Recall Diagnosing the Thoracic Spine

Steps for Treatment:

Upper (T1-T4) Thoracics

1. Stand and monitor SD with hand that is opposite the vertebral rotation (right side) so that you are rotating and side bending toward yourself
   • Place finger on transverse processes (R_L – stand on left side and left hand monitors L transverse process)
2. Place physician’s free hand on patient’s head (right hand grasps the head)
3. Reverse Diagnosis  
4. Ask patient to try to straighten head against isometric resistance for 3 seconds, relax New barrier, repeat 2-3 times, passive stretch, neutral
5. Reassess

Middle (T5-T8) and Lower (T9-T12) Thoracics

1. Patient Seated on side of table or have patient straddle table with you standing on the opposite side of rotation
   • Same positioning as Type I except physician weaves hand from above to grab the pts stabilized arm, monitor SD
2. Reversing Diagnosis
   • Make sure to continuously monitor apex
   • Use your whole body while positioning patient
   • Side bend and rotation toward you so you have more control and it is secure
3. Ask patient to try to straighten against isometric resistance for 3 seconds, relax, move into new barrier, repeat 2-3 times, passive stretch, neutral
4. Reassess