688 Lab 8/19 Fryette's and Muscle Energy

Finding T1

have patient roll over and palpate most prominent as base of neck, this should move away when the patient rises, the one under it is T1

What vertebra is at the level of the spine of the scapula?

T3 (in normal resting)

What vertebra is at the level of the inferior angle of the scapula?

T7 (in normal resting)

What vertebra is at the level of the top of the iliac crests?

L4 (in normal resting)

Where can type 2 dysfunctions be in a type 1 curve?

the top, bottom, and middle (apex)

Thoracic Indications for Thoracic Muscle Energy Techniques

back pain

shoulder pain

chest wall pain

Lumbar Indications for Lumbar Muscle Energy Techniques

back pain

hip pain

visceral probelms

gait abnormalities

Relative Contraindications for Thoracic Muscle Energy Techniques

acute vertebral fractures

active vertibral cancer

shoulder or neck problems that would impair positioning

Relative Contraindications for Lumbar Muscle Energy Techniques

acute vertebral fractures

active vertebral cancer

radicular symptoms (especially if uncertain of etiology)

Thoracic Muscle Energy: Upper Thoracics T1-4 Technique

The practitioner stands beside/behind the patient with one hand monitoring the posterior transverse process, while the other hand holds the top of the head to induce cervical and upper thoracic spine motion. * Note that for Type 1 dysfunctions that practitioner should monitor the segment in the middle of the curve.

The practitioner moves the patient’s head to the feather’s edge of its restrictive barrier for rotation, sidebending, and flexion or extension until motion is felt at the monitoring hand on the specified segment.

The practitioner asks the patient to gently straighten up their head against your equal resistance.

This isometric contraction is held for 3-5 seconds.

Pause and monitor for the tissues to totally relax.

Once the tissues have relaxed, move the head to the feathers edge of the new restrictive barrier.

Repeat steps two to five 3-5 times until the restrictive barrier is eliminated and physiologic motion is returned.

Return the head to neutral.

Retest thoracic rotation.

Thoracic Muscle Energy: Upper Thoracics T1-4 Image

Thoracic Muscle Energy: Lower Thoracics T5-12 Technique

The practitioner sits beside/behind the patient with one hand monitoring the posterior transverse process, while the other reaches across the front of the patient to control the patient’s shoulder and trunk.

* Note that for Type 1 dysfunctions that practitioner should monitor the segment in the middle of the curve.

The practitioner moves the patient’s trunk into the rotation, sidebending, and flexion or extension restrictive barriers until motion is felt at the monitoring hand on the specified segment.

The practitioner asks the patient to gently straighten up their trunk.

This isometric contraction is held for 3-5 seconds.

Allow for full patient relaxation.

The practitioner then moves the trunk to the new restrictive barrier.

Repeat steps three to five 3-5 times.

Retest thoracic rotation.

Thoracic Muscle Energy: Lower Thoracics T5-12 Images

Lumbar Muscle Energy: Seated Technique

The practitioner sits beside/behind the patient with one hand monitoring the posterior transverse process, while the other reaches across the front of the patient to control the patient’s shoulder and trunk.

* Note that for Type 1 dysfunctions the practitioner should monitor the segment in the middle of the curve.

The practitioner moves the patient’s trunk into the rotation, sidebending, and flexion or extension restrictive barriers until motion is felt at the monitoring hand on the specified segment.

* The practitioner may add translation to aid sidebending

The practitioner asks the patient to gently straighten up their trunk.

This isometric contraction is held for 3-5 seconds.

Allow for full patient relaxation.

The practitioner then moves the trunk to the new restrictive barrier.

Repeat steps three to five 3-5 times.

Retest thoracic rotation.

Lumbar Muscle Energy: Seated Image

Lumbar Muscle Energy: Lateral Recumbent Technique

The patient is laying with vertebral rotation side down

The practitioner stands in front of the patient and flexes the upward hip until motion is felt at the restricted vertebral segment and tuck the foot behind the other knee

The practitioner rotates the back toward the table by pushing the upward shoulder posterior and lifting the table-side arm and shoulder until you feel rotation at the restricted segment

The practitioner places their forearm across the buttocks and leans over the top of the arm using the other arm to stabilize the patient’s shoulder

The practitioner asks the patient to push the pelvis backward against the practitioner’s forearm

The isometric contraction is held 3-5 seconds

Allow for full relaxation

The practitioner then moves the trunk to the new restrictive barrier

Repeat steps five to eight 3-5 times

Retest lumbar rotation

Lumbar Muscle Energy: Lateral Recumbent Image

What type of somatic dysfunction should lateral recumbent lumbar muscle energy be performed on?

type ii only