Still's Technique Flashcards
Steps of Still’s technique
- Patient is passive throughout all procedures
- Diagnosis of the joint and position of ease are determined
- The joint gets moved into the position of ease (side of dysfunction), while monitoring the
joint = (Initial Tx position) - Position is slightly exaggerated, so the
relaxation will be increased - Traction or compression (approx. 5 lbs) force will be applied for a few seconds
- While maintaining force, articulate the joint
through neutral position and into the barrier
(into the restriction) = (Final Tx position) - Force and motion will often mobilize the
joint; may hear a “pop” or “click” - Forces are released and the joint/region is
brought back to neutral for reassessment
Clinical application of Still’s Technique - 7
- Hospitalized patient
- Any cardiac patient that may need treatment to visceral somatic levels
- Osteoporotic patient
- Scoliotic patient with or without Harrington rods
- In combination with any other modality
- As an alternative to HVLA
- For acute (i.e. sports injuries) or chronic somatic dysfunction
OA SD - example, doc’s point of contact, and direction of compression
F, RrSl (modified T2): (left) index or middle finger on OA on the (left) side of SB in OCCIPITAL SULCUS
-Compress through top of head.
AA SD - example, doc’s point of contact, and direction of compression
Rl: (left) index or middle finger on TRANSVERSE PROCESS of the ATLAS
-Compress through top of head.
Typical Cervical SD - example, doc’s point of contact, and direction of compression
C3 F RrSl: (left) index or middle finger on ARTICULAR PILLAR on side of rotation
Posterior rib SD - example, pt position, doc’s point of contact, and direction of compression
Left posterior rib 5 (exhalation dysfunction)
- pt seated
- Doc stands behind on (left) side of dysfunction; monitor @ POSTERIOR ANGLE with right thumb and left hand extend’s pts left shoulder –> ABD and arc across face
- Compression from elbow toward humeral head toward rib angle
What thoracic techniques is doc standing in front of seated pt? Behind?
In front - T3 (upper thoracics) type 2 SD; T1-9 type 1 SD
Behind - T1 for type 2 SD; T6 for type 2 SD
T1, type 2 SD - example, pt position, doc’s point of contact, and direction of compression
T1 F RlSl
- Pt seated
- Doc stands behind
- Doc contacts PTP of T1 with ipsilateral (left); contralateral (right) controls H/N
Upper thoracics, type 2 SD - example, pt position, doc’s point of contact, and direction of compression
T3 F RlSl - “Dance”
- Pt seated
- Doc stands in front with forearms on pt’s shoulders
- Doc’s index contacts PTP. Rotation induced by pushing ipsilateral shoulder posterior. F/E SB induced.
- Exaggerated compression on side of SB.
T6 thoracics, type 2 SD - example, pt position, doc’s point of contact, and direction of compression
T6 F RlSl
- Pt seated with ipsilateral hand holding contralateral shoulder
- Doc stands behind
- Doc’s ipsilateral (left) index contacts PTP. Place axilla on contralateral shoulder use contralateral hand to hold ipsilateral shoulder (forearm across shoulders)
- Compression with axilla and hand on shoulder
Thoracic group curve - example, pt position, doc’s point of contact, and direction of compression
T1-9 RrSl
- Pt seated
- Doc stands in front
- Doc contacts apex of curve on CONVEX side
- forearms on either shoulder
Extended Type 2 Lumbar SD - example, pt position, doc’s point of contact, and direction of compression
L3 E RlSl
- Pt supine
- Doc on side of PTP
- Cephalad (R) hand monitors while caudad (L) hand grasps ipsilateral knee
- Flex knee until motion felt at monitoring hand and then –> abd/ER
- Compress downward with caudad hand form knee through femur, directed at lumbar dysfunction
Flexion Type 2 Lumbar SD - example, pt position, doc’s point of contact, and direction of compression
L3 F RlSl
- Pt supine
- Doc on side of PTP
- Cephalad (R) hand monitors while caudad (L) Flex knee until motion felt at monitoring hand and then –>
- hold leg above ankle with caudad hand and move cephalad hand to bold knee –> add/IR
- Compress downward with caudad hand form knee through femur, directed at lumbar dysfunction
L1-5 type 1 SD - example, pt position, doc’s point of contact, and direction of compression
L1-5 RlSr
- Pt supine
- Doc OPPOSITE the PTP (on SB/concavity side) - right
- Cephalad (R) hand monitors while caudad (L) hand grasps ipsilateral knee
- Flex knee until motion felt at monitoring hand and then –> add/IR
- Compress downward with caudad hand form knee through femur, directed at lumbar dysfunction
Anterior innominate SD - pt position, doc’s point of contact, and direction of compression
Left anterior innominate
- Pt supine
- Doc on side of SD (left)
- Cephalad hand (R) monitors PSIS, caudad (L) hand grasps knee on SD-side
- aBD/ER
