OMM COMP 2

Rib 1 Inhalation Dysfunction MET

Flexed RaSt

Patient Lying down on back

• Stand on same side as dysfunction

• 5-7 Times

Ribs 2-6 Inhalation Dysfunction MET

Flexed St

Patient on Back Flex more!

• Stand on same side as dysfunction

• 5-7 Times

Ribs 7-10 Inhalation Dysfunction MET

ONLY St

Get the patient on their back and use their arm to sidebend them towards

• Stand on same side as dysfunction

• 5-7 Times

Ribs 11-12 Inhalation Dysfunction MET

Move the feet away!!!! I is BYE

• Stand opposite the side of dysfunction

• Get patient on stomach

• Locate rib 11 or 12 and put hypothenar on inferior aspect.

• Use other hand to stabilize ASIS

• Move hypothenar caudally to relieve tension of QL

Ribs 1-2 Exhalation Dysfunction MET

WOE IS ME

• Stand on side of dysfunction

• Flip the patient to localize rib

• Hook index and middle finger to claw superior aspect of rib

• Turn patient back onto back

• Put patient into woe is me position and rotate head away

• Get them to try to push head to ceiling 3-5 times. Claw them to feet

Ribs 3-5 Exhalation Dysfunction MET

SAY HI

• Stand on side of dysfunction

• Flip the patient to localize rib

• Hook index and middle finger to claw superior aspect of rib

• Turn patient back onto back

• Get patient into say hi position and get them to try to lift elbow to ceiling.

Exhalation Dysfunction Ribs 6-8 MET

Close the gate

• Stand on side of dysfunction

• Flip the patient to localize rib

• Hook index and middle finger to claw superior aspect of rib

• Form the gate and during pulling part, apply lateral caudad traction on rib.

Ribs 9-10 Exhalation Dysfunction MET

YES

• Opposite Side

• Localize rib and place head laterally to the rib

• Encourage the patient to pull their hip to their side.

• Apply inferior and lateral pressure when pulling on rib.

Rib 11-12 Exhalation Dysfunction MET

Stand on side opposite the dysfunction

• Move legs towards me

• Find rib 11 or 12 and place hypothenar on inferior aspect of rib.  This hand will ONLY stabilize.

• Encourage the patient to breathe in and have them hike up hip.  Resist this and then during exhalation pull hip down a bit.  Keep going 3-5 times.

Counterstrain PR 1

Have patient sit down

• E SART

• Think P1E

• Don’t forget to use opposite leg to stabilize.

Counterstrain PR 2-10

Have patient sit down

• F SARA

• Use your leg (physician) on same side to sidebend away.

• Have the patient do mermaid legs on the side opposite dysfunction

Counterstrain Anterior Ribs

AR 1-2 F STaRT

AR 3-10 F STaRT

Counterstrain Posterior Ribs

Rib 1 E SaRt

Ribs 2-10 F SaRa

Counterstrain AR 1-2

Have the patient ON THEIR BACK

• F STaRT

Counterstrain AR 3-10

Have the patient down

• STaRT

• Use your (physician’s) opposite leg to go out and forward

• Get the patient to do mermaid legs on the side of dysfunction.

Exhalation Dysfunction HVLA Ribs 1-2

Get the patient to sit down.

• Get index finger’s MCP on posterior aspect of rib

• Use your other hand to STAR

• Use opposite leg to stabilize

Inhalation and Exhalation Dysfunction HVLA Ribs 3-10

Basically a typical HVLA setup.

• Stand on side opposite the dysfunction

• Opposite over adjacent

• HOWEVER…..

  • Inhalation dysfunction, go on superior aspect of rib.

  • Exhalation dysfunction, go on inferior aspect of rib.

  • Find force vector

  • Get patient to breathe in and out

  • Wait for approval to thrust

Inhalation Dysfunction HVLA ribs 3-10

Basically a typical HVLA setup.

• Stand on side opposite the dysfunction

• Opposite over adjacent

• HOWEVER…..

  • Inhalation dysfunction, go on superior aspect of rib.

