OMM21 Non NeutralSDofLumbarSpine

8/13/2019 OMM21 Non NeutralSDofLumbarSpine

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OMM #21

Thursday, February 20, 11am

Dr. WilliamsJennifer Thompson

Pae 1 of !

Treatment of Non-neutral Somatic Dysfunction of the Lumbar Spine

"""The poerpoin$ for $his le%$ure has no$ been pos$ed for $he &prin 200! se%$ion of $heOMM %ourse ebsi$e, bu$ i$ is pos$ed in $he &prin 2002 se%$ion. 'f you loo( you ill

find $ha$ i$ is $he e)a%$ same poerpoin$ presen$a$ion $ha$ Dr. Williams used in his le%$ure

* you %an $ell by all $hose pre%ious pi%$ures of him $rea$in his ife+. lso, Dr. Williams

s$ar$ed $he le%$ure by s$a$in $ha$ e should all use the Kimberly manual$o re-ie $he$e%hniues $auh$ $o use. They reser-e $he rih$ $o quiz us directlyfrom $he /imberly

manual

'. Mo$ion of $he umbar &pine 3The posi$ion of $he sai$$al plane hen $heside bendin or $he ro$a$ion o%%urs de$ermines he$her mul$i4plane mo$ion

o%%urs a%%ordin $o neu$ral or non4neu$ral me%hani%s.5a. Remember to take into account all 3 planes of motion*refer $o slide #!

of poerpoin$s+6

i. 7oronal *sidebendin+ii. 8ori9on$al *ro$a$ion+

iii. &ai$$al *F: or ::+

b. Type '' Me%hani%s hen side4bendin is in$rodu%ed in$o $he $hora%i%

and;or lumbar spine and $he reion is in one of $he 2 non4neu$ral ranes*e). F: in lumbar+, $he body of $he superior -er$ebrae of $ypi%ally one

-er$ebral uni$ ill ro$a$e in$o $he in$ended %on%a-i$y *see slide #< ofpoerpoin$s+i. Forard;:a%(ard :endin limi$ed mo$ion

ii. =o$a$ion;&ide bendin $o same side ro$a$ion o%%urs 1s$, &: 2nd

iii. >omen%la$ure =)&) *ro$a$ion firs$, bo$h in same dire%$ion+''. Presen$in &ins; &ymp$oms

a. Pain pa$$ern usually more painful $han neu$ral &;D

i. =ela$ed ana$omy -er$ebral uni$s abo-e and belo may e)hibi$

$ype ' *neu$ral+ me%hani%sii. &ympa$he$i%;Parasympa$he$i% -is%eral inner-a$ion of$en

asso%ia$ed ; sympa$he$i% hypera%$i-i$y in orans inner-a$ed by

T1242 area'''. Trea$men$ of Type '' &;D Dont memorize techniques! Think it throu"h!

a. &ea$ed dire%$ me$hod6 M? >> =&*@@22.11:+

i. Pa$ien$ Posi$ion6 sea$ed, s$raddlin $ableA pa$ien$ does $heos$eopa$hi% salu$e $o $he same side as ro$a$ion &;D

ii. Opera$or Posi$ion6 sea$ed or s$andin behind $he pa$ien$ on $he side

opposi$e of salu$eA rea%hes hand o-er pa$ien$Bs shoulder and

%on$a%$s spinous pro%ess of lesioned semen$ i$h $humb


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OMM #21


Dr. WilliamsJennifer Thompson

Pae 2 of !

iii. *al$erna$i-ely, %an pu$ heel of hand on opposi$e $rans-erse pro%ess

ha$e-er or(s for you and your pa$ien$+

i-. Opera$or applies for%e $o &P of -er$ebrae $o lo%ali9e &:, $henrasps pa$ien$Bs pro)imal humerus on side of salu$e and indu%es

&:, ro$a$ion and F:;:: un$il all ! planes are lo%ali9ed

-. Pa$ien$ is ins$ru%$ed $o $ry $o $is$ ba%( up $o s$raih$ posi$ion

hile opera$or resis$s, $hen $o rela)-i. #ait 3-$ secondsand $hen &:, ro$a$e, ::;F: $o ne barrier and

repea$ *donB$ Cus$ do ro$a$ion, lo%ali9e all $hree planes of mo$ion+

%ii& Do as many times as necessary and then reassess!

b. &upine 4 'ndire%$;P$. 7oopera$ion;=espira$ory For%e 4 >> =&*@@22.11?+i. Pa$ien$ posi$ion6 supine, i$h head and fee$ mo-ed $o side of $able

so as $o indu%e &: $o side of &;D *in $his %ase, $he lef$+ make

sure patient S' is such that it is occurrin" in the affected

re"ion!

ii. Opera$or posi$ion6 sea$ed or s$andin on side opposi$e ro$a$ion,rea%hes hand under $o &P of lesioned semen$ and indu%es ro$a$ion

