Cervical OMM

 OA joint
o Primary  Flexion and Extension
o Secondary  Sidebending
o Follows Type 1 Mechanics
 Rotation and Sidebending are Always Opposites
 AA joint
o Primary  Rotation
 C2–C7 joints
o Follows Type 2 Mechanics
 Rotation and Sidebending are Always Same
 Dysfunction is always named after Ease
o More Prominent
o Ease of Translation

Thoracic OMM (Lumbar are Similar)

 Spine of Scapula  T3
 Inferior Angle  T7
 Type 1 Dysfunction  Neutral with Opposite Sidebending and Rotation
o Grouped
 Type 2  Flexed or Extended with Same Sidebending and Rotation
o Individual
 Dysfunction is always named after Ease
o More Prominent
o Ease of Translation

Ribs OMM
 Ribs 1 – 5  Pump Handle
o Moves Anterior to Posterior
 Ribs 6 – 10  Bucket Handle
o Moves Laterally
 Ribs 11 – 12  Caliper
o Down and Out (Inhalation)
o Up and In (Exhalation)
 Inhalation Dysfunction  Ribs are stuck up
o Restriction during Exhalation
 Exhalation Dysfunction  Rubs are Stuck Down
o Restriction during Inhalation
 Treatment  LITE
o Inhalation Dysfunction  Target Lower Rib
o Exhalation Dysfunction  Target Top Rib
HVLA
 Direct and Passive Technique
 Thoracic HVLA  Push through the barrier
o Group Dysfunction  Treat Middle of the Curve
o Individual Dysfunction
 Flexion Dysfunction  Target Upper Segment
 Extension Dysfunction  Target Same Segment at a Downward Vector
 Cervical HVLA
o Always Flex
o Sidebend Towards and Rotate Away from the Barrier

Other Technique Basis

 Muscle Energy
o Direct and Active Technique
o Using the Golgi Tendon  Forcing Contraction
o PIR  Put patient in the barrier and patient pushes towards the ease
o Reciprocal Inhibition  Put patient in the ease and patient pushes towards the
barrier
 Counter Strain
o Follows the Action of the Muscle
o Indirect and Passive
o Target  Muscle Spindle
o Put Patient in their Ease and hold for 90 Seconds
 Before you Start  Is It Tended
 Hold 90 Seconds
 Return  Is It Tender
 Soft Tissue  Direct and Passive
 MFR  Direct/Indirect and Passive

BLT Steps
 Disengagement 1st Step 
o Release the Tension to allow free movement of the joint/ligament 
o Can be Compression or Traction 
 Compression is used only for Cruciate Ligament Technique 
 Exaggeration  2nd Step 
 Move the joint towards the dysfunction (ease) 
 Balance 3rd Step 
 Slowly wait for balance to be restored by the Inherent Forces as they 
 Considered the Wobble Point 
 Can be Pulsating 
 Continue for 30 Seconds as you slowly move Neutral 
 Considered as Ebb and Flow 
 Manipulation of the Body’s Natural Expansion and Contraction system
FPR
 Targeting the Gamma Efferent Fibers 
o When Muscle is placed into the ease  Muscle length is normalized and
decreased Gamma Efferent Fibers 
o Decreased Gamma Fibers reduce Alpha Afferent Fiber Firing 
 Restores proper Tone and ROM of Muscles
 Indirect  Placing Patient in their Ease
o What their Dysfunction is 
 1st Always Flatten the Curve
o Lordosis Flexion
 Cervical and Lumbar
o Kyphosis Extension
 Thoracic
 2  Place into Their Ease 
nd

o What is the Dysfunction 

 3rd  Activate the Compressive Force
o Cervical Spine  Caudal Compression
o Thoracic Spine  Caudal Compression through the Shoulders 
Lumbar Spine  Pinching the Spine in Lateral Recumbent

Fibular Heads
 Anterior Fibular Head  Due to Eversion Ankle Sprain
o Pronation  Dorsiflexion and Eversion
 Talus  Anterior
 Tibia  Posterior
 Fibular  Anterior
 Posterior Fibular Head  Due to Inversion Ankle Sprain

o Supination  Plantarflexion and Inversion

 Talus  Posterior
 Tibia  Anterior
 Fibular  Posterior

Fibular Head Muscle Energy

 Anterior Fibular Head Dysfunction
o Ease  Pronation
o Barrier  Supination
 Posterior Fibular Head Dysfunction
o Ease  Supination
o Barrier  Pronation
Open Lymphatic Diaphragms
 Thoracic Inlet
 Rib Raising
 Diaphragm
o Point Toward the Side of Exhalation Dysfunction
 Pelvic Floor (Fascia)
 Popliteal Fossa
 Plantar Fascia
 ORDER MATTERS
o Proximal  Distal (Top to Bottom)