Still Technique of an Elevated First Rib

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Still Technique of an Elevated First Rib

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Recall: Diagnosing the First Rib

Steps for Treatment:

EASE, COMPRESSION, BARRIER

  1. The patient is seated with the physician standing behind the patient.
  2. The physician places their fingers in the patient’s supraclavicular fossa to assess the superior and inferior motion of the springing of the first ribs.
  3. After assessing the motion of the first rib the physician places one hand on the dysfunctional rib with the other hand on top of the patient’s head.
  4. Ease
    • For inhalation dysfunctions – the rib is stuck in elevation
      • Physical side bends and rotates the patient’s head and neck AWAY from the dysfunctional rib to find the position of ease
    • For exhalation dysfunctions – the rib does not fully elevate
      • Physical side bends and rotates the patient’s head and neck TOWARD from the dysfunctional rib to find the position of ease
  5. Compression
    • The physical provides gentle axial compression from the top of the patient’s head to the dysfunctional rib
  6. Barrier
    • When maintaining compression, the physician moves the patient’s head to reverse the side bending and rotational components until the patient is positioned into the barrier.
  7. The physician gently releases the compression to return the head and neck to neutral positioning.     
  8. Reassess

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