THORACIC MANIPULATION FOR NECK, SHOULDER AND THORACIC PAIN

THORACIC MANIPULATION FOR NECK, SHOULDER AND THORACIC PAIN

THORACIC MANIPULATION FOR NECK, SHOULDER AND THORACIC PAIN JAMES W. ATCHISON, DO REHABILITATION INSTITUTE OF CHICAGO CENTER FOR PAIN MANAGEMENT

MANIPULATION THE USE OF THE HANDS IN THE PATIENT MANAGEMENT PROCESS USING INSTRUCTIONS AND MANEUVERS TO MAINTAIN MAXIMAL,

PAINLESS MOVEMENT OF THE MUSCULOSKELETAL SYSTEM IN POSTURAL BALANCE. MANUAL MEDICINE

INCLUDES ALL FORMS OF MANUAL TREATMENTS AND TECHNIQUES A PART OF A

COMPREHENSIVE TREATMENT PLAN EMPHASIZES THE CONCEPT THAT MANUAL TREATMENT HAS A WIDESPREAD PHYSIOLOGIC AND PSYCHOLOGIC EFFECT

SOMATIC DYSFUNCTION IMPAIRED OR ALTERED FUNCTION OF RELATED COMPONENTS OF THE SOMATIC SYSTEM; SKELETAL, ARTHRODIAL, AND MYOFASCIAL STRUCTURES; AND RELATED VASCULAR, LYMPHATIC AND NEURAL ELEMENTS DETERMINED BY TENDERNESS

STRUCTURAL ASYMMETRY ALTERED RANGE OF MOTION TISSUE TEXTURE CHANGES CONTRAINDICATIONS BONY ABNORMALITIES OSTEOPOROSIS, TUMOR (MULTIPLE MYELOMA), FRACTURE, PAGETS

NEUROLOGIC CHANGES CAUDA EQUINA OR OTHER PROGRESSIVE NEURO DEFICIT, SPINAL COMPRESSION (TUMOR) JOINT/LIGAMENTOUS ABNORMALITIES HYPERMOBILE JOINTS, DESTRUCTIVE ARTHRIDITIES BLEEDING DISORDERS

CONGENITAL/ACQUIRED (ANTICOAGULANT TX) UNKNOWN DIAGNOSIS COMPLICATIONS BENIGN TRANSIENT SIDE EFFECTS MUSCLE AND JOINT SORENESS IN UP TO 34%

REVERSIBLE SERIOUS COMPLICATIONS PROGRESSION OF HNP w NEURO DEFICIT IN LESS THAN 1% CATASTROPHIC COMPLICATIONS RISK OF 3-6 PER 10,000,000 MANIPULATIONS CAUDA EQUINA SYNDROME INC RISK WITH MUA

ANTERIOR SPINAL ARTERY SYNDROME DEATH < 3 PER 10,000,000 MANIPULATIONS TYPES OF MANIPULATION DIRECT HIGH VELOCITY-LOW AMPLITUDE (HVLA)

THRUSTING MOBILIZATION WITH IMPULSE ARTICULATORY/OSCILLATORY MOBILIZATION WITHOUT IMPULSE INDIRECT

MUSCLE ENERGY STRAIN-COUNTERSTRAIN MYFASCIAL RELEASE

CRANIOSACRAL HVLA/THRUSTING POSITIONING IS KEY MOVE PT TO RESTRICTIVE BARRIER IMPULSE IS VERY SHORT AND QUICK MAY NOT BE NEEDED IF FULLY AT THE BARRIER

TREATMENT SHOULD NOT BE PAINFUL MAIN TECHNIQUE USED IN RESEARCH TRIALS MOBILIZATION WITH IMPULSE DIRECT TECHNIQUE MOVE THROUGH THE RESTRICTIVE BARRIER EXTRINSIC ACTIVATING FORCES

INDIRECT MUSCLE ENERGY POSITION PT AT THE RESTRICTIVE BARRIER ISOMETRIC MUSCLE CONTRACTIONS AWAY FROM THE BARRIER DURING RELAXATION PHASE PT MOVED FURTHER INTO RESTICTIVE BARRIER

