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Nicholas Ch00 Contents
Nicholas Ch00 Contents
Al e xa n d er S . N i c h o l a s DO , FAAO
P rof e ss or an d Ch ai rm a n
D ep ar t m en t o f O st eo pa t h ic M an ip ul at iv e Me di ci ne , P hi la de lp hi a Co ll eg e of O st eo pa th ic
M ed ic in e, P h il ad el ph ia , P e nn sy lv an ia
E va n A. N i c h o l a s D O
A ss oc ia t e P r of es so r
D ep ar t m en t o f O st eo pa t h ic M an ip ul at iv e Me di ci ne , P hi la de lp hi a Co ll eg e of O st eo pa th ic
M ed ic in e, P h il ad el ph ia , P e nn sy lv an ia
Secondary Editors
D o n n a B al ad o
A cq ui si t i on s E di t o r
K at h l ee n H . S c o g n a
D ev el opm en t E di t o r
K ei th D o n n e l l an
M an ag in g E di t o r
D ov et ai l C on t e nt S ol ut io ns
E mi l i e Mo ye r
M ark e t i ng Ma na ge r
E ve Ma l a ko ff -K l e i n
P ro du ct io n E di t o r
S te p h en D ru d i n g
D es ig n C oo rd in at or
M i c h a el F er re i r a
I nd ex er
M ar yl a n d Co mp o s i t i o n , I n c .
C om po si t o r
R . R . Do n n el l e y an d S o n s W il l a rd
P ri nt er
Dedication
Dr. Ni ck
I n 19 74 , t he a ut ho rs ' f at he r, Ni ch ol as S . Ni ch ol as , D O, FAA O, c ha irm an of th e Os te op at hi c
P ri nc ip le s a nd P ra ct ic e De pa rt m en t a t Ph il ad el ph ia Co ll eg e of Os te op at hi c M ed ic in e
( P C O M ) pu bl is he d t he f ir st e di t i on of A tl as o f Os te op at hi c Tec hn iq ue s . Hi s go al was to p ut
i nt o pr in t a n um b er of t h e com m o nl y u se d os te op at hi c m a ni pu la ti ve te ch ni qu es of t ha t tim e.
T he y wer e t o b e us ed b y m ed ic al s t u de nt s t o ref er en ce t he t ec hn iq ue s b ei ng ta ug ht in t he
c la ss ro om an d t o st an da rd ize t he t ec hn iq ue s s o th at i n t he o ra l ex am i na ti on , th e e va lu at io n
of t h ei r wo rk co ul d be m o re o bj ec t i ve l y ev al ua te d.
N ic ho la s S . Ni ch ol as , DO , a 19 39 gr ad ua te of K irk s vi ll e Co ll eg e of Os te op at h y, was a
g en er al pr ac t i t i on er who al so s pe ci al ized in i nd us tr ia l a nd s po rt s m ed ic in e. He u se d
o st eo pa t h ic t e ch ni qu es ro ut in el y i n hi s pr ac ti ce , a nd b ec au se of t he c li ni ca l r es ul ts , he wa s
v er y ex ci t e d t o t e ac h t h es e t ec hn iq ue s t o m ed ic al s tu de nt s. Affe ct io na te l y k no wn as D r.
N ick t o h is s t u de nt s, he b eg an t e ac hi ng at P CO M in 1 94 6 a nd in 1 97 4 be cam e ch ai rm a n of
t he O st eo pa t h ic P r in ci pl es an d P r ac t i ce De pa rtm en t. I n 19 74 , h e en li st ed PC OM f ac ul t y
m em b er s t o d ev el op a l is t of t ec hn iq ue s t o in cl ud e i n th e or ig in al ed it io n of hi s at la s. The se
f ac ul t y m em b er s i nc lu de d Da vi d H ei li g, D O, FAA O; R ob er t E ng la nd , D O, FAA O; M ar vi n
B lum be rg , DO , FAA O ; Je rom e S u lm a n, D O; a nd K at he ri ne En gl an d, DO .
