Manipulation of the Spine, Thorax and Pelvis

The new edition of this popular book continues to present the latest scientific evidence for the successful use of the high velocity low amplitude (HVLA) thrust technique. Prepared in a readily accessible, amply illustrated format, this book is designed to equip practitioners with a detailed understanding of the underlying basis of the HVLA thrust technique and the best means to safely employ it in the effective management of a range of disorders of the spine and pelvic regions.

The book is arranged in three sections to maximise understanding of what can be challenging areas to comprehend and effectively manage. Section One explores the biomechanics of movement and forces between adjacent vertebrae followed by a discussion of positioning and ‘locking’. These chapters are then followed by a discussion about safety with particular reference to the management of the cervical spine. A chapter on evidence - and what represents good medical evidence - concludes. Section Two presents - using an ample array of clear photographs and useful summary boxes - over 40 HVLA techniques ranging from the atlanto-occipital joint (C0-C1) to the coccyx. Section Three concludes with treatment failures (often, technique derived) and analysis.

Prepared by authors of international renown - and now with an associated website containing over 45 minutes of useful film footage - this book will be ideal for all manual therapy practitioners dealing with the management of the spine and pelvic areas.

Table of Contents:

Part A HVLA thrust techniques - an osteopathic perspective

1 Introduction

2 Osteopathic philosophy, practice and technique

3 Kinematics and coupled motion of the spine

4 Spinal positioning and locking

5 Safety and HVLA thrust techniques

6 Rationale for the use of HVLA thrust techniques

7 Validation of clinical practice by research

Part B HVLA thrust techniques

8 Cervical and cervicothoracic spine

8.1 Atlanto-occipital joint C0-1: Contact point on occiput; Chin hold; Patient supine;
Anterior and superior thrust in a curved plane; Ligamentous
myofascial positioning

8.2 Atlanto-occipital joint C0-1: Contact point on atlas; Chin hold; Patient supine;
Anterior and superior thrust in a curved plane; Ligamentous
myofascial positioning

8.3 Atlanto-axial joint C1-2: Chin hold; Patient supine; Rotation thrust; Ligamentous
myofascial positioning

8.4 Atlanto-axial joint C1-2: Cradle hold; Patient supine; Rotation thrust; Ligamentous
myofascial positioning

8.5 Cervical spine C2-7: Up-slope gliding; Chin hold; Patient supine

8.6 Cervical spine C2-7: Up-slope gliding; Chin hold; Patient supine - variation

8.7 Cervical spine C2-7: Up-slope gliding; Cradle hold; Patient supine

8.8 Cervical spine C2-7: Up-slope gliding; Cradle hold; Patient supine; Reversed primary and
secondary leverage

8.9 Cervical spine C2-7: Up-slope gliding; Patient sitting; Operator standing in front

8.10 Cervical spine C2-7: Up-slope gliding; Patient sitting; Operator standing to the side

8.11 Cervical spine C2-7: Down-slope gliding; Chin hold; Patient supine

8.12 Cervical spine C2-7: Down-slope gliding; Cradle hold; Patient supine

8.13 Cervical spine C2-7: Down-slope gliding; Patient sitting; Operator standing to the side

8.14 Cervicothoracic spine C7-T3: Rotation gliding; Patient prone; Operator at side of couch

8.15 Cervicothoracic spine C7-T3: Rotation gliding; Patient prone; Operator at head of couch

8.16 Cervicothoracic spine C7-T3: Rotation gliding; Patient prone; Operator at head of
couch - variation

8.17 Cervicothoracic spine C7-T3: Sidebending gliding; Patient sitting

8.18 Cervicothoracic spine C7-T3: Sidebending gliding; Patient sitting; Ligamentous
myofascial positioning

8.19 Cervicothoracic spine C7-T3: Sidebending gliding; Patient sidelying

8.20 Cervicothoracic spine C7-T3: Sidebending gliding; Patient sidelying; Ligamentous
myofascial positioning

8.21 Cervicothoracic spine C7-T3: Extension gliding; Patient sitting; Ligamentous
myofascial positioning

9 Thoracic spine and rib cage

9.1 Thoracic spine T4-9: Extension gliding; Patient sitting; Ligamentous myofascial
positioning

9.2 Thoracic spine T4-9: Flexion gliding; Patient supine; Ligamentous myofascial
positioning

9.3 Thoracic spine T4-9: Rotation gliding; Patient supine; Ligamentous myofascial
positioning

9.4 Thoracic spine T4-9: Rotation gliding; Patient prone; Short-lever technique

9.5 Ribs R1-3: Patient prone; Gliding thrust

9.6 Ribs R4-10: Patient supine; Gliding thrust; Ligamentous myofascial positioning

9.7 Ribs R4-10: Patient prone; Gliding thrust; Short-lever technique

9.8 Ribs R4-10: Patient sitting; Gliding thrust; Ligamentous myofascial positioning

10 Lumbar and thoracolumbar spine

10.1 Thoracolumbar spine T10-L2: Neutral positioning; Patient sidelying;
Rotation gliding thrust

10.2 Thoracolumbar spine T10-L2: Flexion positioning; Patient sidelying;
Rotation gliding thrust

10.3 Lumbar spine L1-5: Neutral positioning; Patient sidelying; Rotation gliding thrust

10.4 Lumbar spine L1-5: Flexion positioning; Patient sidelying; Rotation gliding thrust

10.5 Lumbar spine L1-5: Neutral positioning; Patient sitting; Rotation gliding thrust

10.6 Lumbosacral joint (L5-S1): Neutral positioning; Patient sidelying; Thrust direction
is dependent upon apophysial joint plane

10.7 Lumbosacral joint (L5-S1): Flexion positioning; Patient sidelying; Thrust direction
is dependent upon apophysial joint plane

11 Pelvis

11.1 Sacroiliac joint: Left innominate posterior; Patient prone; Ligamentous myofascial positioning

11.2 Sacroiliac joint: Right innominate posterior; Patient sidelying

11.3 Sacroiliac joint: Left innominate anterior; Patient supine

11.4 Sacroiliac joint: Sacral base anterior; Patient sidelying

11.5 Sacrococcygeal joint: Coccyx anterior; Patient sidelying

Part C Technique failure and analysis