Ribs 2-10 Exhalation Dysfunction Muscle Energy

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Ribs 2-10 Exhalation Dysfunction Muscle Energy

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Note: Set up the same exact way as 1st rib!

  1. Patient lies supine, with you on side of dysfunction facing the patient’s head
  2. Patient places hand, palm side up (same side of dysfunction) on forehead; you place your cephalad hand on top
  3. Place your caudad hand under patient’s back and grasp posterior/superior angle of key rib (superior rib of group dysfunction)
  4. Instruct patient to lift their ARM (not their head this time) toward the ceiling while inhaling deeply (pump handle) – adjust the arm until you feel motion under your hand
    • For bucket handle – Have patient lift their hand and arm up and laterally 45° from midline (mostly using serratus anterior to help lift bucket handle motion). Instruct patient to press their hand against yours while inhaling deeply
  1. You maintain isometric resistance for 3-5 seconds while simultaneously pulling down on posterior aspect of rib
  2. Repeats 2-3 times
  3. Passive stretch
  4. Reassess

Video Tutorial:

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