Script OA Cervical Treatment I - HVLA (c4ERRSR)

Introduction

• Presentation focused on cervical treatments.

C4 Treatment (Extended, Rotated Right, Side Bent Right)

• Identify C4 segment:

  • Locate EOP (External Occipital Protrusion), palpate inferior to find C2, then C3, and finally C4 spinous process.

• Treatment steps:

  • Use reinforced dip contact on C4 spinous.

  • Draw tissue slack onto right articular pillar of C4.

  • Hook the pillar with index contact and stabilize occiput with supporting hand.

  • Provide slight traction and flex down to C4 segment.

  • Lock out at C4, induce side bend to the right (position of ease).

  • Rotate to the left (restrictive barrier).

  • Line of drive: posterior to anterior, inferior to superior (P to A, I to S).

• Alternate contact method:

  • Use middle digit contact bilaterally on C4 spinous.

  • Draw tissue slack onto C4 articular pillar and stabilize with index finger on C5.

  • Flex C4, side bend to the right, and rotate to the left.

  • Line of drive: posterior to anterior, inferior to superior (PDA, I to S).

C5 Treatment (Extended, Rotated, Side Bent Left)

• Locate C5 segment:

  • Identify by locating C7, then C6, and finally C5 spinous.

• Treatment steps:

  • Use reinforced tip contact on C5 spinous and draw tissue slack onto right C5 articular pillar.

  • Provide flexion to C5 segment.

  • Induce right side bending to the barrier.

  • Rotate to the left (position of ease).

  • Line of drive: lateral to medial through the index contact on right C5 articular pillar.

• Alternate contact method:

  • Middle digits contact on C5 spinous; index on C6 articular pillars.

  • Same flexion and side bending mechanics apply.

  • Line of drive remains lateral to medial.

C4 Treatment (Extended, Rotated, Side Bent Left)

• Locate C4 segment:

  • Find by identifying C7, C6, C5, then C4 spinous.

• Treatment steps:

  • Use reinforced dip contact on left or right C4 articular pillar.

  • Induce flexion at C4 segment.

  • Side bend left (position of ease) and rotate to right (restrictive barrier).

  • Line of drive: posterior to anterior (PDA) to the C4 articular pillar.

• Alternate contact method:

  • Middle digits on C4 spinous while stabilizing with index on C5 articular pillar.

  • Follow same flexion and side bending procedures.

  • Line of drive: PDA to middle digit on C4 left articular pillar.

C4 Treatment (Translational Emphasis)

• Identify C4:

  • Use reinforced dip contact and draw tissue slack onto right articular pillar.

• Actions:

  • Provide flexion and induce right side bending to the restrictive barrier.

  • Rotate to the left (position of ease).

  • Line of drive: lateral to medial to C4 right articular pillar.

C3 Treatment (Flexed, Rotated, Side Bent Right)

• Locate C3 segment:

  • Palpate to find C2 and then C3 spinous process.

• Treatment steps:

  • Use reinforced dip contact on C3 spinous and draw tissue slack onto C3 articular pillar.

  • Induce slight extension at C3 segment while providing slight traction.

  • Side bend to the right (position of ease) and rotate to left (restrictive barrier).

  • Line of drive: anterior to inferior (A to I) to right C3 articular pillar.

• Alternate contact method:

  • Use middle digit contact on spinal processes and index fingers on C4 articular pillars.

  • Provide anterior translation for extension, then side bend and rotate.

  • Line of drive: posterior to anterior, inferior to superior (P to A, I to S) to middle digit on articular pillar.

Conclusion

• Presentation focused on HBA setups for various cervical treatments.