T he s t u de nt s b en ef i t e d, a nd t he ir at t em pt s to l ea rn t he te ch ni qu es wer e im p ro ve d, as wa s
s ee n d ur in g P C O M e xam in at io ns . As wo rd of th is t ex t sp re ad , PC OM a lum ni a nd ot he r
o st eo pa t h ic ph ysi ci a ns al so s a w a n ee d f or t hi s te xt a s a re vi e w an d/ or r ef e re nc e of
s t a nd ar d t ec hn iq ue s f or t he ir p ra ct ic es . B ec au se of i ll ne ss , Dr. Ni ck wa s a bl e t o pr od uc e
o nl y t wo ed it io ns of h is wo rk .
O ve r t h e ye ar s, t h e at la s g av e wa y t o vi de ot ap e d em o ns tr at io ns of te ch ni qu es an d f ur th er
e di t e d a nd e xp an de d v er si on s of t h e wri tt en te ch ni qu es . F rom t he t im e of th e in ce pt io n of
t he a t l as , t he n um b er of nam ed s t yl es of os te op at hi c t ec hn iq ue s b ei ng t au gh t i n os te op at hi c
m e di ca l sc ho ol s ha s g ro wn f rom a pp ro xim a te l y th re e to t wel v e d is ti nc tl y nam ed s t yl es .
M an y of t h e st yle s h av e s im il ar it ie s t h at ca n le ad to c onf u si on , wh ic h i s wh y we h av e
d ec id ed t o e xp an d t he o ri gi na l v er si on a nd up da te it t o th e pr es en t l ev el of pr ac ti ce .
W e d ed ic at e t hi s bo ok t o ou r f at he r, wh o wo u ld m ost l ik el y ha ve wan te d to d ed ic at e i t to a ll
of hi s f orm e r st ud en t s an d t o a ll t h e f utu re o st eo pa th ic ph ys ic ia ns he t ho ug ht wou l d
a pp re ci at e a c om p re he ns iv e wo rk on o st eo pa th ic m an ip ul at iv e t ec hn iq ue s.
Preface
O st eo pa t h ic m ed ic in e as t au gh t a nd p ra ct ic ed in t he U ni te d S ta te s at t he en d of t he 19 th
c en t u r y t h ro ug h t h e b eg in ni ng of t he 2 1s t c en tu r y h as un de rg on e m a n y c ha ng es . The
e vo lu t i on of s ci en t if ic f in di ng s an d u nd er st an di ng of b io lo gi c p ro ce ss es b y wh ic h t he b od y
f un ct io ns an d at t em pt s t o m a in t a in h ea lt h h as h ad a di re ct effe ct o n t he wa y o st eo pa th ic
m e di ca l cu rr ic ul a ar e d ev el op ed .
D ur in g o ur o st eo pa t h ic m ed ic al s ch oo l m at ri cu la ti on , we we r e t au gh t on l y th re e or f o ur
s ep ar at e s t yl es of o st eo pa t h ic t e ch ni qu e. Si nc e t ha t tim e , m an y ne w di ag no st ic an d
t he ra pe ut ic pr oc ed ur es ha ve be en a dd ed to t he arm am en ta ri um of o st eo pa th ic tr ea tm e nt ,
a nd t h er e ar e no w o ve r a do ze n i nd iv id ua l s t yl es . S om e of th es e st yl es ar e ve r y s im i la r, a nd
a s de sc ri be d i n t h e c ha pt er s of t hi s a tl as , th e y h av e d ev el op ed b y n ua nc e i nt o d is ti nc t,
i nd iv id ua ll y n am e d ca t e go ri es of t ec hn iq ue .
