Table Of Contents:

List of boxes xv
Foreword xvii
Preface to the Second Edition xix
Acknowledgments xxi

Connective tissue and the fascial system 1(22)

The fascial network 2(1)

Fascia and proprioception 2(1)

Fascia: collagenous continuity 2(1)

Further fascial considerations 2(1)

Elasticity 3(3)

Plastic and elastic features 3(3)

Connective tissue as a `sponge' 6(1)

Deformation characteristics 6(1)

Hypermobility and connective tissue 7(1)

Trigger points, fascia and the nervous system 8(5)

The importance of Langevin's research 9(4)

Summary of fascial and connective tissue function 13(3)

Fascial dysfunction 16(1)

Restoring gel to sol 17(1)

A different model linking trauma and connective tissue 17(2)

Therapeutic sequencing 19(4)

Muscles 23(22)

Dynamic forces - the `structural continuum' 23(2)

Signals 25(1)

Essential information about muscles 25(1)

Types of muscle 25(2)

Energy production in normal tissues 27(1)

Energy production in the deconditioned individual 28(1)

Muscles and blood supply 28(3)

Motor control and respiratory alkalosis 31(2)

Two key definitions 32(1)

The Bohr effect 32(1)

Core stability, transversus abdominis, the diaphragm and BPD 32(1)

Summary 32(1)

Major types of voluntary contraction 33(1)

Terminology 33(1)

Muscle tone and contraction 33(1)

Vulnerable areas 34(1)

Muscle types 34(1)

Cooperative muscle activity 35(2)

Muscle spasm, tension, atrophy 37(2)

Contraction (tension with EMG elevation, voluntary) 38(1)

Spasm (tension with EMG elevation, involuntary) 38(1)

Contracture (tension of muscles without EMG elevation, involuntary) 38(1)

Increased stretch sensitivity 38(1)

Viscoelastic influence 39(1)

Atrophy and chronic back pain 39(1)

What is weakness? 39(1)

Trick patterns 39(1)

Joint implications 40(1)

When should pain and dysfunction be left alone? 40(1)

Beneficially overactive muscles 41(1)

Somatization - mind and muscles 41(4)

But how is one to know? 41(4)

Reporting stations and the brain 45(18)

Proprioception 45(2)

Fascia and proprioception 46(1)

Reflex mechanisms 47(4)

Local reflexes 50(1)

Central influences 50(1)

Neuromuscular dysfunction following injury 51(1)

Mechanisms that alter proprioception 52(1)

An example of proprioceptive dysfunction 52(1)

Rectus capitis posterior minor (RCPMin) research evidence 52(1)

Neural influences 53(6)

Effect of contradictory proprioceptive information 53(4)

Neural overload, entrapment and crosstalk 57(1)

Manipulating the reporting stations 58(1)

Therapeutic rehabilitation using reflex systems 59(1)

Conclusion 60(3)

Causes of musculoskeletal dysfunction 63(18)

Adaptation - GAS and LAS 63(1)

Posture, respiratory function and the adaptation phenomenon 64(3)

An example of `slow' adaptation 66(1)

What of adaptation to trauma? 67(1)

What of adaptation to habits of use? 67(1)

Making sense of the picture 67(2)

Example 68(1)

Postural and emotional influences on musculoskeletal dysfunction 69(4)

Postural interpretations 69(1)

Contraction patterns 69(1)

Emotional contractions 69(1)

`Middle fist' functions 70(1)

`Upper fist' functions 70(1)

Behavior and personality issues 71(1)

Cautions and questions 72(1)

Postural imbalance and the diaphragm 73(2)

Balance 74(1)

Respiratory influences 75(3)

Effects of respiratory alkalosis in a deconditioned individual 75(1)

Respiratory entrainment and core stability issues 75(1)

Summary of effects of hyperventilation 76(1)

Neural repercussions 77(1)

Tetany 77(1)

Biomechanical changes in response to upper chest breathing 77(1)

Additional emotional factors and musculoskeletal dysfunction 78(1)

Selective motor unit involvement 78(1)

Conclusion 79(2)

Patterns of dysfunction 81(16)

