Soft Tissue-Thoracic

Question 1

Prone Pressure

Answer 1

• Patient: Prone
• Physician: Standing at side of table opposite the side to be treated
• Place thenar and hypothenar eminence on paravertebral muscles opposite the side you are standing
• Place other hand on top of hand contacting the muscles
• Keeping your elbows straight and using your own body weight, engage soft tissues with a ventral force and move out laterally to induce a perpendicular stretch
• Repeat by repositioning hands on different levels of the thoracic spine

Question 2

Prone Pressure with Counterpressure

Answer 2

• Patient: Prone
• Physician: Side of the table
• Place thumb and thenar eminence of caudad hand over the thoracic paravertebral muscles opposite the side you are standing
• Place hypothenar eminence of cephalad hand on paravertebral muscles on the same side you are standing
• Engage tissues with a ventral force and then move the hands in the direction in which the fingers are pointing, creating a longitudinal stretch

Question 3

Subscapular Stretch

Answer 3

• Patient: Prone
• Physician: Standing at side to be treated
• Take patient’s arm, on the side being treated, and place it behind their back
• Place fingers around medial border of scapula
• Engage the tissue upward and laterally, pulling scapula away from rib cage

Question 4

Upper Thoracic with Shoulder Block, Lateral Recumbent

Answer 4

• Patient: Lateral recumbent with side to be treated up
• Physician: Standing at side of table facing patient
• Caudad hand passes under patient’s arm and contacts paravertebral muscles
• Cephalad hand contacts anterior portion of shoulder to give counterforce. -Drape patient’s arm over your arm.
• With both hands, engage soft tissues ventrally and move out laterally to create a perpendicular stretch

Question 5

Lower Thoracic Under the Shoulder, Lateral Recumbent

Answer 5

• Patient: Lateral recumbent with side to be treated up
• Physician: Standing at side of table facing patient
• Forearms contacting the axilla and iliac crest, fingers contact medial aspect of the erector spinae
• Elbows spread apart, elongating distance between the shoulder and the hip
• Engage muscle with ventral force and move out laterally to give perpendicular stretch

Question 6

Paraspinal Inhibitory Technique

Answer 6

• Patient: Supine or Prone
• Physician: Standing on side being treated
• Place finger pads over the paraspinal tissues
• Apply gentle, firm pressure to engage tissue for 30-60 seconds or until release occurs