HVLA - Cervicothoracic Junction (C7-T1) Spinal Manipulation - Prone, Lateral Break Technique

Описание: Cervicothoracic Junction
Setup
Contact Point Right side of T3 spinous process
Applicator Thumb of right hand
Patient Position Prone with the head rotated to the left, left UE abducted and externally rotated to 90 °, and right UE shoulder depression with the arm lying at the patient’s side. Introduce a small amount of side bending to the right. Do not introduce too much side bending
Operator Stance Left (or Right) side of the patient-facing towards the head of the plinth
Palpation of Contact Point Place the thumb of your right hand against the right side of the spinous process of T3. Spread the fingers of your right hand to rest over the patient's trapezius muscle and clavicle

Fixation of Contact Points
Positioning for thrust Lace your left hand against the left side of the patient's head. Increase rotation of the head and neck to the left until a sense of tension is palpated at the contact point. Move your right forearm so that it lines up with your thumb against the spinous process of T3 and forms an angle of approximately 90° at the elbow
Levers Primary: lateral flexion away from operator
Secondary: rotation toward operator
Tertiary: cervical extension
Additional: compression and exhalation of patient

Adjustments for Pre-load and Thrust
Immediately Pre-thrust Relax and adjust your balance
Delivering the thrust Thrust is directed towards the patient's left shoulder joint. Simultaneously, apply a slight, rapid increase of head and neck rotation to the left with your left hand (Fig. 8.73). You must not overemphasize the thrust with your left hand against the patient's head
Technique Modifications - Different shoulder girdle holds can be used
Different applicators can be used
Respiration can be used to make the technique more effective