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STRA SART for lumbar

Flexion for anterior 1-5


STRT for anterior 6-10

STRT with rib


SARA for rib posterior

Thoracic Tender Points


Anterior1-6: flexion
Anterior 7-12: STRA
Posterior1-4: extension
Posterior 4-12: rotation

Rib Tender Points


Anterior 1-10: Flexion and STRT
Posterior 1-6: SARA

Lumbar Tender Points:


AL1: medial to ASIS. F STRA
AL2: Medial to AIIS. F SART
AL3: lateral to AIIS. F SART
AL4: inferior to AIIS
AL 5: anterior, superior aspect of pubic ramus, F SARA

BLT= thick/membranous
Muscle energy=taut/stretched/plastic/leathery.

Esophagus=T2-T8
Heart/Respiratory: T1/T2-T5/T6
Upper GI: T5-T9
Middle GI: T10-T11
Lower GI: T12-L2

Rib 1= anterior and middle scalenes


Rib 2= posterior scalene
Rib 3,4,5= pec minor
Rib 6,7,8= Serratus anterior
Rib 9,10= latissimus dorsi
Rib11,12= Quadratus Lumborum.
Straight leg raise
-0-35=slack in sciatic nerve.
-35-70=sciatic nerve deformation
-over 70= normal joint pain

 Bragard test=modified SLR with dorsiflexion


 Thomas test=tests for psoas hypertonicity
 Hip Drop test= positive if less than 20 degrees
 Trendelenberg=positive if more than 20 degrees.
 Ferguson angle=30-35 between L5 and horizontal plane.
 BUMBULBM
 Sitting with forward slouch= most strain on lumbar spine
 Herniation at L4 will effect L5 (X+1 rule)
 Greenman’s half dozen:
1)non neutral dysfunction within the lumbar spine
2)dysfunction at the pubic symphysis
3) restriction of anterior movements of the sacral base
4) inonimate hip shear dysfunction
5) short-leg, pelvis tilt syndrome
6) muscle imbalance of the trunk and lower extremities.
-Iliolumbar ligament first ligament to become tender

ICS 2= thyroid esophagus


ICS3= upper lung
ICS 4=lower lung
ICS 5 left= stomach acid
ICS 5 Right=Liver
ICS6 left=stomach peristalsis
ICS6 right=gallbladder
ICS7 right= pancreas
ICS left=Spleen

-Sacralization=L5 looks like the sacrum


-Lumbarization=S1 looks like 6th lumbar vertebrae.
-rule of X+1 nerve impingement
-ferguson angle
Appley scratch=ROM
Apprehension=shoulder stability
Still technique=Indirect-> Direct
FPR= decreases muscle hypertonicity and adds a compression force
-indirect myofasical release.
Goal of counterstrain is to decrease pain to 3/10 from 10/10. So go until you get to
30 percent
Absolute CI=lack of somatic disfunction and patient refusal/lack of consent.
-Ruffini and free nerve endings not found in high numbers on finger tips.
-elastic barrier= difference between physiological and anatomical barrier

t2=superior angle of scapula


t7=inferior angle of scapula
-type 1 rotates into the convexity
-type 2 rotates into the concavity
-cross extensor reflex=muscle energy
-post isometric relaxation is towards the diagnosis

-SC joint moves oppositive of movement of shoulder (moves anteriorly with


retraction and inferiorly with soulder elevation)

pec minor= tilt scapula anteriorly


subclavius= draws clavicle down
serratus anterior= abducts the scapula
Lats= extend abduct and medially rotate shoulder joint
Levator= downwardly rotate the scapula
Rhomboids= downwardly rotate the scapula
Infraspinatous= laterally rotate, adduct, extend the shoulder joint
Subscapularis= medially rotate the shoulder joint
Teres minor= laterally rotate, adduct, extend shoulder joint
Teres Major= extend, adduct, medially rotate humerus.

Apley left shoulder: LERFAB


Spencer technique: EFCARP

Falling with hand forward leas to posterior radial head-> fix this by putting arm into
extension and then applying anterior force.

For muscle energy of posterior head, since we want to take them to the barrier, we
supinate their arms and have them try to pronate.

For muscle energy of anterior head, since their barrier is in pronation, we pronate
their hands and have them try to supinate.

Falling with hand backwards leads to anterior radial head-> fix this by carrying arm
into flexion and applying downward pressure.
HVLA with rib= do the opposite for exhalation