CLINICALLY VERY USEFUL IN THE CERVICAL REGION CAN BE PART OF HOME EXERCISE PROGRAM VERY LITTLE USE IN RESEARCH PROTOCOLS INDIRECT MANIPULATION

NON-THRUSTING MYOFASCIAL RELEASE COMBINES MANUAL TRACTION AND TWISTING MANEUVERS OF SOFT TISSUE NO RESEARCH STRAIN/COUNTERSTRAIN POSITIONAL RELEASE

NO RESEARCH MYOFASCIAL RELEASE COMBINES MANUAL TRACTION AND TWISTING MANEUVERS TO EFFECT BIOMECHANICAL AND REFLEX CHANGES DIRECTION CANNOT BE PREDETERMINED COMBINES DIRECT AND INDIRECT PRINCIPLES

USED DURING EXTREMELY ACUTE OR CHRONIC CONDITIONS REQUIRES A STRONG PT/PRACTITIONER RELATIONSHIP TO DEVELOP NO RESEARCH STUDIES COUNTERSTRAIN

A FUNCTIONAL, INDIRECT TECHNIQUE LOCALIZE SPECIFIC TENDER POINTS FIND POSITION OF EASE HOLD POSITION FOR 90-120 SECONDS CLINICALLY EFFECTIVE IN SACRUM/PELVIS REGION A VERY PASSIVE TREATMENT MODALITY

NO RESEARCH STUDIES DEVELOPED BY JONES L A E V

N E I L P S A R

C I U C T A C R

U O R H ST F T O 1st RIB & THORACIC EVALUATION

T N E CIC M RA T A O E

TR R TH A E L P V P H U F

O UPPER THORACIC HVLA T C N E CI M RA

T A O E H R T T R A E

L V H LOW F O LOWER THORACIC HVLA

MUSCLE ENERGY TREATMENT PASSIVELY ROTATE PT TO THE BARRIER PT CONTRACTS AWAY FROM THE BARRIER HOLD FOR 3 5 SECONDS THEN RELAX ROTATE PT FURTHER TOWARDS THE BARRIER PERFORM A SERIES OF 3 - 5 REPETITIONS MUST ADD FLEXION TO TREAT UPPER CERVICAL LEVELS

MUSCLE ENERGY POSITION PT AT THE RESTRICTIVE BARRIER IN COLLAR WILL REMAIN IN NEUTRAL AND WORK AWAY FROM MIDLINE ISOMETRIC MUSCLE CONTRACTIONS AWAY FROM THE BARRIER TOWARDS THE MIDLINE POSITION

DURING RELAXATION PHASE PT MOVED FURTHER INTO RESTICTIVE BARRIER VERY LITTLE USE IN RESEARCH PROTOCOLS F O C

T N N E FU M YS T A D E

B R I T ST R 1 N O

I T 1 RIB MUSCLE ENERGY ST MYOFASCIAL RELEASE COMBINES MANUAL TRACTION AND

TWISTING MANEUVERS TO EFFECT BIOMECHANICAL AND REFLEX CHANGES DIRECTION CANNOT BE PREDETERMINED COMBINES DIRECT AND INDIRECT PRINCIPLES USED DURING EXTREMELY ACUTE OR CHRONIC CONDITIONS REQUIRES A STRONG PT/PRACTITIONER RELATIONSHIP TO DEVELOP

NO RESEARCH STUDIES MYOFASCIAL RELEASETRACTION & ROTATION MYOFACIAL RELEASE - CERVICAL/SCAPULAR

GLENO-HURMERAL RELEASE SCAPULAR RELEASE THORACIC RELEASE : S

T EN IN M A T A TR E R RS T

E L T A N N U O O

I T -C I D N I D A RA

ST BENEFICIAL PRACTICES COUNTERSTRAIN FOR TRAPEZIUS AND LEVATOR POSITION OF EASE HOLD FOR 90 SECONDS RETURN SLOWLY TO BASELINE POSITION

LIMITATIONS OF TREATMENT PASSIVE TREATMENT VERY TEMPORARY F O T N

N E TIO M C T N A U E

F TR YS A D NLY L O B V I

N H ST R RATIO ST N 1 EMO D

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