Questionable Claims Made for Activator Methods (AM)
Samuel Homola, D.C.
Activator Methods Chiropractic Technique is a diagnostic and treatment system centered on the idea that leg-length analysis can determine when to adjust and when not to adjust the spine. Proponents claim that its procedures "generally enable the clinician to confidently and consistently identify subluxations." . Most chiropractic colleges offer an elective course, and the leading proponents sponsor weekend seminars throughout the United States.
In 1991, 51.2% of 4,835 full-time American chiropractors who responded to a survey by the National Board of Chiropractic Examiners (NBCE) said they used AM in their practice . Subsequent NBCE surveys found percentages of 40.7% in Canada (1992) , 72.7% in Australia (1993) , 54.3% in New Zealand (1993) , 62.8% in the United States (1998) , and 69.9% in the United States (2003) .
The claims made by AM's leaders are not modest. For several years, the Activator Methods Web site suggested that AM is a "program for total health" and:
- "By removing nerve interference with gentle adjustments, chiropractic allows you to enjoy optimal health without using drugs or surgery!"
- "By coming to our office for regular chiropractic care, you'll help your body stay healthy for years to come."
- "Regular spinal adjustments can become your body's line of defense against illness, disease, and pain."
The Web site's current message is softer but still overly suggestive:
You may think that chiropractic care is only for back and neck pain. The truth is, chiropractic care can benefit a wide variety of health problems that stem from the dysfunction of your spinal joints and nervous system. Everyday wear and tear, old injuries, and even stress can cause your vertebrae to lose their proper motion or position. Spinal joint dysfunction may be a source of irritation to your nervous system, causing pain and nerve interference throughout your body.
By correcting spinal joint dysfunction, chiropractic care helps your body heal itself. Now you and your whole family can experience the Activator Methods Chiropractic Technique difference! . . .
One of the unique features of the Activator Technique is that we can zero in on the exact area of the body that is causing your health problems .
The AM system is based on a concept of "pelvic deficiency (P.D.)"—also called "functional short leg"—which proponents define as an "apparent" difference in length, not an anatomical difference. To determine where the alleged problem is located, the practitioner holds the patient's feet in various prescribed ways while the patient lies facedown on an examining table. Other parts of the body may be tested in various other ways. If any inequality or "imbalance" is found, the practitioner taps various points along the spine, pelvis, and/or elsewhere with a handheld, spring-loaded mallet  until the legs appear to be equal in length. This approach is not a method of spinal manipulation. Slight variations of hip position or normal spinal muscle tension are probably responsible for the "imbalances." Despite this, the FDA has issued a 510k clearance for the Activator Adjusting Instrument for "chiropractic adjustment of the spine and extremities." 
Activator Methods thus piles one dubious concept upon another. Its leg-length tests have not been demonstrated to be reliable or to yield significant data. Nor is there any reason to believe that "pelvic deficiency" or its associated "subluxations" are pathologic conditions. Despite this, many AM practitioners tell their patients that use of an Activator mallet is a "state of the art" procedure that replaces the "old" method of manual spinal manipulation. Nothing could be further from the truth. Properly performed spinal manipulation, whether done by a physiatrist, an orthopedist, an osteopath, or a chiropractor, is always done manually. Only chiropractors use an Activator mallet. When I was in practice, I had a big problem with patients who had been convinced that their spine had tiny misalignments that required frequent correction with the tap of a mallet. Chiropractors who scare patients into believing that slight vertebral or pelvic misalignments are harmful to health are rendering a great disservice to their patients.
For Additional Information
- Fuhr AW. Activator Methods Chiropractic Technique. St. Louis: Mosby, 1997, p 92.
- Christenson MG, Morgan DRD. Job Analysis of Chiropractic: A Report, Survey Analysis, and Summary of the Practice of Chiropractic within the United States. Greeley, CO: National Board of Chiropractic Examiners, 1993.
- Christenson MG, Morgan DRD. Job Analysis of Chiropractic in Canada: A Report, Survey Analysis, and Summary of the Practice of Chiropractic within Canada. Greeley, CO: National Board of Chiropractic Examiners, 1993.
- Christenson MG, Morgan DRD. Job Analysis of Chiropractic in Australia and New Zealand: A Report, Survey Analysis, and Summary of the Practice of Chiropractic within Australia and New Zealand. Greeley, CO: National Board of Chiropractic Examiners, 1994.
- Christenson MG and others. Job Analysis of Chiropractic: A Project Report, Survey Analysis, and Summary of the Practice of Chiropractic within the United States. Greeley, CO: National Board of Chiropractic Examiners, 2000.
- Job Analysis of Chiropractic 2005: A Project Report, Survey Analysis, and Summary of the Practice of Chiropractic within the United States. Greeley, CO: National Board of Chiropractic Examiners, Jan 2005. (Chapter 10)
- Common conditions. Activator Methods Web site, accessed March 25, 2006.
- Keller TS, Fuhr AW. Chiropractic adjusting instrument. Patent No. 5,626,615, May 6, 1997.
- Witten CM. Letter to Arlan W, Fuhr, D.C., Jan 27, 1998. [Link to download PDF document]
About the Author
Dr. Homola, who lives in Panama City, Florida, retired in 1998 after practicing chiropractic for 43 years. His 12 books include Bonesetting, Chiropractic, and Cultism; Backache: Home Treatment and Prevention; and Muscle Training for Athletes. He has also written many articles for magazines and journals, ranging from Cosmopolitan and Scholastic Coach to Chiropractic Technique and Archives of Family Medicine. This article is adapted from Inside Chiropractic: A Patient's Guide (Prometheus Books, June 1999).
This article was revised on March 25, 2006.