B ec au se of t he se a dd it io ns an d c ha ng es , b ot h os te op at hi c m e di ca l st ud en ts an d
p ra ct it io ne rs ha ve ha d a m uc h m ore diffic ul t t im e tr yin g t o l ea rn a nd rem em be r th es e
t ec hn iq ue s, an d p ra ct it io ne rs h av e f ac ed an i nc re as in gl y c om pl ex p ro ce ss in d ec id in g wh ic h
t ec hn iq ue is c li ni ca ll y in di ca t e d f or a pa rt ic ul ar p at ie nt . To a id t he s tu d y an d pr ac ti ce , we
h av e g ra du al l y de ve lo pe d a c om p il at io n of t ec hn iq ue s t ha t a re c om m on l y u se d b y
o st eo pa t h ic ph ysi ci a ns an d t h at ar e cl in ic al l y effe ct iv e. Th e re su lt of t hi s effor t is t he A tl as
o f O s t e op at hi c Tec hn iq ue s .
A t P h il ad el ph ia Co ll eg e of O s t e op at hi c M ed ic in e, a tr ad it io n of te ch ni qu e a tl as g oe s ba ck to
a t le as t 1 94 9 wit h t he pu bl ic at io n of Os te op at hi c Tech ni qu es , b y Sam ue l Ru bi ns te in , D O. I t
wa s d ed ic at ed t o t wo h ig hl y r es pe ct ed ph ysi ci an s, Ot te rb ei n D re ss le r, D O, a nd Jo hn
E im e rb ri nk , DO . I n h is p ref ac e, D r. R ub in st ei n n ot ed , T he ne ce ss it y f or th is t yp e of
t ex t b ook ha s b ec om e i nc re as in gl y a pp ar en t wit h tim e be ca us e of th e ne ed to h av e a v is ua l
r ec or d of t h e va ri ou s p h ys ic ia n a nd pa ti en t p os it io ns a nd f orc e ve ct or s a t pl a y. Yet n o ot he r
e xam pl e was re ad il y re pr od uc ed un t i l N . S. N ic ho la s, D O, FAA O, p ub li sh ed hi s At la s of
O st eo pa t h ic Tec hn iq ue in 1 97 4.
T hr ou gh ou t o ur ye a rs of t ea ch in g, m an y p ra ct ic in g p h ys ic i an s h av e ask ed u s wh y th er e
we re no ne w ed it io ns of t he A t l as o f Os te op at hi c Tec hn iq ue . O ur i ni ti al an s we r wa s t ha t
o t h er t ex t s h ad be en pu bl is he d. Ho wev e r, t he se ref e re nc e te xt bo ok s f oc us o n th e
p hi lo so ph y a nd pr in ci pl es of os t e op at hi c m e di ca l pr ac ti ce an d in cl ud e o nl y a f ew us ef u l
t ec hn iq ue s. Th e n ee d f or a n up da t e d, com pr eh en si ve at la s of t ec hn iq ue s b ec am e
i nc re as in gl y c le ar, an d we ha ve r es po nd ed wit h a te xt bo ok t ha t in cl ud es a st ra ig htf or war d,
h ig hl y o rg an ized , a nd e as il y na vi ga bl e com p en di um of o st eo pa th ic te ch ni qu es al on g wi th
t he p hi lo so ph y a nd pr in ci pl es t h at s up po rt th em . Thi s m ate ri al is i nt en de d t o he lp s tu de nt s
a nd pr ac t i t i on er s un de rs t a nd t he r ea so ni ng be hi nd th e pr oc ed ur es an d t he r am if ic at io ns of
t he ir u se in t he c li ni ca l s et t i ng .
