Authors

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

i ll us t r at in g, whi ch f ina ll y m ov ed t hi s pr oj ec t t o com pl et io n, a s wel l a s h el pi ng t o g iv e it i ts

d is t i nc t i ve lo ok .
W e also must thank our wives, Benita and Vicki, for their patience with us during this enterprise.

List of Techni ques

Cha pter 3
Forward Bending and Backward Bending (Flexion and Extension), Active

18

Forward Bending and Backward Bending (Flexion and Extension), Passive

19

Side Bending, Active and Passive

20

Rotation, Active and Passive

21

T1 to T4 Side Bending, Passive

22

T5 to T8 Side Bending, Passive

23

T9 to T12 Side Bending, Passive

24

T9 to T12 Rotation, Active

25

T9 to T12 Rotation, Passive

26

Forward Bending and Backward Bending (Flexion and Extension), Active

27

Side Bending, Active

28

Side Bending, Passive, with Active Hip Drop Test

29

Cha pter 5

L1 to L5-S1 Rotation, Short-Lever Method, Prone (L4 Example)

37

L1 to L5-S1 Side Bending, Translational Short-Lever Method, Prone (L4 Example)

38

L1 to L5-S1 Type 2, Extension (Sphinx Position) and Flexion, Prone

39

L1 to L5-S1 Passive Flexion and Extension, Lateral Recumbent Position

40

L1 to L5-S1 Passive Side Bending, Lateral Recumbent Position (L5-S1 Example)

42

T1 to T4 Side Bending, Lateral Recumbent Position (Long Lever)

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

T1 to T12 Translatory Method (Passive Side Bending), Seated

47

T1 to T12 Prone Short-Lever Method, Passive Rotation, Side Bending (Example T7)

48

T8 to T12 Long-Lever Method, Passive Flexion and Extension, Lateral Recumbent

49

T8 to T12 Long-Lever Method, Passive Side Bending, Lateral Recumbent

50

Upper Ribs 1 and 2, Supine Method

54

First Rib, Elevated, Seated Method

55

Upper Ribs 3 to 6, Supine Method

56

Lower Ribs 7 to 10, Supine Method

57

Floating Ribs 11 and 12, Prone Method

58

Occipitoatlantal Articulation (Occiput-C1), Type I Coupling Motion

60

Atlantoaxial Articulation (C1-C2), Rotation

62

Atlantoaxial (C1-C2), Supine, with Flexion Alternative

63

C2 to C7 Articulations, Short-Lever Translatory Effect, Type II Motion

64

C2 to C7 Articulations, Long-Lever Method, Type II Motion (e.g., C3SRRR or SLRL)

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

Sacroiliac Joint Motion, Pelvis on Sacrum (Iliosacral Dysfunction), Anteroposterior Rotation

Prone, Long Lever

69

Sacroiliac Joint Motion, Pelvis on Sacrum (Iliosacral Dysfunction), Inflare-Outflare Prone, Long
Lever

70

Sacroiliac Joint Motion, General Restriction, Prone, Short Lever

71

Sacroiliac Joint Motion, General Restriction or Anteroposterior Rotation, Supine, Short Lever

72

Cha pter 7

Traction, Supine

81

Forward Bending (Forearm Fulcrum), Supine

82

Forward Bending (Bilateral Fulcrum), Supine

83

Contralateral Traction, Supine

84

Cradling with Traction, Supine

85

Suboccipital Release, Supine

86

Rotation, Supine

87

Supine, Forefingers Cradling

88

Thumb Rest, Supine

89

Coupling with Shoulder Block, Supine

90

Lateral Traction, Seated (Example: Left Cervical Paravertebral Muscle Hypertonicity, Fascial
Inelasticity, and Others)

91

Sitting Traction (Example, Using Right Knee)

92

Head and Chest Position, Seated

93

Prone Pressure

94

Prone Pressure with Two Hands (Catwalk)