Upper crossed syndrome 82(1)

Lower crossed syndrome 82(1)

Layer (stratification) syndrome 83(1)

Chain reaction leading to facial and jaw pain: an example 84(1)

Patterns from habits of use 84(1)

The big picture and the local event 85(1)

Janda's `primary and secondary' responses 85(1)

Recognizing dysfunctional patterns 86(2)

Excessive muscular tone 86(1)

Simple functional tests for assessing excess muscular tone 87(1)

Functional screening sequence 88(4)

Prone hip (leg) extension (PLE) test 89(1)

Trunk flexion test 90(1)

Hip abduction test 90(1)

Scapulohumeral rhythm test 91(1)

Neck flexion test 92(1)

Push-up test 92(1)

Breathing pattern assessments 92(2)

Seated assessment 92(1)

Supine assessment 93(1)

Sidelying assessment 93(1)

Prone assessment 93(1)

Trigger point chains 94(3)

Trigger points 97(28)

Ischemia and muscle pain 101(1)

Ischemia and trigger point evolution 102(1)

Trigger point connection 102(1)

Microanalysis of trigger point tissues 103(1)

Ischemia and fibromyalgia syndrome (FMS) 103(2)

FMS and myofascial pain 105(1)

Facilitation - segmental and local 105(4)

Trigger points and organ dysfunction 106(2)

How to recognize a facilitated spinal area 108(1)

Local facilitation in muscles 108(1)

Lowering the neural threshold 109(1)

Varying viewpoints on trigger points 109(3)

Awad's analysis of trigger points 109(1)

Nimmo's receptor-tonus techniques 109(1)

Improved oxygenation and reduced trigger point pain - an example 110(1)

Pain-spasm-pain cycle 110(1)

Fibrotic scar tissue hypothesis 110(1)

Muscle spindle hypothesis 110(1)

Radiculopathic model for muscular pain 111(1)

Simons' current perspective: an integrated hypothesis 111(1)

Central and attachment trigger points 112(1)

Primary, key and satellite trigger points 112(1)

Active and latent trigger points 113(1)

Essential and spillover target zones 114(1)

Trigger points and joint restriction 114(1)

Trigger points associated with shoulder restriction 114(1)

Other trigger point sites 114(1)

Testing and measuring trigger points 114(4)

Basic skill requirements 115(1)

Needle electromyography 116(1)

Ultrasound 116(1)

Surface electromyography 116(1)

Algometer use for research and clinical training 117(1)

Thermography and trigger points 117(1)

Clinical features of myofascial trigger points 118(7)

Developing skills for TrP palpation 119(2)

Which method is more effective? 121(4)

The internal environment 125(36)

Local myofascial inflammatory influences 125(6)

Pain progression 126(1)

Sensitization 126(1)

Mechanisms of chronic pain 126(1)

Glutamate: a contrary view of the cause of tendon pain 127(1)

Acute (lag) phase of the inflammatory response 128(1)

Regeneration (repair) phase 128(1)

Remodeling phase 128(1)

Difference between degenerative and inflammatory processes 129(1)

Antiinflammatory nutrients and herbs 129(1)

What about antiinflammatory medication? 130(1)

Controlled scarring - friction and prolotherapy 130(1)

When inflammation becomes global 131(9)

Hormonal influences 131(9)

Muscles, joints and pain 140(2)

Reflex effects of muscular pain 141(1)

Source of pain 142(2)

Is it reflex or local? 142(1)

Radicular pain 142(1)

Are the reflexes normal? What is the source of the pain? 142(1)

Differentiating between soft tissue and joint pain 143(1)

Neuropathic pain 143(1)

Neurotoxic elements and neuropathic pain 144(7)

Effects of pH changes through breathing 149(1)

Alkalosis and the Bohr effect 149(1)

Deconditioning and unbalanced breathing 149(1)

Caffeine in its various forms 150(1)

When should pain and dysfunction be left alone? 151(3)

Somatization 152(1)

How is one to know? 152(2)

Pain management 154(7)

Gunn's view 154(1)

Questions 154(1)

Pain control 154(7)

Assessment, treatment and rehabilitation 161(16)

