Lumbar spine facilitated positional release

Page created: March 23, 2021

Notes

Lumbar spine

Lumbar spine facilitated positional release

LUMBAR “NEUTRAL / EXTENSION” DYSFUNCTIONS
Example: L3 N SLRR

Hypertonicity of the erector spinae muscles can be treated with FPR in the same manner as lumbar neutral or extension dysfunctions. Instead of monitoring a lumbar transverse process, the left hand should instead be placed on the point of most hypertonic musculature.

  1. With the patient lying prone, stand on their left side and rest your knee against their left ilium
  2. With your left hand, monitor the right transverse process of L3
  3. With your right hand, extend their right hip and cross their right ankle over the left
  4. Slide your right hand up to grasp the patient’s knee, then extend and externally rotate the right lower extremity until the L3 paravertebral muscles appear maximally relaxed
  5. With your left hand, push gently (activating force) over the right transverse process of L4 for 3–5 seconds or until a release is palpated
LUMBAR “FLEXION” DYSFUNCTIONS
Example: L4 F SRRR

The patient positioning to treat lumbar flexion dysfunctions with FPR is very similar to the positioning for lumbar roll HVLA.

  1. With the patient lying in the left lateral recumbent position, stand facing their front
  2. Place your right forearm and hand on the patient’s right anterolateral chest wall (under their axilla), and your left forearm and hand on the right posterior pelvis / lumbar region
  3. Monitor the transverse processes of L4 and L5 with both hands
  4. Gently flex the patient’s hips until flexion is palpated at L4
  5. Gently push the patient’s right shoulder posteriorly until L4 is engaged and rotated (to the right) on L5
  6. Gently push the patient’s pelvic and lumbar region anteriorly until L5 is engaged and rotated (to the left) under L4
  7. While the patient exhales, further side bend to the right (by approximating your forearms)
  8. Apply an activating force in the form of gentle axial compression (both hands pushing toward L4) for 3–5 seconds or until a release is palpated
Author: Arman Israelyan, OMS-III
Editor: Matt Lipinski, DO
Editor: Robyn Hughes, MScBMC

Key Takeaways

Lumbar spine facilitated positional release is a type of massage that uses gravity and pressure to help relieve tension and pain in the lower back. The therapist will position you in a way that increases the space between the vertebrae, then use their hands to apply pressure to the affected area. This relieves tension and helps improve blood flow and movement in the area.