$o $he side of &;D *pull &P $oards you $his indu%es ro$a$ion

$oard &;D and $hus also indu%es a %er$ain amoun$ of &:+

iii. Pa$ien$ is ins$ru%$ed $o 3ar%h or fla$$en ba%(5, and minoradCus$men$s %an be made in all $hree planes un$il a 3poin$ of

balan%ed $ension5 is found

i-. 'ns$ru%$ pa$ien$ $o inhale deeply and $hen e)hale all $he ay andhold i$ for as lon as possible hile opera$or moni$ors for a release,

hile also balan%in $ension in ro$a$ion, &:, and sai$$al *F:;::+

plane-. 'ns$ead of ha-in pa$ien$ $o blo ou$ all $heir air, you %an also find

$ha$ poin$ in $he respira$ory %y%le $ha$ feels rih$ and ha-e $hem

hold $heir brea$h a$ $his poin$

%. &i$$in Dire%$6 8 4 >> =&*@@22.11E+i. Pa$ien$ Posi$ion6 sea$ed, s$raddlin $ableA pa$ien$ does $he

os$eopa$hi% salu$e $o $he same side as ro$a$ion &;D

ii. Opera$or Posi$ion6 sea$ed or s$andin behind $he pa$ien$ on $he sideopposi$e of salu$e i$h a (ide stanceA rea%hes hand o-er pa$ien$Bs

shoulder and %on$a%$s spinous pro%ess of lesioned semen$ i$h

$humb *al$erna$i-ely, %an pu$ heel of hand on opposi$e $rans-ersepro%ess ha$e-er or(s for you and your pa$ien$+

OMM #21


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Dr. Williams

Jennifer ThompsonPae ! of !

iii. Opera$or applies for%e $o &P of -er$ebrae $o lo%ali9e &:, $henrasps pa$ien$Bs pro)imal humerus on side of salu$e and indu%es

&:, ro$a$ion and F:;:: un$il all ! planes are lo%ali9ed

i-. $ $his poin$ an 8 $hrus$ is dire%$ed an$;supd. a$eral re%umben$ Dire%$6 7ombined Opera$or and Pa$ien$ For%es *a(a

ar$i%ula$ory i$h pa$ien$ %oopera$ion+ 4 >> =&*@@22.118+

i. Pa$ien$ posi$ion6 la$eral re%umben$, layin on side opposi$e &;D

ii. Opera$or posi$ion6 s$andin, fa%in an$erior side of pa$ien$iii. Opera$or palpa$es in$erspinnous spa%e of lesioned semen$ i$h

inde) and middle finers of %ephalad hand, and rasps pa$ien$Bs

an(les and lif$s $hem slih$ly *$o indu%e &:+ i$h %audad hand

i-. Opera$or lo%ali9es sai$$al plane by fle)in or e)$endin hips and(nees of pa$ien$ *$his %an also be done by pla%in $he pa$ien$Bs

(nees on your $hih and %on$rollin $hem $ha$ ay+-. Opera$or pla%es his;her eih$ on pa$ien$Bs les $o immobili9e

$hem, and $hen ins$ru%$s pa$ien$ $o roll o-er on %hes$ and %ome up

on $heir elbos *mu%h li(e a sphin)+-i. Pa$ien$ is $hen ins$ru%$ed $o al( elbos $oard side of $able

opposi$e from here opera$or is s$andin and $hen $o e)$end $heir

head and $urn i$ aay from opera$or

-ii. Opera$or $hen pulls &P of lesioned semen$ upard *sendin i$ in$oro$a$ion aay from &;D+ i$h %ephalad hand, and $hen lif$Bs

pa$ien$s an(les i$h %audad hand

-iii. Opera$or $hen pushes pa$ien$Bs $hihs $oard $he %en$er of $he $ableand s$raih$ens ou$ $heir les so $ha$ $he pa$ien$ is no prone.

There is >OT a pop i$h $his $e%hniue

i). =e%he%( >o$e6 #atch the %ideo of this that Dr& #illiams has

uploaded on the course (ebsite! )t is much more fluid than a

%erbal e*planation can communicate!

'. &$eps for &u%%essful Manipula$ion of $he &pine

a. Dianose a%%ura$elyb. De%ide ha$ $rea$men$ $o use, indi%a$ions;%on$raindi%a$ions, %ondi$ions of

$he pa$ien$, dire%$ or indire%$ me$hod

%. pply $he prin%iples hi%h uide $he me$hod %hosen *lo%ali9e $o $he poin$of ease or lo%ali9e a$ $he res$ri%$i-e barrier in all ! planes+

d. 8old $he pa$ien$ se%urely, bu$ lih$ly and %omfor$ably

e. &ense $he pa$ien$ rela)ed and $he for%es lo%ali9edf. se $he %orre%$ dire%$ion and dosae of a%$i-a$in for%e

. =e%he%( $o de$ermine $he %hane produ%ed

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OMM21 Non NeutralSDofLumbarSpine