Using the same adjusting hand as for the Heel Contact, place the middle of the ulnar edge of the fifth metacarpal bone in contact with the spinous process. If the vertebra be superior, place the edge of hand _above_, if inferior, place the hand _below_. This contact is especially good for S or I vertebrae. Position of Hands and Arms The fingers of adjusting hand cross the spine at a right angle to its long axis. The back of hand will be toward patient’s head except in adjusting the last two Lumbars, with which a change of hands is made necessary by the upward slant of the lower half of the Lumbar curve. The palpating hand now grips the adjusting hand so that the fingers of the upper hand, held close together, press against and reinforce the lower on its dorsum and just above the contact point. The thumbs are hooked together as shown in Fig. 27, so that the hands may be stiffened and their tendency to roll avoided. The elbows are outrotated and locked as in the Pisiform Double Transverse Move and both shoulders are loosened. Movement This is chiefly delivered with the upper arm, using upper hand to drive the lower. Force should be quickly delivered when patient is relaxed. The direction of force should be determined by the direction of subluxation and by the slant of the spinous process. Thus, when patient lies prone upon a bifid bench and sways downward against a lax abdominal support, the spinous processes of the lower dorsal make an acute angle with the plane of the floor. If one be superior, contact above it and force driven straight toward the floor will tend to correct the subluxation. There is a slightly different force angle for every subluxation correctable by this move. This move is less painful than the pisiform contact and may often be used to advantage, especially in the Lumbar region. LUMBAR SINGLE TRANSVERSE For the correction of a rotated Lumbar. Best used on second and third. This movement should never be attempted unless the transverse process can be palpated. Lumbar transverses are sometimes short or fragile, and unless they can be distinctly felt no force should be applied where they are _believed_ to lie. Contact Pisiform bone with posterior transverse. [Illustration: Fig. 28. Lumbar single transverse move.] Palpation and Placing of Hands Palpating as if for other movements, pause with the second finger of palpating hand indicating the spinous process of the vertebra to be moved. Note that if the spinous process be to the right of the median line the left transverse will be posterior, if to the left, the right transverse.