O ne of t he m aj or im pr ov em e nt s in t he At la s of O st eo pa th ic Tech ni qu es is t he p re se nt at io n
of m or e t h an 1 00 0 c ol or p ho t o s of ev er y p ro ce du ra l s te p in vo lv ed in e ac h t ec hn iq ue . The
p ho t o s f or e ac h t e ch ni qu e a re pl ac ed t og et he r o n t he s am e o r ad ja ce nt pa ge s, a lo ng wit h
d es cr ip t i ve t e xt , t o m ak e t he b ook ea s y to u se i n th e c li ni ca l se tt in g. Th e ne w p ho to s wer e
c re at ed sp ec if ic al l y f or t hi s a t l as u nd er th e di re ct io n of th e au th or s a nd a p rof es si on al
p ho t o gr ap he r. Ar ro ws an d ot he r a nn ot at io ns di re ct l y o n th e p ho to s gu id e t he r ea de r t hr ou gh
t he t ec hn iq ue s. T he c la ri t y of t he se p ho to s a nd t he ir an no ta ti on s, com b in ed wit h t he ir
o rg an izat io n i nt o a n ea s y- t o- us e f orm a t, m ak e t hi s at la s a n ex tr em el y us ef u l to ol i n bo th th e
l ab or at or y a nd t he cl in ic .
A ls o in cl ud ed in t he at la s ar e t h e v ar io us d ia gn os ti c p ro ce du re s c om m on t o os te op at hi c
m e di ci ne . Th e d es cr ip t i on s f or t he se i nc lu de th e m us cu lo sk el et al st ru ct ur al e xam in at io n,
r eg io na l r an ge of m ot io n a ss es sm en t , la yer - b y- l a ye r p al pa to r y ex am i na ti on , an d t he
i nt er se gm e nt al exam in at io n of t h e sp in al an d pe lv ic re gi on s. D ia gn os is is i nc lu de d s o th e
r ea de r c an r el at e t he s pe cif i c t r ea t m e nt t o th e d ia gn os ti c c ri te ri a th at g ov er n i ts u se . Thi s is
im po rt an t , a s t h e p h ys ic ia n m u st u nd er st an d t he n at ur e of th e d ysf un ct io n a nd th e
t ec hn iq ue be st s ui t e d t o t r ea t it s uc ce ssf ul l y.
W e h av e or ga ni ze d t hi s a t l as i nt o t wo se ct io ns : P ar t 1, O st eo pa th ic Pr in ci pl es i n D ia gn os is ,
a nd P a rt 2 O st eo pa t h ic Ma ni pu la t i ve Tech ni qu es . Th e or de r of Pa rt 1 i s sim il ar t o ho w we
p re se nt t h e m at er ia l t o o st eo pa t h ic m ed ic al s tu de nt s a nd i s in k e ep in g wit h wh at we b el ie ve
i s t h e m os t ap pr op ri at e a nd saf e m et ho d of pe rf o rm in g th e o st eo pa th ic m usc ul osk el et al
e xam i na t i on . W e h av e ar ra ng ed P a rt 2 in wh at we c on si de r t he c la ss ic al f o rm at , b y
t ec hn iq ue st yle , a s t h e r ea de r sh ou ld f irs t de ci de on a s t yl e, th en pr oc ee d t o th e
a pp ro pr ia t e ch ap t e r a nd t o t he s pe cif i c an at om i c re gi on wit hi n t ha t ch ap te r.
W e h op e t h at t h e re ad er wil l f in d t h is u sef ul i n al l st ag es of o st eo pa th ic ed uc at io n:
u nd er gr ad ua t e , po st gr ad ua t e re si de nc y, an d c on ti nu in g m e di ca l ed uc at io n. W e h op e u se of
t hi s t e xt wi ll in st il l m or e co nf id en ce in p erf o rm i ng t he se te ch ni qu es an d th er eb y h el p
r ea de rs t o b et t e r he lp pa t i en t s . As ph ysi ci an s, we a re tr ai ne d to u se ou r m in ds a nd h an ds ,
a nd as o st eo pa t h ic ph ysi ci an s, we a re f req ue nt l y rem i nd ed th at i t is i nh er en t t o ou r pr ac ti ce
t o do so . As t he s ea l of P h il ad el ph ia Co ll eg e of Os te op at hi c Me di ci ne st at es , M en s e t
M an us .
