Thoracic Manipulation

Position of the patient •The patient lies supine on the couch and position his or her thoracic spine onto the thigh so that the affected area lie just above the knee. •The patient clasps the hands behind the head. Position of the therapist The therapist stands at the head of the couch and flexes the thigh and knee on the couch. Method •Insert your arms through the patient’s arm and grasp the patient around the posterolateral aspects of the mid thorax bilaterally. •The slack is taken up by gently stretching the patient over your thigh while the patient adducts the arms to ensure that a firm application is made against your arms. •Now firmly (not forcibly) extend the patient thoracic spine over your thigh by simultaneously: Dropping your body back and down so that your shoulders and buttock drop toward floor Thrusting with your forearms directly downward across the patient’s shoulders/ axilla region. 5. Sternal Thrust ➢It is suitable for patients with lesion from T3 to T8 and those with tender rib cages Position of the patient •The patient sits across the couch with his or her back to therapist •The patient locks the hand behind the neck with the elbows pointing outwards. Position of the therapist Stands behind the patient and place a small rolled up towel between the patient’s back and the chest so that the upper edge is just below the painful level Method Slide your hands in front of the patient’s axilla and grasp the patient’s wrists. The palm of your hands face out wards. Ask the patient to slightly adduct the arm to allow snug apposition. Gently yet firmly extend the patient’s back against your chest in a lifting The patient is asked to breath in and out to relax. When the patient is relaxed, take up the slack, increase the stretching lift and backward extension and apply a sharp forward thrust with your upper chest.