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First Rib: Inhalation Somatic Dysfunction Muscle Energy
Steps for Treatment:
- Patient supine w/physician behind patient’s head
- Use MCP joint to contact the first rib (not the thumb which is used for diagnosis)
- Put the head into flexion
- Side-bend the head towards the dysfunction side and rotate the head opposite to loosen up the musculature
- (FLEX, SIDE-BEND TOWARD, ROTATE AWAY)
- Patient instructed to take a deep breath in and during inhalation resist movement and as he/she exhales physician presses down on the rib following it into exhalation
- Resist the upward movement during inhalation and follow the downward movement during exhalation
- Continue to hold the rib down as the patient breathes in again.
- Repeat 2-3 times
- Passive stretch
- Reassess
