12: HVLA Flashcards
HVLA definition
Technique employing a rapid, therapeutic force of brief duration that travels a short distance within the anatomic range of a joint that engages the restrictive barrier to elicit release of restriction
Force in HVLA
Not extreme or overpowering; use the minimum required for release of localized segment
When is HVLA most effective?
When there is a distinct barrier with a firm/hard end feel
Three benefits of HVLA
- Time efficient
- Well tolerated
- Immediate results
Most likely cause of the pop sound
Conversion of N gas in joint from liquid to gas by negative pressure
Seven steps in HVLA
- Diagnose SD
- Provide soft tissue preparation
- Localize forces to a segment or joint
- Accumulation of forces
- Release enhancing maneuver
- Corrective thrust
- Return to neutral and reassess
Examples of soft tissue preparation used before HVLA
MET, MFR, kneading, etc.
Two reasons to use soft tissue techniques before HVLA
- Relaxes and prepares physician
2. Relaxes patient, allowing more confidence + less risk of injury
How to stack restrictive barriers in HVLA
All three planes of motion are stacked to localize a joint - but dont stack restrictions in different joints
Typical release enhancing maneuver for HVLA
Patient exhalation
The corrective thrust
A short, rapid thrust in the direction of force of all vectors used for localization
Is the pop sound necessary?
No - it is not necessary for success of treatment, and it is not the goal of the treatment
How often can one thrust a segment?
Discouraged to thrust the same segment more than once a week
What can too frequent of treatment cause?
Hypermobility of segments
What to do if the same SD keeps recurring
Evaluate and address possible underlying inciting factors
Proportion of manipulative complications with HVLA and severe complications
Manipulative complications: 1 in 400,000
Severe complications: 1 in 1,000,000
Two motions to avoid in the C spine during HVLA
Hyperextension, excess rotation
Why should you not do upper cervical HVLA on patients with Down Syndrome and RA?
Alar ligament instability
