Medicine wheels were constructed by laying stones in a particular pattern on the ground. Most medicine wheels follow the basic pattern of having a center cairn of stones, and surrounding that would be an outer ring of stones, then there would be “spokes”, or lines of rocks, coming out the cairn.
Almost all medicine wheels would have at least two of the three elements mentioned above (the center cairn, the outer ring, and the spokes), but beyond that there were many variations on this basic design, and every wheel found has been unique and has had its own style and eccentricities.
The most common deviation between different wheels are the spokes. There is no set number of spokes for a medicine wheel to have. The spokes within each wheel are rarely evenly spaced out, or even all the same length. Some medicine wheels will have one particular spoke that’s significantly longer than the rest, suggesting something important about the direction it points.