Numerous influences 162(1)

A biomechanical example 162(1)

`Looseness and tightness' as part of the biomechanical model 163(2)

Lewit (1996) and `loose-tight' thinking 164(1)

Soft tissue treatment and barriers 164(1)

Pain and the tight-loose concept - and the trigger point controversy 164(1)

Three-dimensional patterns 165(1)

Methods for restoration of `three-dimensionally patterned functional symmetry' 165(1)

Neuromuscular management of soft tissue dysfunction 166(1)

Manipulating tissues 166(1)

Nutrition and pain: a biochemical perspective 167(3)

Nutritional treatment strategies 167(1)

Specific nutrients and myofascial pain 167(1)

Allergy and intolerance: additional biochemical influences on pain 168(1)

What causes this increase in permeability? 169(1)

Treatment for `allergic myalgia' 169(1)

Antiinflammatory nutritional (biochemical) strategies 169(1)

Psychosocial factors in pain management: the cognitive dimension 170(1)

Guidelines for pain management 171(1)

Group pain management 171(1)

The litigation factor 171(1)

Other barriers to progress in pain management 171(1)

Stages of change in behavior modification 171(1)

Wellness education 172(1)

Goal setting and pacing 172(5)

Low back pain rehabilitation 172(1)

The biopsychosocial model of rehabilitation 172(1)

Concordance 173(1)

Patient advice and concordance (compliance) issues 173(4)

Modern neuromuscular techniques 177(28)

Neuromuscular therapy - American version 177(14)

Biomechanical factors 178(1)

Biochemical factors 179(1)

Psychosocial factors 180(1)

Biomechanical, biochemical and psychosocial interaction 180(1)

NMT techniques contraindicated in initial stages of acute injury 181(1)

NMT for chronic pain 182(1)

Palpation and treatment 182(7)

Treatment and assessment tools 189(1)

Pain rating tools 190(1)

Treatment tools 190(1)

European (Lief's) neuromuscular technique (NMT) 191(14)

NMT thumb technique 192(1)

Liefs NMT finger technique 193(1)

Use of lubricant 194(1)

Variations 194(1)

Variable ischemic compression 194(1)

A framework for assessment 195(1)

Some limited NMT research 196(1)

Integrated neuromuscular inhibition technique 197(8)

Associated therapeutic modalities and techniques 205(38)

Hydrotherapy and cryotherapy 206(4)

How water works on the body 206(1)

Warming compress 206(2)

Alternate heat and cold: constitutional hydrotherapy (home application) 208(1)

Neutral bath 209(1)

Alternate bathing 209(1)

Alternating sitz baths 210(1)

Ice pack 210(1)

Integrated neuromuscular inhibition technique (INIT) 210(2)

INIT method 1 210(1)

INIT rationale 211(1)

Ruddy's reciprocal antagonist facilitation (RRAF) 212(1)

Lymphatic drainage techniques 212(1)

McKenzie Method® 213(2)

Massage 215(2)

Petrissage 215(1)

Kneading 215(1)

Inhibition 215(1)

Effleurage (stroking) 215(1)

Vibration and friction 216(1)

Transverse friction 216(1)

Effects explained 216(1)

Mobilization and articulation 217(1)

Notes on sustained natural apophyseal glides (SNAGs) 217(1)

Muscle energy techniques (MET) and variations 218(3)

Neurological explanation for MET effects 218(1)

Use of breathing cooperation 218(1)

Muscle energy technique variations 219(2)

Myofascial release techniques (MFR) 221(2)

Exercise 1 Longitudinal paraspinal myofascial release 222(1)

Exercise 2 Freeing subscapularis from serratus anterior fascia 223(1)

Myofascial release of scar tissue 223(1)

Neural mobilization of adverse mechanical or neural tension 223(2)

Adverse mechanical tension (AMT) and pain sites are not necessarily the same 224(1)

Types of symptoms 224(1)

Neural tension testing 224(1)

Positional release techniques (PRT) 225(5)

The proprioceptive hypothesis 225(1)

The nociceptive hypothesis 226(1)

Resolving restrictions using PRT 226(1)

