Manual Therapy

10-21-09

Thoracic spine was our topic today in manual therapy as well as what treatments can be performed. First test we learned was a mobilisation of the thoracic spine. So we first have the patient lie prone on the table where we go onto find the most prominent vertebra C-7 to give us a reference point so we can go up or down on the spine stopping where the patient has discomfort. Have bed level with superior aspect of patella while standing sideways over patient. Placing thumbs back to back over spinous process then apply PA (posterior---->anterior) movement using body weight over vertical arms and then grade accordingly. Next technique was a manipulation called the "Butterfly" (i.e. lying extension rotation). Have patient in prone position with feet resting over a pillow. Bed level with patella and locate C-7 spinous process and count accordingly to level at which patient feels discomfort. Than find transverse process of levels to be manipulated. From here you want to locate the scaphoid of your upper hand on lower segment and pisiform of lower hand on upper segment. Apply downward pressure and rotate hands together like a butterfly to take up soft tissue slack. Ask patient to take a deep breath in and out. On way out of patients follow the release of air with hands and at end of breath apply short amplitude thrust to receive a "crack" in patients back. Finally, the last technique was called "over hand technique." Essentially, this does the same thing as the butterfly but in a more complex way. Not going to type instructions out for this one because it's better to be in person. But you can look it up on youtube or come see me! Cheers!