Thoracic spine facilitated positional release

Thoracic spine facilitated positional release

Chronic Week 1

Chronic Week 1

Down syndrome (Trisomy 21)

Tay-Sachs disease (NORD)

Mucopolysaccharide storage disease type 1 (Hurler syndrome) (NORD)

Phenylketonuria (NORD)

Phenylketonuria (NORD): Year of the Zebra

Classical homocystinuria (NORD)

Glycogen storage disease type II (NORD)

Hypertrophic cardiomyopathy

Abnormal heart sounds

Normal heart sounds

Development of the cardiovascular system

Fetal circulation

Aortic valve disease

Mitral valve disease

Pulmonary valve disease

Tricuspid valve disease

Valvular heart disease: Pathology review

Cyanotic congenital heart defects: Pathology review

Acyanotic congenital heart defects: Pathology review

Atrial septal defect

Ventricular septal defect

Patent ductus arteriosus

Coarctation of the aorta

Cardiomyopathies: Pathology review

Approach to cyanosis (newborn): Clinical sciences

Aortic dissections and aneurysms: Pathology review

Peripheral artery disease

Peripheral artery disease: Pathology review

Vasculitis: Pathology review

Deep vein thrombosis and pulmonary embolism: Pathology review

Raynaud phenomenon

Diagnosing cervical somatic dysfunction

Cervical spine counterstrain

Cervical spine facilitated positional release

Cervical spine HVLA

Cervical muscle energy treatment

Cervical spine myofascial release

Other cervical spine treatments

Diagnosing lower limb somatic dysfunction

Special tests for the lower limb

Lower limb counterstrain

Lower limb HVLA

Lower limb muscle energy treatment

Lower limb myofascial release

Other lower limb treatments

Diagnosing lumbar spine somatic dysfunction

Lumbar muscle energy treatment

Lumbar spine counterstrain

Lumbar spine facilitated positional release

Lumbar spine HVLA

Lumbar spine myofascial release

Other lumbar spine treatments

Cranial osteopathy: Cranial nerves

Primary respiratory mechanism

Diagnosing cranial somatic dysfunction

Cranial treatments

Diagnosing pelvis somatic dysfunction

Pelvis counterstrain

Pelvis muscle energy treatment

Other pelvis treatments

Diagnosing rib somatic dysfunction

Rib counterstrain

Muscle energy for rib somatic dysfunction

Other rib treatments

Diagnosing sacral somatic dysfunction

Sacrum counterstrain

Sacrum muscle energy treatment

Sacrum myofascial release

Diagnosing thoracic spine somatic dysfunction

Thoracic spine counterstrain

Thoracic spine facilitated positional release

Thoracic spine HVLA

Thoracic muscle energy treatment

Thoracic spine myofascial release

Other thoracic spine treatments

Diagnosing upper limb somatic dysfunction

Special tests for the upper limb

Upper limb counterstrain

Upper limb HVLA

Upper limb muscle energy treatment

Upper limb myofascial release

Other upper limb treatments

Angina pectoris

Coronary artery disease: Clinical sciences

Coronary artery disease: Pathology review

Heart failure: Pathology review

Congestive heart failure: Clinical sciences

Dilated cardiomyopathy

Restrictive cardiomyopathy

ACE inhibitors, ARBs and direct renin inhibitors

Adrenergic antagonists: Beta blockers

Calcium channel blockers

Thiazide and thiazide-like diuretics

Potassium sparing diuretics

cGMP mediated smooth muscle vasodilators

Lipid-lowering medications: Statins

Cardiac conduction velocity

Cardiac conduction system

ECG normal sinus rhythm

ECG QRS transition

ECG rate and rhythm

ECG cardiac infarction and ischemia

ECG cardiac hypertrophy and enlargement

Notes

Thoracic spine

Thoracic spine facilitated positional release

Please refer to the "Introduction to facilitated positional release" learn page for more information about facilitated positional release (FPR).

THORACIC “EXTENSION” DYSFUNCTIONS

Example: T6 E S_RR_R

Stand at the right side of the seated patient
Place your left hand at the right transverse process of T6 to monitor the patient’s dysfunction
Place your right forearm on the patient’s right shoulder with the remainder of the forearm and hand resting across the patient’s upper back
Instruct the patient to sit up straight until extension is palpated at the level of T6
Apply gentle compression with your right forearm downward into the thoracic spine
While maintaining compression, apply an inferior and posterior force with the right forearm to position T6 into further extension, right side bending, and rotation (position of ease) until the T6 paravertebral muscles appear maximally relaxed
Hold the position for 3–5 seconds and slowly release the compression, returning the patient to neutral

TRAPEZIUS MUSCLE HYPERTONICITY

Example: right-sided dysfunction

With the patient lying prone, have them rotate their head and neck to the right
Stand at the left side with the left hand palpating the right trapezius (fingers pointed toward their head)
Grasp the patient’s right shoulder with your right hand around the anterior deltoid and AC joint
With your right hand, gently pull the right shoulder inferior and posterior
Apply an activating force in the form of gentle compression (from the shoulder toward the trapezius) with the right hand 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

Thoracic spine facilitated positional release (FPR) is a manual therapy technique used to relieve pain and improve mobility in the thoracic spine. It involves positioning the patient in a specific position that reduces tension and compression in the affected area, followed by gentle pressure to specific points on the body to release muscle tension and improve range of motion. Thoracic spine FPR is used to treat a variety of conditions like back pain, postural problems, and musculoskeletal disorders.