95

Prone Pressure with Counterpressure

96

Side Leverage, Lateral Recumbent

97

Bilateral Thumb Pressure, Prone

98

Trapezius, Inhibitory Pressure, Supine

99

Upper Thoracic with Shoulder Block, Lateral Recumbent

100

Cha pter 8
Supine Cradling

118

Thoracic Inlet and Outlet, Seated Steering Wheel

119

Prone

120

Bilateral Sacroiliac Joint with Forearm Pressure, Supine

121

Prone

122

Interosseous Membrane, Seated

123

Supine Leg Traction

124

Cha pter 9

AC1

136

AC2 to AC6

138

AC7 (Sternocleidomastoid Muscle)

139

AC8

140

PC1 Inion

142

PC1 and PC2

143

PC3 to PC7, Midline

144

PC3 to PC7, Lateral

145

AT1 and AT2

147

AT1 to AT6

148

AT3 to AT4, Alternative Technique

149

AT7 to AT9

150

AT 9 to AT12

151

PT1 to PT4, Midline

153

PT1 to PT6, Midline

154

PT7 to PT9, Midline

155

PT4 to PT9, Lateral

156

PT4 to PT9, Lateral

157

PT9 to PT12

158

Anterior Rib, Exhaled and Depressed, AR1 and AR2

160

Cha pter 10

Trapezius Muscle Spasm (Long Restrictor): Post Isometric Relaxation

184

Left Sternocleidomastoid Spasm (Acute Torticollis): Reciprocal Inhibition

185

Left Sternocleidomastoid Contracture (Chronic): Post Isometric Relaxation

186

Cervical Range of Motion: Oculocervical Reflex

187

Occipitoatlantal (C0-C1) Dysfunction, Example: CO ESLRR, Post Isometric Relaxation

188

Occipitoatlantal (C0-C1) Dysfunction, Example: CO FSLRR, Post Isometric Relaxation

190

Atlantoaxial (C1-2) Dysfunction, Example: RL, Post Isometric Relaxation

192

C2C7 Dysfunction, Example: C3-FSRRR, Post Isometric Relaxation

193

T1T4 Dysfunction, Example: T4-ESRRR, Post Isometric Relaxation

194

T1T6 Dysfunction, Example: T4-FSRRR, Post Isometric Relaxation

196

T5T12 Dysfunction, Example: T8 ESRRR, Post Isometric Relaxation

198

Right First Rib, Inhalation Dysfunction: Respiratory Assist, Seated

200

Right First Rib, Inhalation Dysfunction: Respiratory Assist, Supine

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

Right Ribs 2 to 6, Inhalation Dysfunction: Respiratory Assist

204

Right Ribs 7 to 10, Inhalation Dysfunction: Respiratory Assist

205

Right Ribs 11 and 12, Inhalation Dysfunction: Respiratory Assist

206

Right Ribs 1 and 2, Exhalation Dysfunction: Contraction of Scalene Muscles Mobilizes

Dysfunctional Ribs

208

Cha pter 11

Occipitoatlantal (C0C1, OA) Dysfunctions, Example: OA, F/E/or N-SLRR

278

Atlantoaxial (C1C2, AA) Dysfunction, Example: C1 RL

280

C2 to C7 Dysfunctions, Example: C4 FSLRL, Short-Lever, Rotational Emphasis

281

C2 to C7 Dysfunctions, Example: C5 ESRRR, Long-Lever Rotational Emphasis

282

C2 to C7 Dysfunctions, Example: C5 NSLRL, Short-Lever Technique, Side-Bending Emphasis

283

T1 to T12 Dysfunctions, Example: T4 FSLRL, Supine

284

T1 to T12 Dysfunctions, Example: T9 ESRRR, Supine

286

T1 to T8 Dysfunctions, Example: T2 FSLRL, Supine Over the Thigh

288

T3 to T8 Dysfunctions, Example: T6 FSRRR, Prone

289

T1 to T4 Dysfunctions, Example: T2 FSRRR, Prone (Long Lever)