Circulatory hypothesis 227(1)

Variations of PRT 227(3)

Rehabilitation 230(1)

Relaxation methods 231(1)

Rhythmic (oscillatory, vibrational, harmonic) methods 231(2)

What's happening? 231(1)

Application exercise for the spine 232(1)

Trager® exercise 233(1)

Spray and stretch for trigger point treatment 233(2)

Additional stretching techniques 235(1)

Facilitated stretching 235(1)

Proprioceptive neuromuscular facilitation (PNF) variations 235(1)

Active isolated stretching (AIS) 236(1)

Yoga stretching (and static stretching) 236(1)

Ballistic stretching 236(1)

Using multiple therapies 236(7)

The cervical region 243(82)

The vertebral column: a structural wonder 244(6)

Cervical vertebral structure 246(2)

The upper and lower cervical functional units 248(2)

Movements of the cervical spine 250(3)

Upper cervical (occipitocervical) ligaments 251(2)

Lower cervical ligaments 253(1)

Assessment of the cervical region 253(20)

Landmarks 255(1)

Functional features of the cervical spine 255(1)

Muscular and fascial features 256(1)

Neurological features 256(1)

Circulatory features and thoracic outlet syndrome 256(3)

Cervical spinal dysfunction 259(1)

Assessments 259(7)

Assessment becomes treatment 266(2)

Assessment and treatment of occipitoatlantal restriction (CO-C1) 268(1)

Functional release of atlantooccipital joint 269(1)

Translation assessment for cervical spine (C2-7) 269(1)

Treatment choices 270(1)

Alternative positional release approach 271(1)

SCS cervical flexion restriction method 271(1)

SCS cervical extension restriction method 271(1)

Stiles' (1984) general procedure using MET for cervical restriction 272(1)

Harakal's (1975) cooperative isometric technique (MET) 272(1)

Cervical treatment: sequencing 273(52)

Cervical planes and layers 274(1)

Posterior cervical region 275(2)

NMT for upper trapezius in supine position 277(1)

MET treatment of upper trapezius 278(1)

Positional release of upper trapezius 279(1)

Myofascial release of upper trapezius 280(1)

Variation of myofascial release 280(1)

NMT: cervical lamina gliding techniques - supine 281(1)

Semispinalis capitis 282(1)

Semispinalis cervicis 283(1)

Splenii 283(1)

NMT techniques for splenii tendons 284(1)

Spinalis capitis and cervicis 285(1)

NMT for spinalis muscles 286(1)

Longissimus capitis 286(1)

Longissimus cervicis 286(1)

Iliocostalis cervicis 286(1)

Multifidi 287(1)

Rotatores longus and brevis 287(1)

Interspinales 287(2)

NMT for interspinales 289(1)

Intertransversarii 289(1)

Levator scapula 289(1)

NMT for levator scapula 290(1)

MET treatment of levator scapula 291(1)

Positional release of levator scapula 291(1)

Suboccipital region 292(2)

Rectus capitis posterior minor 294(1)

Rectus capitis posterior major 295(1)

Obliquus capitis superior 295(1)

Obliquus capitis inferior 295(1)

NMT for suboccipital group - supine 296(2)

Platysma 298(1)

NMT for platysma 299(1)

General anterior neck muscle stretch utilizing MET 299(1)

Sternocleidomastoid 300(1)

NMT for SCM 301(2)

Treatment of shortened SCM using MET 303(1)

Positional release of sternocleidomastoid 304(1)

Suprahyoid muscles 304(1)

Infrahyoid muscles 304(1)

Sternohyoid 305(1)

Sternothyroid 306(1)

Thyrohyoid 306(1)

Omohyoid 306(1)

NMT for infrahyoid muscles 307(1)

Soft tissue technique derived from osteopathic methodology 308(1)

Longus colli 308(1)

Longus capitis 309(2)

NMT for longus colli and capitis 311(1)

MET stretch of longus capitis 312(1)

Rectus capitis anterior 312(1)

Rectus capitis lateralis 313(1)

NMT for rectus capitis lateralis 313(1)

Scalenii 314(2)

NMT for scalenii 316(2)

