Thoracic spine HVLA

Page created: March 11, 2021

Notes

Thoracic spine

Thoracic spine HVLA

STEPS OF SUCCESSFUL THORACIC HVLA
  1. Stand at opposite side of posterior transverse process
  2. Instruct the patient to cross their arms over their chest with the arm opposite you on top
  3. Rotate the opposite shoulder and thorax toward you and place your thenar eminence (fulcrum) on the posterior transverse process of the somatic dysfunction
  4. Flex the patient’s torso and side bend toward the restriction (toward or away from you depending on whether it is a type I or II dysfunction)
  5. Instruct the patient to inhale and move them further into their restriction as they exhale
  6. On the next respiratory cycle, deliver a high velocity, low amplitude thrust toward the fulcrum at the end of exhalation
TREATMENT POSITIONS FOR THORACIC HVLA
DIAGNOSISFULCRUM PLACEMENTSIDE BENDING
T5–T7 N SRRL
On posterior transverse process of T6
Side bend trunk away from you (left)
T6  F SLRL
On posterior transverse process below dysfunctional segment
Side bend trunk toward you (right)
T6  E SLRL
On posterior transverse process
Side bend trunk toward you (right)

Tips for success

  • When treating a group curve (type I somatic dysfunction) of the thoracic spine, treat the “apex” segment (e.g., T6 of T5–T7 N SRRL)
  • With upper thoracic somatic dysfunctions (T1–T4), instruct the patient to put both hands behind the neck to help better engage the upper thoracic region
  • Since you are always standing opposite the side of rotation, you will side bend the trunk away for a type 1 somatic dysfunction and toward for a type 2 somatic dysfunction
  • As with other HVLA treatments, prepare the tissue with soft tissue treatment
Author: Arman Israelyan, OMS-III
Editor: Matt Lipinski, DO
Editor: Robyn Hughes, MScBMC

Key Takeaways

Thoracic spine HVLA (High-Velocity Low-Amplitude) is a manual therapy technique used to manipulate and mobilize the thoracic spine. It involves a quick and forceful thrust applied to a specific joint in the thoracic spine to restore mobility and reduce pain and discomfort. Thoracic spine HVLA is often used to treat conditions such as thoracic spine pain, postural problems, and musculoskeletal disorders.