A. S . Ni ch ol as
E. A. Ni ch ol as
Acknowledgments
T he A t l as o f O s t e op at hi c Tec hn iq ue s i s ou r effor t to m ain ta in a hi st or ic al c on ti nu um of th e
m a n y v ar ia t i on s of os t e op at hi c m an ip ul at iv e t ec hn iq ue s t ha t h av e be en us ed f o r ov er a
c en t u r y in t he U ni t e d S t a t e s an d no w i n m an y o th er co un tr ie s. W e o bv io us l y ha ve no t
i nv en t e d a n y t ec hn iq ue s, no r h av e an y b ee n nam ed af te r us . Th e m an y os te op at hi c
p h ys ic i an s wh o h av e p re ce de d u s in t o t hi s pr of e ss io n ha ve ta ug ht u s t he se t ec hn iq ue s, an d
we ho pe t h at t hi s m a y c on t i nu e t he ir l eg ac y.
A f e w p h ys ic i an s m us t be pa rt ic ul ar l y t ha nk e d. F ir st , we m u st r ec og ni ze o ur f ath er, Ni ch ol as
S . Ni ch ol as . O ve r m an y yea rs of wi t n es si n g h is p at ie nt s' ov er whe lm in gl y po si ti ve f eel in gs
a bo ut t h e ca re t he y r ec ei ve d a t hi s ha nd s, we c ou ld n ot c ho os e a n y o th er f orm of
o cc up at io n, as t he y j us t se em e d m ino r com pa re d t o th e wor k h e di d. Se co nd , we m u st t ha nk
D av id He il ig . O u r f at h er m an y t im e s st at ed t ha t H ei li g was th e m os t ab le p h ysi ci an he h ad
e ve r s ee n wit h o st eo pa t h ic di ag no si s a nd t ec hn iq ue . W e we re lu ck y en ou gh to k no w h im a s
c hi ld re n a nd l at er t o b e t a ug ht b y h im . W e th en wor k e d s id e- b y- s id e f or m or e t ha n 25 ye a rs ,
s ha ri ng id ea s an d t ec hn iq ue s. W e we r e b le ss ed t o be hi s f rie nd s.
W alt e r E h re nf eu ch t e r, ou r f rie nd an d co ll ea gu e f or m a n y ye ar s, m us t al so b e re co gn ized , a s
h e he lp ed in d ev el op in g t h e st yle of t hi s a tl as a nd p ut to p en m a n y of th e t ec hn iq ue s i n ou r
o ri gi na l m an ua ls at P CO M. H is u nd er st an di ng of m usc le e ne rg y t ec hn iq ue was sp ec if ic al l y
u se d a s a m od el i n de ve lo pm e nt of t ha t ch ap te r, an d hi s im p ri nt c an b e f ou nd i n o th er
c ha pt er s a s wel l.
W e m us t t h ank o t h er s who ha ve inf l ue nc ed us a s ro le m ode ls , t ea ch er s, a nd pr ac ti ti on er s
B er yl Ar bu ck le , Ma rv in B lum be rg , Alb er t D' Al on zo , He nr y D 'A lo nzo, Fa irm a n De nl in ge r,
K at he ri ne E n gl an d, Ro be rt E ng la nd , W ayn e E ng li sh , Ro be rt Ka pp le r, An th on y Le on e, Pa ul
T. Ll o yd , R ob er t M ea ls , I d a S chm i dt , Ed war d St il es , Jam e s St ook e y, J er om e Su lm a n, G al en
D . Youn g, G a le n S . Youn g, a nd Ab ra ha m Ze ll is f o r al l of t he ir s up po rt an d h el pf ul
c om m en t s o ve r t hr ee d ec ad es . M or e re ce nt l y, we h av e ha d im p or ta nt in pu t f rom ou r f rie nd s
a nd as so ci at es D en is e B ur ns , W illiam Thom as C ro w, J oh n Jo ne s, an d Mi ch ae l K uc he ra .
