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Flashcards in Thoracic Spine - Manual Therapy Deck (3)
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Describe the supine flexion restriction T-spine HVLA thrust.

- Pt supine with arms crossed across chest with the targeted facet's arm on top
- Use a palm grip with both palmar eminences in contact with the transverse processes or use a trigger grip
- Lock the skin in place with a slight twisting motion of the hand
- Localize motion using the patient's arms, flex from above, and contralaterally sidebend and rotate down to the targeted segment
- Provide HVLA from your chest through the patient's arms in an anterior to posterior direction


Describe a prone extension restriction HVLA of the T-spine.

- Pt prone
- PT using arm on the caudal side of the patient reaches across and places the hypothenar eminence on the transverse process of the targeted vertebra with fingers pointed superiorly
- PT using arm on cranial side of the patient places the hypothenar eminence of their hand on the ipsilateral transverse process facing with fingers pointed inferiorly
- Twist hands into skin lock so that the contralateral hand is oriented perpendicular to the spine, and the ipsilateral hand is still fairly parallel
- Provide an anteriorly directed force with the contralateral hand and an inferiorly directed force with the ipsilateral hand to engage the movement barrier
- Perform quick HVLA in a P-->A direction


Describe a sitting extension restriction HVLA of the T-spine.

- Pt sitting back far enough to be against the practioner's thigh
- Firm towel roll placed over transverse process of vertebra inferior to the targeted segment
- Pt crosses arms completely, but comfortably
- Grip patient's elbows with contralateral arms
- Pt relaxes and flexes their neck and upper T-spine down to the targeted segment
- Rock forward and take up the slack form the segments below the targeted segment