  • Find force vector

  • Get patient to breathe in and out

  • Wait for approval to thrust

Exhalation Dysfunction HVLA ribs 3-10

Basically a typical HVLA setup.

• Stand on side opposite the dysfunction

• Opposite over adjacent

• HOWEVER…..

  • Exhalation dysfunction, go on inferior aspect of rib.

  • Find force vector

  • Get patient to breathe in and out

  • Wait for approval to thrust

Inhalation Dysfunction HVLA Ribs 11-12

Get patient on stomach

• Get legs to go bye.  I is BYE

• Localize rib 11 or 12 and place hypothenar on inferior aspect of dysfunctional rib

• Use other hand to stabilize ASIS

• Use hand on rib 11 or 12 to thrust caudad.

Exhalation Dysfunction HVLA Ribs 11-12

Get patient on stomach

• Get legs to go to me. E is ME

• Localize rib 11 or 12 and place hypothenar on inferior aspect of rib ABOVE dysfunctional rib.  So if it’s rib 11, go on inferior aspect of rib 10.

• Use other hand to locate ASIS

• YOU WILL PULL ASIS UP AND YOUR OTHER HAND WILL GO UP AND TOWARDS BOOTY on thrust!!

OA MET Flexed

• V Hold - patient laying down

• The diagnosis is OPPOSITE ALWAYS, so go opposite that.

• If the patient is flexed, put your hand below chin to resist.

• Encourage patient to close eyes, then open eyes, and look down for three seconds.

• Then rest for 2 seconds.

• Go further into barrier each time.

OA MET Extended

• V Hold - patient laying down

• The diagnosis is OPPOSITE ALWAYS, so go opposite that.

• If the patient is extended, put your hand on bottom of chin. This will encourage the patient’s head to

• Encourage patient to close eyes, then open eyes, and look down for three seconds.

• Then rest for 2 seconds.

• Go further into barrier each time.

AA MET

Patient is laying down (you can be seated)

• ROTATE AWAY (rotation only component)

• Flex head 15 degrees

• Patient will try to use 10% of their strength to rotate head into barrier

MET cervical 2-7

Remember that cervical 2-7 has type 2 mechanics.

• Use V-hold to monitor articular pillars

• Patient Lying down

• This technique you will set F/E SARA

• You will encourage patient to rotate head in opposite direction with just 10% of strength.

Counterstrain PC1 inion

*1 of the exceptions

F STAR

Find the hard inion and go to inferior nuchal line and go lateral.

Counterstrain PC1 Occiput

Go to find inion and go inferior and more laterally to find it.

E SARA

Counterstrain PC2 Occiput

Go to find inion and go a little bit inferiorly and just a tad bit laterally to find it

E SARA

Counterstrain PC2 SP midline

Simply find superior aspect of C2

• Ask your questions

• E SARA

Counterstrain PC 4-8 SP Medial

Find ribs on inferior aspect of cervical above it.

EX: PC4 go to inferior aspect of PC3

E SARA

Counterstrain PC 3 Midline

F SARA

• Go on inferior aspect of SP of C2

Counterstrain PC 3-7 lateral

E SARA

• Just go lateral of cervical. Example C4, go a bit laterally on articular process to find

Counterstrain AC1 TP

Just a bit superior and lateral to AC2, which lies on the ascending ramus of mandible.

• Patient lying on back and ONLY Rotate away

Counterstrain AC1 Mandible

Go on the ascending ramus of mandible

• Patient lying on back and Rotate away

p.s. every single counterstrain technique is on the patient’s back

Counterstrain AC2-6

Find sternocleidomastoid and just go down

F SARA

Counterstrain AC7

Go on top of clavicle medially.

F STAR

Counterstrain AC8

It is Medial compared to AC7. Find it on top of manubrium and right before it meets with clavicle.

F SARA

HVLA Cervical

Stand on side of diagnosis

• Place MCP on side of diagnosis.

• Induce some flexion

• Sidebend towards the freedom

• Rotate away from diagnosis

• Rotational thrust on exhale. Do not move head it’s just a quick small thrust.