W e c an no t f or ge t t h e m an y un de rg ra du at e PC OM o st eo pa th ic m ani pu la ti ve m ed ic in e f ell o ws
wh o h av e b ee n a ss oc ia t e d wit h t hi s effo rt . Ev er yon e a ss oc ia te d wi th ou r d ep ar tm e nt h as
h ad som e ef f e ct o n t he o ut com e, b ut s om e s ho ul d b e si ng le d o ut f or t he ir o ri gi na l i de as ,
e di t i ng , p ho t o l a you t s , a rt wor k , an d g ra ph ic s on th e m an ua ls t ha t pr ec ed ed an d e ve nt ua ll y
c ulm in at ed i n t h is at la s: S an dr a R an ie ri -C os ta , Da ni el Cs as za r, Todd F ea th er s, Tro y
H en ni ng , P a yc e H an dl er - Ha l y, T hom as H al y, Sh er yl Lyn n Ol esk i , Co nc et ta Ot er i, Tar a
H ei nz- L a wlo r, Da vi d G l usk o, D av id K el le r, L au re n N ot o- B el l, F ra nc is co L ab o y, Sc ot t
P ee re nb oo m , D an ie ll e Cam pb el l, R ic ha rd Sl oa n, E un St ra wse r, an d Ke ll i You ng . Sp ec ia l
t ha nk s t o K yl ie Jo hn st on - K a nze f or he r wo rk on t he c ra ni al ch ap te r.
T ha nk s t o ou r ot he r P C O M s t u de nt s wh o p ut in t im e he lp in g wi th th is p ro je ct : N im i Pa te l
a nd Ni ch ol as R os si (m od el s) ; K a t e S t o r y, As hl e y P al es e, a nd Am an da Sc hom p er t ( ed it in g) ;
B ra d Tai ch er ( com pu t e r sk il ls ); a nd P a tr ick So to a nd Ju st in S n yde r (m e di ca l i ll us tr at io n) .
A pp re ci at io n t o Do nn a B al ad o f or b ri ng in g t hi s po ss ib il it y to L ip pi nc ot t W illiam s & W ilk ins
a nd t h ank s t o K e it h D on ne ll en an d B r et t Ma cN au gh to n f o r th ei r pr od di ng , e di ti ng , a nd
18
19
20
21
22
23
24
25
26
27
28
29
Cha pter 5
37
38
39
40
42
43
T1 to T4 Passive Flexion, Extension, Side Bending, and Rotation, Seated, Long-Lever Method
44
T1 to T12 Passive Flexion and Extension, Translatory Method, Seated (T6-T7 Example)
46
47
T1 to T12 Prone Short-Lever Method, Passive Rotation, Side Bending (Example T7)
48
49
50
54
55
56
57
58
60
62
63
64
65
Pelvis on Sacrum (Iliosacral), Anteroposterior Rotation, Supine, Long Lever (Leg Length)
66
Sacroiliac Joint and Pelvic Dysfunctions, Pelvic (e.g., Innominate Rotation, Shear, InflareOutflare), Standing Flexion Test
67
Sacroiliac Joint and Pelvic Dysfunctions, Pelvic (Innominate) or Sacral, Seated Flexion Test
68
69
Sacroiliac Joint Motion, Pelvis on Sacrum (Iliosacral Dysfunction), Inflare-Outflare Prone, Long
Lever
70
71
Sacroiliac Joint Motion, General Restriction or Anteroposterior Rotation, Supine, Short Lever
72
Cha pter 7
Traction, Supine
81
82
83
84
85
86
Rotation, Supine
87
88
89
90
Lateral Traction, Seated (Example: Left Cervical Paravertebral Muscle Hypertonicity, Fascial
Inelasticity, and Others)
91
92
93
Prone Pressure
94
95
96
97
98
99
100
Cha pter 8
Supine Cradling
118
119
Prone
120
121
Prone
122
123
124
Cha pter 9
AC1
136
AC2 to AC6
138
139
AC8
140
PC1 Inion
142
143
144
145
147
AT1 to AT6
148
149
AT7 to AT9
150
AT 9 to AT12
151
153
154
155
156
157
