Thoracic

Question 1

How do you diagnose thoracic spine SD?

Answer 1

TAT:

• Look for assymetry
• Palpate for Tissue texture abnormalities/tenderness

PTP evaluation:

Find hard end feel starting at T1-T12

TONGO = Type One Neutral Grouped Opposite Direction

Type 2 = Flexed/Extended, Single Segment, Same Direction

Question 2

How do you do a Direct Treatment for Upper Thoracic SD?

Answer 2

MET

Upper Thoracic = T1-T4

TYPE 1:

• Have patient seated
• Examiner sitting at their side with one hand monitoring the TP one segment below
• Place other hand on head and induce Rotation and Sidebending into the Restrictive barrier (opposite to diagnosis
• Have pt resist force for 3-5 seconds
• Find new barrier
• Repeat 2 more times
• Return to neutral
• Reassess TAT

TYPE 2:
- Same as Type, but add Flexion/Extension component

Question 3

How do you do an Direct Treatment for Lower Thoracic SD?

Answer 3

MET

Lower Thoracic = T5-T12

TYPE 1:

• Have pt seated
• Have pt grasp their neck with Ipsilateral hand to the PTP
• Examiner sitting at their side monitoring TP at the APEX of the group
• Other hand is on the Pt’s bicep ipsilateral to side of PTP by passing it beneath opposite arm first

Type 1 - Pass on top of 1 arm

• Move pt into restrictive barrier (Rotation and Sidebending)
• Have pt resist force into restrictive barrier for 3-5 seconds
• Find new barrier
• Repeat 2 more times
• Return to neutral
• Reassess TAT

TYPE 2:
- Same as Type 1, but Pass non-monitoring arm over BOTH biceps

Question 4

How do you do an Indirect treatment for Upper and Lower Thoracic SD?

Answer 4

Perform Thoracic Prone Pressure MFR

“Feel hypertonicity in paraspinal muscles”

• Pt is prone
• Doc standing opposite side of dysfunction
• Place hands on paraspinal muscles
• Provide gentle ventral and lateral force using body weight
• Induce Perpendicular stretch repeat along the thoracic spine