine the relative length of the PD leg in P#2. Now you can

determine which Possibility the patient is.

If the PD leg is short in P#1 and relatively lengthens in P#2, then the patient is Possibility 1 and

start the analysis by testing the knees/feet

If the PD leg is short in P#1 and stays as short or shorter in P#2, then the patient is Possibility 2

and start the analysis by testing L4

If the legs are even in P#1 and P#2, then the patient is Possibility 3 and start the analysis by

testing the pubic bone

POSSIBILITY 1

Possibility 1 (PD short in P#1 and relatively lengthens in P#2) is the most common Possibility.

Possibility 1 is comprised of three components that need to be tested. The goal of the first and second

components are to test and adjust as necessary until the legs are even or near even in P#1 and P#2.

First component: Test the medial and lateral knees to determine if they are subluxated and need to be

adjusted. If the PD leg remains short in P#1, then test the second component.

Second component: Test the AS ilium and PI ilium to determine if they are subluxated and need to be

adjusted.

Third component: Once the legs are even or near even in P#1 and P#2, test the pubic bone to determine

if it is subluxated and needs to be adjusted.

First component: Start Possibility 1 by Pressure Testing the knees.

PRESSURE TESTS

are used when the

legs are uneven

POSSIBILITY 1 – COMPONENT 1; KNEES/FEET

Activator Adjusting Instrument (AAI) settings when adjusting a knee/foot – AAI 4 or 5 setting 2; AAI 2

setting is 3 rings.

MEDIAL KNEE: Pressure Test each medial knee individually. To Pressure Test the medial knee apply

pressure over the medial collateral ligament in an inferior-lateral (S to I and M to L) direction. If the PD

leg becomes more even to the opposite leg (OPD leg) then you need to adjust the following.

first adjust the medial aspect of the talus with a LOD posterior, superior and lateral (A to P, I to S

and M to L).

then adjust on the medial collateral ligament with a LOD inferior-lateral (S to I and M to L).

LATERAL KNEE: Pressure Test each lateral knee individually. To Pressure Test the lateral knee apply

pressure over the lateral collateral ligament in an inferior-medial (S to I and L to M) direction. If the PD

leg becomes more even to the opposite leg (OPD leg) then you need to;

first adjust the cuboid with a LOD posterior, superior and medial (A to P, I to S and L to M).

then adjust on the lateral collateral ligament with a LOD inferior-medial (S to I and L to M).

Activator Methods International recommends the following order for testing the knees:

PD medial knee, OPD (opposite PD medial knee, PD lateral knee, OPD lateral knee

If after adjusting a medial and/or lateral knee the PD leg again shortens, this indicates there is another

subluxation present at either a medial or lateral knee you have not Pressure Tested yet, or there is an

AS ilium and/or a PI ilium subluxation.

NOTE: Having to adjust the above Basic Scan knee/feet for subluxations are not common, but if present

it is very important to adjust as it will help stabilize the pelvis.

After Pressure Testing and adjusting as necessary the first component (knee/feet) if the legs are not

even in P#1 and P#2, then proceed to the second component of Possibility 1 – Pressure Testing for AS

ilium and PI ilium. But if after Pressure Testing and adjusting as necessary for the knees, if the legs are

even in P#1 and P#2, then skip the pelvis and go the third component – the pubic bone.

POSSIBILITY 1- COMPONENT 2: PELVIS – AS ILIUM AND PI ILIUM

INSTRUMENT SETTINGS FOR PELVIS: AAI 4 OR 5 – SETTING 4, AAI 2 – 6 RINGS

After Pressure Testing and adjusting as necessary the knees, if the legs are still uneven then Activator

Method International recommends Pressure Testing the AS ilium

before

Pressure Testing the PI ilium.

AS ILIUM: The AS ilium is always on the OPD side.

PRESSURE TESTING AS ILIUM: Place your hand or knife edge on the OPD crest of the ilium and Pressure

Test in an inferior-medial (S to I and L to M).

One of four things will happen

If after Pressure Testing the AS ilium the PD leg remains short, then the AS ilium is not

subluxated. Now Pressure Test the PI ilium on the PD side.

If after Pressure Testing the AS ilium the PD leg becomes more even with the OPD leg, then

a subluxation is present and adjust the following Contact Points (CP)

CP 1 – ½ inch lateral to S1 tubercle on the OPD side. LOD: anterior-inferior (P to A and S

to I)

CP 2 – 1 inch superior to the PSIS on the iliac crest on OPD side. LOD: inferior-medial (S

to I and L to M) (parallel to the SI joint)

CP 3 –

superio

r aspect of ischial tuberosity on OPD side. LOD: anterior-inferior (P to A

and S to I)

If after adjusting the AS ilium, if the PD leg again shortens, then you must Pressure Test for a

PI ilium on the PD side.

If after adjusting the AS ilium the legs are even in P#1 and P#2, then skip the PI ilium

Pressure Test and go the third component – the pubic bone.

PI ILIUM: If the PD leg is again short or remains short, then Pressure Test for a PI ilium on the PD side.

PRESSURE TESTING PI ILIUM: Use your thumb and place it under the sacrotuberous ligament and

Pressure Test posterior, superior and lateral (A to P, I to S and M to L). The PD leg will become more

even with the OPD leg, meaning there is a PI ilium subluxation. Adjust the following Contact Points (CP)

CP 1 – ischial spine on PD side.

LOD: posterior-superior-lateral (A to P, I to S and M to L)

CP 2 – under sacrotuberous ligament. LOD: posterior-superior-lateral (A to P, I to S and M to L)

CP 3 – iliac fossa, on the gluteus medius muscle. LOD: anterior-superior (P to A and I to S)

Now the legs should be even or very close to being even in P#1 and P#2 and you are ready to test the

third component of Possibility 1 – the pubic bone Isolation Tes