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OMM Techniques (Labs 1-3) - Coggle Diagram

- - - - Neutral Passive Diagnosis
        
        Patient is prone, apply slight anterior force along spine with thenar eminence, areas which do not "bounce back" are more likely to be dysfunctional
        
        In this area, place thumbs on respective transverse processes, see which thumb is more posterior
        
        More posterior side indicates which side is "rotated"
        
        Next, create "sidebending" by translating spinous process to left and right gently (moving to the left creates RIGHT sidebending and vise versa)
        
        Side with less motion is the direction of "sidebending" (so if you get less motion when pushing to the right, the patient is sidebent LEFT
        
        Bring patient into Sphinx position
        
        Cradle patient's head in your hand and induce flexion and extension. On flexion the spinous processes of vertebrae should move apart, on extension they should move together. If one of these things is not true, then there is an extension or flexion preference for the one that IS true.
        
        :Warning: Sphinx position only works for T1-T4
        
        To check for extension and flexion preference below T4, have patient lay on their side facing you and bring their knees toward you for flexion and away from you for extension
      - Active non-neutral thoracic diagnosis
        
        1.With patient seated facing away from you, feet firmly on the ground, use a screening modality such as inducing sidebending to test for areas of restriction
        
        Place thumbs on spinous processes of restricted vertebrae (you will need to be seated most likely)
        
        Check for which thumb is more posterior
        
        Check for improvement in symmetry of thumbs with extension or flexion by having patient look down or up (T1-T4)
        
        Side bending in this form of testing is based on knowledge of mechanics relative to type fo dysfunction
        
        Check surrounding vertebrae to determine dysfunction group
        
        For levels below T4, have patient reach for their toes for flexion and puff our stomach while looking at ceiling for extension
      - Thumb-Rolling
        
        On known affected vertebrae, place thumbs on transverse processes and apply equal bilateral rolling anterior pressure superiorly and then inferiorly
        
        Feel for "giving sensation" on either inferior or superior sides. Superior = flexed segment and inferior = extended segment
  - - - With patient prone and yourself standing on side opposite side being treated, place thenar eminence of your right hand on paraspinal muscles in affected lumbar area
      - Using your right hand, simultaneously pull back and up on the patient's ASIS opposite you while pushing the paraspinal muscles under your left hand away from yourself, perpendicular to the spine
      - Repeat this rhythmically until the muscles have relaxed and repeat BILATERALLY
    - - :star: Active and Passive
      - With patient seated and you standing behind them, diagnose their dysfunction in all three planes
        
        Type 1
        
        Have patient bring their hand on the rotated side (e.g left if transverse process posterior on left) to cup the back of their neck on that side and grab that elbow with their other hand (kind of like the macarena)
        
        Standing on side opposite the side of rotation, reach around patient and thread you arm under the right arm and over the left arm (or vise versa for dysfunction on opposite side: under the bridge and over the hill) and grasp left upper arm
        
        Bring patient into barriers in all three planes (or two if neutral)
        
        Ex) if patient is ER(R)S(R), you would rotate the patient to the left, side bend them to the left, and place them in flexion until maximum tension under fingerpads (KEEP YOUR FINGERS ON TRANSVERSE PROCESSES)
        
        Have patient rotate against you for 5 seconds, relax for 2, bring to new rotation barrier
        
        In new rotation barrier, have patient sidebend against you for 5 seconds, relax for 2, and then bring to new barrier
        
        Have patient rotate against you for 5 seconds, relax for 2, rotate to new barrier, and then RELAX
        
        May need to repeat 4-6 times before fingerpads will be symmetric and segment will be considered treated
- - - - Cervical
        
        Stand opposite side being treated with patient supine
        
        With right hand, reach across patients anterior neck and place finger pads on paraspinal muscles
        
        Place left hand on patient forehead and push head counter to movement of right hand/paraspinal muscles
        
        Gently pull paraspinal muscles (do NOT pull on spine) around toward face in rhythmic motion until muscles relax
        
        DO NOT place pressure on the lateral neck, as you would compress important vessels
      - Thoracic/Lumbar
        
        1.With patient prone, diagnose areas of dysfunction using red reflex or skin drag or other modality
        
        Standing opposite the side being treated, place thenar eminence of right hand parallel to paraspinal muscles on side being treated
        
        Place left hand on top of right hand and apply pressure laterally to the paraspinal muscles, stretching them perpendicular to the spine WITHOUT putting pressure on the spine or sliding hands on skin (this would create friction)
        
        Can do this all along the thoracic and lumbar spine in areas of dysfunction, make sure to apply this BILATERALLY
    - - Have patient side-laying facing you with knees bent to a 90 degree angle in front of them for stability
      - In area of dysfunction in lumbar spine, place finger pads of both hands on paraspinal muscles
      - Brace your left elbow against the patient's iliac crest and your right elbow against the patient's axilla
      - Lean away from the patient to create perpendicular stretching of the paraspinal muscles while SIMULTANEOUSLY pushing your elbows away from one another (this requires a bit of bending on your part) to create parallel stretch of the paraspinal muscles until they relax