290

T8 to T12 Dysfunctions, Example: T9 ESRRR, Seated (Short Lever)

291

T8 to T12 Dysfunctions, Example: T10 ESRRR, Seated (Long Lever)

292

Right First Rib Inhalation Dysfunction, Seated

293

Left First Rib Inhalation Dysfunction, Supine

294

Left Rib 6 Inhalation Dysfunction, Supine

295

Left Rib 8 Exhalation Dysfunction, Supine

296

Right Ribs 11 and 12 Inhalation Dysfunction, Prone

297

Right Ribs 11 and 12 Exhalation Dysfunction, Prone

298

L1 to L5 Dysfunctions, Example: L5 NSLRR, Lateral Recumbent (Long Lever)

299

L1 to L5 Dysfunctions, Example: L4 FRRS, Lateral Recumbent (Long Lever)

300

Cha pter 12
Right: Suboccipital Muscle Hypertonicity

334

C2 to C4 Dysfunction Example: C4 FSRRR

335

T4 to T12 Dysfunctions Example: T6 ESRRR

336

Right-Sided Trapezius Muscle Hypertonicity

337

Left First Rib Dysfunction, Posterior Elevation: Nonrespiratory Model, Soft-Tissue Effect

338

Left Seventh Rib, Inhalation Dysfunction

339

L1 to L5 Dysfunctions Example: L3 NSLRR

340

L1 to L5 Dysfunctions Example: L4 FSRRR

341

Left-Sided Erector Spinae Muscle Hypertonicity

342

Left Posterior Innominate Dysfunction

343

Left Anterior Innominate Dysfunction

344

Cha pter 13

Occipitoatlantal (C0C1, OA) Dysfunction, Example: C0 ESRRL, Seated

349

Atlantoaxial (C1C2) Dysfunction, Example: C1 RL, Supine

350

C2 to C7 Dysfunction, Example: C4 ESRRR, Supine

351

T1 and T2 Dysfunctions, Example: T1 ERRSR, Seated

352

T1 and T2 Dysfunctions, Example: T2 FRLSL, Supine

353

T3 to T12 Dysfunctions, Example: T5 NSLRR, Seated

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

First Rib, Example: Right, First Rib Exhalation Dysfunction, Seated

357

L1 to L5 Dysfunctions, Example: L4 NSRRL, Supine

358

L1 to L5 Dysfunctions, Example: L3 ESRRR, Lateral Recumbent

359

Innominate Dysfunction, Example: Right Anterior Innominate, Modified Sims Position

360

Innominate Dysfunction, Example: Right Posterior Innominate, Modified Sims Position

361

Elbow: Radial Head, Pronation Dysfunction

362

Elbow: Radial Head, Supination Dysfunction

363

Acromioclavicular Joint, Example: Right Distal Clavicle Elevated

364

Acromioclavicular Joint, Example: Right, Proximal Clavicle Elevated (Distal Clavical

Depressed)

365

Cha pter 14

Occipitoatlantal (C0C1, OA) Dysfunction, Example: C0-C1 ESLRR

370

Atlantoaxial (C1C2, AA) Dysfunction, Example: C1 RR

371

Atlantoaxial (C1C2) Dysfunction, Example: C1 Right, Lateral Translation

372

C2 to C7 Dysfunction, Example: C4 ESRRR

373

T1 and T2 Dysfunctions, Example: T1 FSRRR

374

Anterior Cervical Fascia, Direct Technique

375

T3 to L4, Example: T12 ESLRL

376

T8 to L5, Example: L5 FSRRR with Sacral Tethering

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

Clavicle: Left Sternoclavicular Dysfunction (Direct Method)

380

Shoulder: Spasm in the Teres Minor Muscle (Direct Method)

381

Shoulder: Glenohumeral Dysfunction

382

Forearm and Elbow: Ulnohumeral and Radioulnar Dysfunctions

383

Wrist: Carpal Tunnel Syndrome

384

Hypertonicity of the External Hip Rotators and Abductors of the Femur (Example: Piriformis
Hypertonicity and Fibrous Inelasticity)