Treatment of short scalenii by MET 318(1)

Positional release of scalenii 319(1)

Cervical lamina - prone 319(1)

NMT for posterior cervical lamina - prone position 320(1)

NMT for posterior cranial attachments 320(5)

The cranium 325(74)

Cranial structure 326(25)

Occiput 328(4)

Sphenoid 332(3)

Ethmoid 335(1)

Vomer 336(1)

Mandible 337(3)

Frontal 340(3)

Parietals 343(1)

Temporals 344(3)

Zygomae 347(2)

Maxillae 349(1)

Palatines 350(1)

NMT treatment techniques for the cranium 351(48)

Muscles of expression 351(1)

Mimetic muscles of the epicranium 352(1)

Occipitofrontalis 352(1)

Temporoparietalis and auricular muscles 352(2)

NMT for epicranium 354(1)

Positional release method for occipitofrontalis 355(1)

Mimetic muscles of the circumorbital and palpebral region 355(1)

NMT for palpebral region 355(1)

Mimetic muscles of the nasal region 356(1)

NMT for nasal region 356(1)

Mimetic muscles of the buccolabial region 356(1)

NMT for buccolabial region 357(1)

Muscles of mastication 358(1)

Neck pain and TMD 359(6)

External palpation and treatment of craniomandibular muscles 365(1)

NMT for temporalis 366(1)

NMT for masseter 367(1)

Massage/myofascial stretch treatment of masseter 368(1)

Positional release for masseter 368(1)

NMT for lateral pterygoid 369(1)

NMT for medial pterygoid 369(1)

Stylohyoid 369(2)

External palpation and treatment of styloid and mastoid processes 371(1)

Intraoral palpation and treatment of craniomandibular muscles 372(1)

Intraoral NMT applications 372(1)

Temporalis 372(1)

NMT for intraoral temporalis tendon 373(1)

Masseter 373(2)

NMT for intraoral masseter 375(1)

Lateral pterygoid 375(3)

NMT for intraoral lateral pterygoid 378(1)

Medial pterygoid 379(1)

NMT for intraoral medial pterygoid 380(1)

Musculature of the soft palate 380(2)

NMT for soft palate 382(1)

Muscles of the tongue 382(1)

NMT for muscles of the tongue 383(1)

Suprahyoid muscles - the floor of the mouth 384(1)

NMT for intraoral floor of mouth 385(2)

Cranial treatment and the infant 387(1)

The craniocervical link 388(1)

Sleeping position and cranial deformity 389(1)

What other factors do medical authorities think cause serious cranial distortion in infants? 389(1)

What are the long-term effects of deformational plagiocephaly? 389(1)

Different cranial approaches 390(1)

Ear disease and cranial care 390(2)

Summary 392(7)

Shoulder, arm and hand 399(140)

Shoulder 401(6)

Structure 401(1)

Key joints affecting the shoulder 401(3)

Pivotal soft tissue structures and the shoulder 404(3)

Assessment 407(22)

Repetitions are important 408(2)

Janda's perspective 410(1)

Observation 410(1)

Palpation of superficial soft tissues 411(1)

Range of motion of shoulder structures 411(1)

Active and passive tests for shoulder girdle motion (standing or seated) 412(1)

Strength tests for shoulder movements 413(1)

Muscular relationships 413(2)

Spinal and scapular effects of excessive tone 415(1)

Shoulder pain and associated structures 415(1)

Therapeutic choices 416(1)

Specific shoulder dysfunctions 417(3)

Specific muscle evaluations 420(1)

Infraspinatus 420(1)

Levator scapula 420(1)

Latissimus dorsi 420(1)

Pectoralis major and minor 421(1)

Supraspinatus 421(1)

Subscapularis 421(1)

Upper trapezius 421(1)

Is the patient's pain a soft tissue or a joint problem? 422(1)

The Spencer sequence 422(7)

Treatment 429(56)

Trapezius 429(2)

Assessment of upper trapezius for shortness 431(1)

NMT for upper trapezius 432(1)

NMT for middle trapezius 433(1)

NMT for lower trapezius 433(1)

NMT for trapezius attachments 434(1)

