Source: www.acofp.org/member_publications/0904_1.html
MUSCLE ENERGY, UPPER THORACIC SPINE
Standing Structural Examination Step-by-Step Technique Directions
Dysfunction: T3 extended, side bent left, and rotated left. This technique may be used on the upper thoracics either flexed or extended.
Objective: Increase the flexion, side bending right and rotation right of T3 on T4.
Patient Position: Seated
Physician Position: Standing behind the patient.
Procedure:
Place the middle finger of your left hand between the spinous processes of T3-T4; index finger is between T2 and T3, and the third finger is between T4 and T5.
Place your right hand on top of the patient’s head to passively produce flexion, right side bending, and right rotation of T3 to engage the barrier.
Direct the patient to extend the lower cervical and upper thoracic areas to include T3. Offer a counter force equal to the patient’s force.
Maintain the forces long enough to sense the patient’s contractile force at the localized segment
Direct the patient to gently cease the directive force while simultaneously ceasing your counter force.
Wait 2 seconds for the tissues to relax, and then take up the slack to engage the new barrier.
Repeat until the best possible increase of motion is obtained.
For flexed dysfunctions, passively extend the patient’s head and neck down to the segment you are treating.
With your hand on the patient’s forehead, instruct the patient to flex against your holding force.
Tuesday, November 22, 2005
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