Soft Tissue-Lumbar

Question 1

Lumbar Prone Pressure

Answer 1

Patient: Prone

Physician: Standing at side of the table opposite the side being treated

• Place thenar and hypothenar eminence of one hand on patient’s lumbar paravertebral muscle on side opposite you
• Place other hand’s thenar eminence over the other hand
• Keep elbows straight and exert a gentle ventral and lateral force using your body weight to induce a perpendicular stretch
• Repeat the above steps along the lumbar spine

Question 2

Lumbar Prone Pressure with Counterleverage

Answer 2

Patient: Prone

Physician: Stand at side of table opposite the side being treated

• Thenar eminence of cephalad hand contacts paravertebral muscles on the side opposite you
• Caudad hand gently grasps patient’s ASIS on the side opposite of you. Gently lift it towards the ceiling in order to create the counter leverage
• Cephalad hand will engage tissues ventrally and move out laterally creating a perpendicular stretch
• Repeat by repositioning caudad hand along the paravertebral lumbar musculature

Question 3

Lumbar Paraspinal Perpendicular Stretch

Answer 3

Patient: Lateral recumbent position with side to be treated up

Physician: At side of table facing patient

• Reach over patient’s back and place finger pads on the paravertebral muscles
• Engage tissues with a ventral and lateral force to create a perpendicular stretch

Modification: This stretch can also be performed by bracing the ASIS with the caudad hand and inducing a ventral stretch with the cephalad hand