The Muscle energy manual, volume two : evaluation and treatment of the thoracic spine, lumbar spine, and rib cage

Front Cover......Page 1 Back Cover ......Page 2 Cover Page ......Page 3 Dedication ......Page 6 Preface to the First Edition ......Page 7 Preface to the Second Edition ......Page 8 Brief Contents ......Page 9 Table of Contents ......Page 10 List of Illustrations ......Page 16 List of Tables ......Page 17 List of Procedures ......Page 18 Historical Chronology of Muscle Energy Technique ......Page 19 PART I ANATOMY & BIOMECHANICS ......Page 21 1. RELEVANT GROSS ANATOMY OF THE TRUNK ......Page 23 Anatomic Features of the Anterior Trunk ......Page 24 Posterior Landmarks and Regions ......Page 26 Elements of Costal Cage Anatomy ......Page 30 Abnormal Anteroposterior Spinal Curvatures ......Page 34 Anatomy of the Sympathetic Nervous System ......Page 36 2. NORMAL SPINAL MOTION ......Page 37 Kinesiologic Relationship of Cervicals to Thorax ......Page 40 Kinesiology of Flexion and Extension Movements ......Page 41 Arthrokinematics of the Intervertebral Disc ......Page 42 Sacroiliac Flexion/Extension ......Page 43 Axial Rotation of Vertebrosternal Segments: T2-T7 ......Page 44 Lee Hypothesis ......Page 45 Axial Rotation of Vertebroabdominal Segments: T10-L1 ......Page 46 Biomechanics of Segmental Spinal Sidebending (z-axis motion) ......Page 47 Introduction to Neutral Spinal Motion ......Page 49 Sidebending Adaptation in Rotoscoliosis ......Page 50 Coupling of Rotation and Sidebending ......Page 51 Causes of Joint Movement Restriction ......Page 53 Role of Facets in Types I and II Segmental Dysfunctions ......Page 55 Clinical Characteristics of Type I and Type II Segmental Dysfunctions ......Page 56 Neutral Sidebending of Segments ......Page 60 Historical Notes and Comments on Fryette's Laws ......Page 62 PART II RIBS AND RESPIRATION ......Page 63 4. THE MOVEMENTS OF NORMAL RESPIRATION ......Page 65 The Diaphragm and Associated Muscles of Respiration ......Page 66 Breathing Movements of the Pelvic Diaphragms ......Page 68 Respiratory Movements of the Axial Skeleton ......Page 69 Chest Movements ......Page 71 Respiratory Movements of the Paired Muscles ......Page 74 5. RESPIRATORY RESTRICTIONS OF THE RIBS ......Page 77 Diagnosing Respiratory Rib Dysfunction: Overview ......Page 78 Rib Cage Screening Procedures ......Page 79 Screening for Exhalation or Inhalation Restriction of the Ribs (Step Breathing Method) ......Page 80 Locating the Key Rib ......Page 81 Counting the Monitoring Individual Ribs ......Page 83 Scanning for the Key Rib (Ribs i Through xii) ......Page 84 Sequence of Treatment ......Page 88 Treatment of the Inhalation Restrictions ......Page 89 Procedure for Treating Restricted Inhalation (ribs i and ii - ix) ......Page 90 Procedure for Treating Restricted Inhalation (ribs x through xii) ......Page 92 Treatment of Exhalation Restrictions ......Page 93 Procedure for Treating Restricted Exhalation (ribs x - vii) ......Page 94 Procedure for Treating Restricted Exhalation (ribs vi - iii) ......Page 95 Procedure for Treating Restricted Exhalation (ribs ii and i) ......Page 96 Relationship of Respiratory Restriction of the Ribs to Spinal Evaluation ......Page 97 PART III EVALUATION AND TREATMENT OF THE THORACIC AND LUMBAR SPINE ......Page 99 6. THE THORACIC INLET ......Page 101 Consequences of Altered Shape of the Inlet ......Page 102 Structural Lesions of the First Rib ......Page 103 Seated Screening and Scannin of the First Ribs ......Page 106 Interpretation of Results ......Page 107 Interpretation of Results ......Page 108 First Rib Superior Subluxation ......Page 109 Interpretation of Results ......Page 110 Anterior or Posterior Subluxations of Rib i ......Page 111 Practice Exercises for the Evaluation of the First Ribs and First Thoracic Segment ......Page 112 Comments on Treating Rib Subluxations ......Page 113 The Procedure for Reducing First Rib Superior Subluxation ......Page 114 The Procedure for Reducing First Rib Posterior Subluxation ......Page 115 A Brief Theoretical Explanation of the Isolytic Technique Mechanisms ......Page 116 The Procedure ......Page 117 7. ERS AND FRS SEGMENTAL DYSFUNCTION: T1 - T6 ......Page 119 Integrated Vertebral Segment and Rib Motion ......Page 122 Procedures for Evaluating Segmental Dysfunction in the Thoracics ......Page 123 Method 1: Seated Anterior Screening Procedure ......Page 124 Method 2: Seated Posterior Screening Procedure ......Page 126 Method 3: Supine Screening Procedure ......Page 127 Method 4: Prone Posterior Screening Procedure ......Page 128 "Key Rib" Test