Practical 2/19 Flashcards
HVLA Lumbar Walk Around
Take it where it does NOT want to go in all directions
HVLA Lumbar- On side
Pt on side DYSFUNCTION DOWN Palpate posterior component and interspinous space below dysfunction Flex hips and knees to level Top leg over .....
HVLA Thoracic- Lateral Curve
Pt seated hands clasped behind neck
Reach into concavity across their chest
Sidebend thru axilla
Keep ischial tuber-sixties on table at all times
Hell of hand over transverse process of apex
Walk around until barrier
HVLA forward and medial thru hand (rotation of spine)
LAS Lumbar- Iliolumbar Ligaments
Lateral Recumbent Ligamentous Release
Pt lateral recumbent w DYSFUNCTION UP
Doc stands at lower thorax facing pt feet
Pad of thumb contacts ILL (medial and superior to PSIS, btw L4-L5)
Press anterior to contact ligament
Press anterior and inferior until release
ME Lumbar Walk around
Single Plane and Combined
For extended dysfunctions in thoracolumbar junction
Ischial tuber-sixties in contact w table always
Rotation and Sidebending treated separately or Combined
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MFR Lumbar- Prone Traction Direct
Heel of head hand on sacral base
Palm of other hand on spinous process of L5
Engage tissue and distract
Do NOT increase lordosis
Deep sustained pressure 5-10 sec
Breathe deeply and relax
Maintain pressure over sacrum and do other levels
ME Thoracic- Lateral Group Curve
Pt seated hands clasped behind neck
Reach across chest into concavity
Grasp convexity side shoulder (heel over costotransverse apex)
Sidebend by up thru axilla and down thru hand
Maintain firm pressure on apex (de-rotates)
Do NOT engage flexion/extension
Correct sidebending OR rotation via Muscle Energy
MFR- Popliteal Spread
Knee bent 90 deg
Thumbs contact anterior tibia
Direct fascial stretch prying apart popliteal space
Load and hold, wait for release
MFR- Supine Leg Traction
Both legs 20-30 deg Lean backward into slight traction (In/Ex)ternal Rotation (Ab/Ad)duction Direct into barrier and hold 10-60 sec Repeat opposite direction
MFR Thoracic- Bilateral Thoracic Inlet
Thumbs- posterior transverse process T2 and head of 2nd rib Index- sternoclavicular joint Middle- 2nd rib Ring and Pinky- btw clavicle and 1st rib Palm rests on apex of thoracic inlet Go either indirect or direct or Still Wait for release or have pt breathe deep 3x Follow release thru exhalations
ART- Spencer Technique
Pt lying on side, Dysfunction up
Stabilize clavicle and scapula, other hand induces motion (6-8x)
Extend (you want ice cream)
Flex (I want ice cream)
Circumduct (both directions, little cone)
Traction Circumduct (gradually increase size, both directions, big cone)
Abduction (should we fly there)
Internal Rotation (who’s gonna pay)
Traction stretch (lean back, let’s just take it)
HVLA- Anterior Radial Head
Grasp pt hand (shaking hands)
Other hand fingers contact olecranon
Thumb in AC, posterior pressure to radial head
Pronate and flex forearm and wrist
Rapid flex elbow w posterior thrust of radial head
HVLA- Poserior Radial Head
Grasp pt hand w your same hand, Stabilize wrist
Thumb applies anterior pressure to posterior radial head
Maintain anterior pressure, pronation, and elbow flexed
Corrective: fluid supination and extension
Just before complete extension HVLA thru thumb anteriorly
HVLA- Abducted Ulna
Pt hand dysfunction hand in your opposite axilla
Maintain supination
Dorsal middle phalanx of index contacts olecranon
Lateral thumb BELOW AC fossa
Medial thumb ABOVE
Just out of full extension
Laterally translate thru index fingers
Move distal forearm medially into barrier
Pt leans back to slight traction
HVLA increase in ADduction
HVLA- Adducted Ulna
Pt hand dysfunction hand in your opposite axilla
Maintain supination
Dorsal middle phalanx of index contacts olecranon
Lateral thumb ABOVE AC fossa
Medial thumb BELOW
Just out of full extension
Medially translate w index fingers
Move distal forearm laterally into barrier
Pt leans back to slight traction
HVLA increase ABduction