Lief's NMT for upper trapezius area 434(1)

MET treatment of upper trapezius 435(1)

Myofascial release of upper trapezius 435(1)

Levator scapula 435(1)

Assessment for shortness of levator scapula 436(1)

NMT for levator scapula 436(2)

MET treatment of levator scapula 438(1)

Rhomboid minor and major 438(1)

Assessment for weakness of rhomboids 439(1)

Assessment for shortness of rhomboids 439(1)

NMT for rhomboids 439(1)

MET for rhomboids 440(1)

Deltoid 441(2)

NMT for deltoid 443(1)

Supraspinatus 443(3)

Assessment for supraspinatus dysfunction 446(1)

Assessment for supraspinatus weakness 446(1)

NMT treatment of supraspinatus 446(1)

MET treatment of supraspinatus 446(1)

MFR for supraspinatus 447(1)

Infraspinatus 447(1)

Assessment for infraspinatus shortness/dysfunction 447(1)

Assessment for infraspinatus weakness 448(1)

NMT for infraspinatus 448(1)

MET treatment of short infraspinatus (and teres minor) 448(1)

MFR treatment of short infraspinatus 449(1)

PRT treatment of infraspinatus (most suitable for acute problems) 449(1)

Triceps and anconeus 449(3)

Assessment for triceps weakness 452(1)

NMT for triceps 452(1)

MET treatment of triceps (to enhance shoulder flexion with elbow flexed) 452(1)

NMT for anconeus 453(1)

Teres minor 453(1)

Assessment for teres minor weakness 453(1)

NMT for teres minor 454(1)

PRT for teres minor (most suitable for acute problems) 455(1)

Teres major 456(1)

NMT for teres major 457(1)

PRT for teres major (most suitable for acute problems) 457(1)

Latissimus dorsi 458(1)

Assessment for latissimus dorsi shortness/dysfunction 458(1)

NMT for latissimus dorsi 459(1)

MET treatment of latissimus dorsi 460(1)

PRT for latissimus dorsi (most suitable for acute problems) 460(1)

Subscapularis 460(2)

Assessment of subscapularis dysfunction/shortness 462(1)

Observation of subscapularis dysfunction/shortness 462(1)

Assessment of weakness in subscapularis 463(1)

NMT for subscapularis 463(1)

MET for subscapularis 463(1)

PRT for subscapularis (most suitable for acute problems) 464(1)

Serratus anterior 464(1)

Assessment for weakness of serratus anterior 465(1)

NMT for serratus anterior 465(1)

Facilitation of tone in serratus anterior using pulsed MET 466(1)

Pectoralis major 467(3)

Assessment for shortness in pectoralis major 470(1)

Assessment for strength of pectoralis major 470(1)

NMT for pectoralis major 471(1)

MET for pectoralis major 472(1)

Alternative MET for pectoralis major 473(1)

MFR for pectoralis major 474(1)

Pectoralis minor 474(2)

NMT for pectoralis minor 476(1)

Direct (bilateral) myofascial stretch of shortened pectoralis minor 477(1)

Subclavius 477(1)

MFR for subclavius 477(2)

Sternalis 479(1)

Coracobrachialis 479(1)

Assessment for strength of Coracobrachialis 479(2)

NMT for coracobrachialis 481(1)

MFR for coracobrachialis 481(1)

PRT for coracobrachialis 481(1)

Biceps brachii 482(1)

Assessment for strength of biceps brachii 483(1)

Assessment for shortness and MET treatment of biceps brachii 483(1)

NMT for biceps brachii 483(1)

MET for painful biceps brachii tendon (long head) 484(1)

PRT for biceps brachii 485(1)

Elbow 485(1)

Introduction to elbow treatment 485(1)

Structure and function 485(2)

Humeroulnar joint 486(1)

Humeroradial joint 486(1)

Radioulnar joint 486(1)

Assessment of bony alignment of the epicondyles 486(1)

The ligaments of the elbow 486(1)

Assessment for ligamentous stability 487(1)

Evaluation 487(1)

Biceps reflex 487(1)

Brachioradialis reflex 487(1)

Triceps reflex 488(1)