Protocols to Assess Vertebral Mechanics or Structural Rib Lesions ......Page 129 Scanning Procedures: Key Rib Test Protocols ......Page 130 I. The First Prodecure: Superior View ......Page 134 II. The Second Procedure: Posterior View ......Page 136 III. The Third Procedure: The Prone Focused Extension Test for FRS Dysfunction ......Page 138 Relationship of Rib Evaluation to Spinal Evaluation ......Page 139 Localization Sequences in Treatment ......Page 140 Use of Breathing in Articular Mobilization ......Page 141 Turban Technique ......Page 142 The Longus Colli Technique Protocol for Treating FRS ......Page 144 The Modified Longus Colli Technique ......Page 146 Procedure Protocol for Modified Longus Colli Technique ......Page 147 Salad Bowl Technique Protocol ......Page 148 Supine Technique Procedure Protocol ......Page 149 Seated Axial Rotation Procedure Protocol ......Page 150 A Clinical Example of Vertebral Diagnosis Using the Ribs ......Page 151 Acquired Intraosseous Deformities ......Page 155 Rib Dislocations (Costovertebral Subluxations) ......Page 158 Differential Diagnosis of Structural Rib Lesions ......Page 159 Testing for Anterior or Posterior Costovertebral Subluxations ......Page 160 Palpating Rib Angle for Position and Breathing Motion ......Page 162 Reducing Anterior Rib Subluxation- "Hara Kiri" Technique ......Page 164 Reducing Posterior Rib Subluxation- The "Push Me Pull You" Procedure ......Page 166 Management of Recurrent Rib Subluxation ......Page 167 Protocol for Diagnosing "Bucket Bail" Lesions ......Page 168 Bucket Bail Treatment Protocol ......Page 169 Differentiating Rib Torsion and Compression ......Page 170 Diagnosing Single Rib Torsion by Stereognostic Palpation ......Page 171 Treatment Procedure Protocol ......Page 172 Treatment Procedures for Intraosseous Deformities of the Ribs ......Page 173 Symptom and Sign Indicators of Lower Thoracic and Lumbar Segmental Dysfunction ......Page 175 Lower Thoracic and Lumbar Diagnostic Landmarks ......Page 176 Costovertebral Relationships ......Page 177 Normal Segmental Motion for the Lower Thoracic and Lumbar Spine ......Page 178 Normal Mechanics of the Lumbosacral Joint ......Page 179 Posture from Behind ......Page 180 Posture from the Side ......Page 182 Seated Iliac Crest Heights Test ......Page 183 Observing Paravertebral Fullness ......Page 184 Testing the Muscles of the Abdominal Wall ......Page 186 Locating the PSIS for Execution of the Flexion Tests ......Page 187 Standing Flexion Test ......Page 188 The Standing Flexion Test Protocol ......Page 189 The Seated Flexion Test Protocol ......Page 190 Inferior Lateral Angle of the Sacrum (ILAs) ......Page 192 Seated Trunk Sidebending Tests ......Page 193 Rib Screen for the Lower Thoracic Spine ......Page 194 Detailed Examination of the Lower Thoracic and Lumbar Spine ......Page 195 The Posterior Seated Test ......Page 197 Protocol for Locating Lumbar Transverse Processes - Patient Prone ......Page 198 The Procedure for Locating the Lower Thoracic Transverse Processes - Patient Prone ......Page 200 The Sphinx Test Procedure Protocol ......Page 202 The Seated Hyperflexion Test ......Page 204 The Seated Hyperflexion Test Procedure Protocol ......Page 205 Alternate Test: The "Slump-Sit Tall" Transverse Process Test Protocol ......Page 206 The Hip Drop Test as a Lumbosacral Test ......Page 207 The 50-Step Procedure ......Page 208 The 50-Step ERS Treatment Protocol ......Page 210 The Procedure Protocol ......Page 214 Protocol for Releasing Tension in Oblique Muscles ......Page 215 Stages of the 500-Step Treatment Procedure ......Page 216 Stage I - Neutral Rotation ......Page 218 Stage II - Extended Rotation ......Page 220 Stage III - Pure Extension Stage ......Page 221 The Procedure Protocol ......Page 222 Lateral Recumbent Treatment Procedures ......Page 223 The Lateral Recumbent Treatment Procedure Protocol for ERS ......Page 224 The FRS Treatment Protocol ......Page 226 "Stacked" Segmental Dysfunctions ......Page 228 Diagnosis and Treatment of Type I Neutral Dysfunction ......Page 229 Group Curve Tests and Results ......Page 230 The Focused Sidebending Test for Thoracic NSR Dysfunction ......Page 232 Lateral Recumbent Position ......Page 233 The Lateral Recumbent "Universal" Technique ......Page 234 Procedure Protocol ......Page 236 Procedure Protocol ......Page 237 Sidebending Stretch Treatment for Lumbar NSR Dysfunction ......Page 238 Lateral Recumbent Sidebending Stretch Isometric Procedure for Lumbar NSR ......Page 239 APPENDIX ......Page 241 BIBLIOGRAPHY AND RECOMMENED READING ......Page 245 INDEX ......Page 253