385

Knee: Posterior Fibular Head Dysfunction

386

Knee: Femorotibial Dysfunctions, Example: Sprain of the Cruciate Ligaments

387

Gastrocnemius Hypertonicity, Direct Method

388

Ankle: Posterior Tibia on Talus

389

Foot and Ankle, Example: Left Calcaneus Dysfunction, the Boot Jack Technique

390

Foot Dysfunction: Metatarsalgia

391

Foot: Plantar Fasciitis, Direct Method

392

Cha pter 15
Occipitomastoid Suture Pressure

398

Alternating Pressure, Left Second Rib

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

Anterior Cervical Arches: Hyoid and Cricoid Release

416

Cervical Chain Drainage Technique

417

Mandibular Drainage: Galbreath Technique

418

Auricular Drainage Technique

419

Alternating Nasal Pressure Technique

420

Submandibular Release

421

Trigeminal Stimulation Technique

422

Maxillary Drainage: Effleurage

424

Frontal Temporomandibular Drainage: Effleurage

425

Thoracic Inlet and Outlet: Myofascial Release, Direct or Indirect, Seated, Steering Wheel
Technique

426

Thoracic Inlet and Outlet: Myofascial Release, Direct, Supine

427

Miller Thoracic (Lymphatic) Pump

428

Miller Thoracic (Lymphatic) Pump, Exaggerated Respiration

429

Thoracic (Lymphatic) Pump, Side Modification

430

Thoracic (Lymphatic) Pump, Atelectasis Modification

431

Pectoral Traction: Pectoralis Major, Pectoralis Minor, and Anterior Deltoid

432

Anterior Axillary Folds: Pectoralis Major and Anterior Deltoid Muscles

433

Doming the Diaphragm

434

Rib Raising: Bilateral Upper Thoracic Variation

436

Marian Clark Drainage

437

Mesenteric Release, Small Intestine

438

Mesenteric Release, Ascending Colon

440

Mesenteric Release, Descending Colon

442

Presacral Release, Direct or Indirect

444

Ischiorectal Fossa Release, Supine

445

Ischiorectal Fossa Release, Prone

446

Pedal Pump (Dalrymple Technique), Supine

447

Pedal Pump (Dalrymple Technique), Prone Variation

448

Hip, Indirect LAS/BLT, Supine

449

Popliteal Fossa Release, Supine

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

Shoulder Girdle: Spencer Technique Stage 5AAbduction with Elbow Flexed

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

Hip Girdle: Spencer Technique Stage 1Hip Flexion

464

Hip Girdle: Spencer Technique Stage 2Hip Extension

465

Hip Girdle: Spencer Technique Stages 3 and 4Circumduction

466

Hip Girdle: Spencer Technique Stages 5 and 6Internal and External Rotation

467

Hip Girdle: Spencer Technique, Stages 7 and 8Abduction and Adduction

468

Elbow: Radioulnar Dysfunction, Long Axis, Pronation Dysfunction (Loss of Supination),

Muscle Energy, HVLA

469

Elbow: Radioulnar Dysfunction, Long Axis, Supination Dysfunction (Loss of Pronation),

Muscle Energy, HVLA

470

Right Anterior Innominate Dysfunction: HVLA with Respiratory Assistance, Leg-Pull Technique

471

C2 to C7, Articulatory, Type 2 Motion

472

T1 to T4, Articulatory, Side Bending

473

Cha pter 18
Cranial Vault Hold

481

Fronto-occipital Hold

482

Sacral Hold

483

Decompression of the Occipital Condyles

484

Occipitoatlantal Decompression

485

Compression of the Fourth Ventricle

486

Interparietal Sutural Opening (V-Spread)

488

Sutural Spread (V-Spread, Direction-of-Fluid Technique)

489

Venous Sinus Drainage

490

Unilateral Temporal Rocking Example: Left Temporal Bone in External or Internal Rotation

492

Frontal Lift

493

Parietal Lift