High-velocity low-amplitude thrusting techniques

The best known of all manipulative techniques are the high-velocity, low-amplitude thrusting techniques. In these techniques, the physician positions the patient in such a way that the restricted joint is placed into its restrictive barrier(s) to motion. The physician then quickly applies a small to moderate amount of force to the joint in such a way as to move it through the barriers. Improved joint motion should result very quickly. 

This section describes the application of high-velocity, low-amplitude thrusting techniques to correct somatic dysfunctions of the cervical spine. The vertebra may be placed into one or all of its barriers to motion. Frequently with this technique, however, only one plane of motion is addressed. When this motion restriction is corrected, the other planes of restriction respond as well. After placing the vertebra into its restrictive barrier, the physician applies a rapid, gentle force through a very short distance to pass through the barrier. 

FIG. 32-1 High-velocity, low-amplitude thrusting technique for somatic dysfunction of the occipitoatlantal joint. 

This chapter describes high-velocity, low-amplitude thrusting techniques for treating somatic dysfunctions of the thoracic spine by region-upper, middle, and lower spine. For most of the techniques, the patient is supine a variation is iiiustrated in which the patient is seated. 

F I G. 4 3 -1 High-velocity low-amplitude thrusting technique for upper thoracic somatic dysfunction. 

FI G. 43 - 2 Hand placement for mid-thoracic high-velocity low-amplitude thrusting technique. 

Note As with high-velocity, low-amplitude thrusting techniques of the thoracic spine, flexion of the spine down to the segment of dysfunction may be necessary for rib dysfunctions lower in the thorax. Flexion is achieved by the physician grasping and cradling the patient behind the shoulders with his nonlocalizing hand and then flexing the patient to create localization down to the necessary point. 

R.T. was treated with osteopathic manipulation. He received soft tissue myofascial techniques to the neck and upper back. The somatic dysfunctions were treated with facilitated positional release techniques, as was the first rib. The T3-4 somatic dysfunction was also treated with high-velocity, low-amplitude thrusting technique. 

HIGH-VELOCITY, LOW-AMPLITUDE THRUSTING TECHNIQUES FOR THE SHOULDER GIRDLE... 

FIG. 100-2 High-velocity, low-amplitude thrusting technique for a posterior fibular head somatic dysfunction. (Physician is on opposite side to allow viewing of hand positions.)... 

---