Ribs R4–10: Patient supine

9.6 Ribs R4–10


Patient supine




Gliding thrust


Ligamentous myofascial tension locking



Assume somatic dysfunction (S-T-A-R-T) is identified and you wish to produce cavitation at the costotransverse joint of the sixth rib on the left (Fig. 9.41).



image

Figure 9.41



Key




image Stabilization


image Applicator


image Plane of thrust (operator)


image 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 points




(a) Sixth rib on the left, just lateral to the transverse process of T6


(b) Patient’s elbows and left forearm.



2 Applicators




(a) Hypothenar eminence of the operator’s right hand


(b) Operator’s lower sternum or upper abdomen.



3 Patient positioning


Supine with the arms crossed over the chest and the hands passed around the shoulders. The left arm is placed over the right arm. The arms should be firmly clasped around the body as far as the patient can comfortably reach.



4 Operator stance


Stand on the right side of the patient, facing the couch.



5 Positioning for thrust


Reach over the patient with your left hand to take hold of the left shoulder and gently pull it towards you. With your right hand, locate the sixth rib on the left. Now place the hypothenar eminence of your right hand against the rib just lateral to the transverse process of T6 (Fig. 9.42).


image

Figure 9.42

Related posts:

Validation of clinical practice by research Cervicothoracic spine C7–T3: rotation gliding Cervical spine C2–7: Up-slope gliding Cervical spine C2–7: Up-slope gliding Thoracic spine T4–9: Rotation gliding Lumbosacral joint (L5–S1): Neutral positioning

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Sep 3, 2016 | Posted by in MUSCULOSKELETAL MEDICINE | Comments Off on Ribs R4–10: Patient supine

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