PT9 to PT12
158
160
Cha pter 10
184
185
186
187
188
190
192
193
194
196
198
200
201
Right Ribs 1 and 2, Inhalation Dysfunction: Post Isometric Relaxation to Relax Scalene
Muscles, Seated
202
Right Ribs 1 and 2, Inhalation Dysfunction: Post Isometric Relaxation to Relax Scalene
Muscles, Supine
203
204
205
206
208
Cha pter 11
278
280
281
282
283
284
286
288
289
290
291
292
293
294
295
296
297
298
299
300
Cha pter 12
Right: Suboccipital Muscle Hypertonicity
334
335
336
337
Left First Rib Dysfunction, Posterior Elevation: Nonrespiratory Model, Soft-Tissue Effect
338
339
340
341
342
343
344
Cha pter 13
349
350
351
352
353
354
First Rib Dysfunction, Example: Right, Posterior, Elevated First Rib (Nonphysiologic,
Nonrespiratory)
355
First or Second Rib, Example: Left, First Rib Exhalation Dysfunction, Seated
356
357
358
359
360
361
362
363
364
365
Cha pter 14
370
371
372
373
374
375
376
377
First Rib Dysfunction, Example: Left, Posterior, Elevated First Rib (Nonphysiologic,
Nonrespiratory)
378
Dysfunction of the Respiratory Diaphragm and/or Exhalation Dysfunction of the Lower Ribs
379
380
381
382
383
384
Hypertonicity of the External Hip Rotators and Abductors of the Femur (Example: Piriformis
Hypertonicity and Fibrous Inelasticity)
385
386
387
388
389
Foot and Ankle, Example: Left Calcaneus Dysfunction, the Boot Jack Technique
390
391
392
Cha pter 15
Occipitomastoid Suture Pressure
398
400
Singultus (Hiccups)
402
Rib Raising
404
Colonic Stimulation
405
Splenic Stimulation
406
Sacral Rock
407
Gastric Release
408
Hepatic Release
409
Gallbladder
410
Kidney Release
411
Cha pter 16
416
417
418
419
420
Submandibular Release
421
422
424
425
Thoracic Inlet and Outlet: Myofascial Release, Direct or Indirect, Seated, Steering Wheel
Technique
426
427
428
429
430
431
432
433
434
436
437
438
440
442
444
445
446
447
448
449
450
Cha pter 17
Shoulder Girdle: Spencer Technique Stage 1Shoulder Extension with Elbow Flexed
456
Shoulder Girdle: Spencer Technique Stage 2Shoulder Flexion with Elbow Extended
457
Shoulder Girdle: Spencer Technique Stage 3Circumduction with Slight Compression and
Elbow Flexed
458
Shoulder Girdle: Spencer Technique Stage 4Circumduction and Traction with Elbow
Extended
459
460
Shoulder Girdle: Spencer Technique Stage 5BAdduction and External Rotation with Elbow
Flexed
461
Shoulder Girdle: Spencer Technique Stage 6Internal Rotation with Arm Abducted, Hand
Behind Back
462
Shoulder Girdle: Spencer Technique Stage 7Distraction, Stretching Tissues, and Enhancing
Fluid Drainage with Arm Extended
463
464
465
466
Hip Girdle: Spencer Technique Stages 5 and 6Internal and External Rotation
467
468
469
470
Right Anterior Innominate Dysfunction: HVLA with Respiratory Assistance, Leg-Pull Technique
471
472
473
Cha pter 18
Cranial Vault Hold
481
Fronto-occipital Hold
482
Sacral Hold
483
484
Occipitoatlantal Decompression
485
486
488
489
490
Unilateral Temporal Rocking Example: Left Temporal Bone in External or Internal Rotation
492
Frontal Lift
493
Parietal Lift