Ribs 11-12 Exhalation Dysfunction Muscle Energy

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Ribs 11-12 Exhalation Dysfunction Muscle Energy

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  1. Patient lies Prone this time.
  2. Stand on opposite side of dysfunction and bend the patient’s arms and legs 15-20 degrees toward you (frowny face activates QL).
  3. Patient’s arm on involved side should be placed above their head (arm position uses latissimus dorsi to move posterior rib up and out while resisting the downward pull of the quadratus lumborum)
  4. Caudad hand is placed on the ASIS  on the side of dysfunction and rotate pelvis posteriorly (pull ASIS slightly toward ceiling)
  5. The thenar eminence of the cephalad hand will be placed between ribs 11 and 12
  6. Patient asked to inhale deeply while you push laterally on rib, separating it from its articulation and holding position during exhalation
  7. Repeat 2-3 times
  8. Passive stretch
  9. Reassess

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