Flexed somatic dysfunction

FIG. 49-2 Muscle energy treatment for a flexed somatic dysfunction. 

LUMBAR TYPE II FLEXED SOMATIC DYSFUNCTION (L3 F S, RR)-PATIENT SUPINE... 

FIG. 52-2A Lumbar type II flexed somatic dysfunction (t3 F S, RR), patient supine. 

C3 Create flexion with rotation away and side-bending toward the tender point (STAR). Occasionally C 3 will require extension. This tender point may be present with either a flexed or an extended somatic dysfunction. Flexion is used most commonly. 

The condition of "flat back" in the thoracic spine may be caused by an exaggerated "military" type of posture or may be caused by bilateral paravertebral muscle hypertonicity or spasm. Extension somatic dysfunctions may cause the individual to keep the back in an unusually straight posture because of discomfort or pain on flexing. The cause of the problem must be determined. Most of the causes are responsive to osteopathic manipulation. 

The patella should be articulated and any pain or crepitus noted. The accessory motions with the knee semi-flexed are anteroposterior glide, abduction, adduction, and long-axis extension. These are the motions most likely involved in somatic dysfunction of the tibia/femur articulation. 

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