It's Manipulation Week - well, until Friday that is. Here are more tidbits from my recent Eclectic Approach to Spinal Manipulation in Buffalo, NY. This time it's for lumbar manipulation.
You generally do not hear cheers or gasps or see lots of fist bumping during neurodynamics techniques or during cervical retraction exercises. That's why I love teaching this course! Here are some hints I always pass on during the lumbar roll kickstart variation.
With the advent of research stating we no longer need to be specific, this is my go to technique for lumbar thrust manipulation. It's also much easier when you do not have high/low tables, which my new practice did not have when we first started 2 years ago. That forced me to have better body mechanics and make the most of leverage.
- The tendency is to flex over the patient and get your chest closer to them
- for the "kickstart" hip extension to be as fast as it needs to be, your chest needs to be upright, minimizing hip flexion
- minimizing hip flexion puts the hip in neutral before the rapid movement into extension to rotate the patient
- Also forget the towel roll! This is uncomfortable for the patient
- with your hand on the patient's upper lateral chest, push not only A/P into rotation, but also superiorly for lumbar gapping
- also place your forearm of the thrusting hand on the patient's top thigh and pull inferiorly, and voila, no towel needed!
Watch as a student from my most recent class "gets it" as I tell him to be more upright. He's 6'6"! No need to be so low on a normal table!
A bonus vid of me being manipulated by the above student's partner, a 6'8" monster of a student! It was like he was manipulating a small child. Now I know how all those colicky babies feel being manipulated by straight chiros!