8.20 Cervicothoracic spine C7–T3

Sidebending gliding

Patient sidelying

Ligamentous myofascial tension locking

Assume somatic dysfunction (S-T-A-R-T) is identified and you wish to use a sidebending gliding thrust, parallel to the apophysial joint plane, to produce cavitation at the T2–3 apophysial joint (Figs 8.101, 8.102).

Figure 8.101

Figure 8.102

Key

Stabilization

Applicator

Plane of thrust (operator)

Direction of body movement (patient)

Note: The dimensions for the arrows are not a pictorial representation of the amplitude or force of the thrust.

1 Contact point

Right side of the spinous process of T2.

2 Applicator

Thumb of left hand.

3 Patient positioning

Patient lying on the left side. Flex the patient’s knees and hips for stability.

4 Operator stance

Stand facing the patient and gently place your right arm under the head, lightly spreading your fingers around the patient’s occiput. The head should now be cradled in your right arm with your upper arm against the patient’s forehead and your forearm and hand supporting the head and neck.

5 Palpation of contact point

Locate the spinous process of T2. Place the thumb of your left hand gently but firmly against the right side of this spinous process. Spread the fingers of your left hand to enable firm contact of your thumb and position your left forearm over the posterior aspect of the patient’s thorax and lumbar spine. This will ensure that you have good contact and will not slip off the spinous process when you apply a force against it. Maintain this contact point but do not press too hard, as it can be uncomfortable.

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