Ranges of motion of the elbow 488(1)

Range of motion and strength tests 488(1)

Elbow stress tests 488(1)

Strains or sprains 489(1)

Indications for treatment (dysfunctions/syndromes) 489(4)

Median nerve entrapment 489(1)

Carpal tunnel syndrome 489(1)

Ulnar nerve entrapment 489(3)

Radial nerve entrapment 492(1)

Tenosynovitis (`tennis elbow' and/or `golfer's elbow') 492(1)

Assessments for tenosynovitis and epicondylitis 492(1)

Elbow surgery and manual techniques 492(1)

Treatment 493(5)

Brachialis 493(1)

NMT for brachialis 493(1)

Triceps and anconeus 493(1)

NMT for triceps (alternative supine position) 494(1)

NMT for anconeus 494(1)

Brachioradialis 494(1)

Assessment for strength of brachioradialis 494(1)

NMT for brachioradialis 495(1)

MFR for brachioradialis 495(1)

Supinator 495(1)

Assessment for strength of supinator 496(1)

NMT for supinator 496(1)

MET for supinator shortness 496(1)

MFR for supinator 496(1)

Pronator teres 496(1)

Assessment for strength of pronator teres 497(1)

NMT for pronator teres 497(1)

MFR for pronator teres 498(1)

PRT for pronator teres 498(1)

Pronator quadratus 498(1)

NMT for pronator quadratus 498(1)

Forearm, wrist and hand 498(1)

Forearm 499(1)

Wrist and hand 499(9)

Capsule and ligaments of the wrist 501(1)

Ligaments of the hand 502(1)

Key (osteopathic) principles for care of elbow, forearm and wrist dysfunction 503(1)

Active and passive tests for wrist motion 503(3)

Reflex and strength tests 506(1)

Ganglion 506(1)

Carpal tunnel syndrome 507(1)

Phalanges 508(3)

Carpometacarpal ligaments (2nd, 3rd, 4th, 5th) 509(1)

Metacarpophalangeal ligaments 510(1)

Range of motion 510(1)

Thumb 511(1)

Thumb ligaments 511(1)

Range of motion at the joints of the thumb 511(1)

Testing thumb movement 511(1)

Dysfunction and evaluation 511(1)

Preparing for treatment 511(2)

Terminology 512(1)

Neural entrapment 513(1)

Distant influences 513(1)

Anterior forearm treatment 513(9)

Palmaris longus 513(2)

Flexor carpi radialis 515(1)

Flexor carpi ulnaris 515(1)

Flexor digitorum superficialis 515(1)

Flexor digitorum profundus 516(1)

Flexor pollicis longus 516(2)

NMT for anterior forearm 518(1)

Assessment and MET treatment of shortness in the forearm flexors 519(2)

MET for shortness in extensors of the wrist and hand 521(1)

PRT for wrist dysfunction (including carpal tunnel syndrome) 521(1)

MFR for areas of fibrosis or hypertonicity 521(1)

Posterior forearm treatment 522(7)

Superficial layer 522(1)

Extensor carpi radialis longus 523(1)

Extensor carpi radialis brevis 523(1)

Extensor carpi ulnaris 524(1)

Extensor digitorum 524(1)

Extensor digitiminimi 525(1)

NMT for superficial posterior forearm 525(2)

Deep layer 527(1)

Abductor pollicis longus 527(1)

Extensor pollicis brevis 528(1)

Extensor pollicis longus 528(1)

Extensor indicis 528(1)

NMT for deep posterior forearm 528(1)

Intrinsic hand muscle treatment 529(10)

Thenar muscles and adductor polliris 530(2)

Hypothenar eminence 532(1)

Metacarpal muscles 532(1)

NMT for palmar and dorsal hand 533(6)

The thorax 539(40)

Structure 540(1)

Structural features of the thoracic spine 540(1)

Structural features of the ribs 541(1)

Structural features of the sternum 541(1)

Posterior thorax 541(9)

Identification of spinal levels 542(1)

The sternosymphyseal syndrome 542(1)

Spinal segments 543(1)

Palpation method for upper thoracic segmental facilitation 544(1)

How accurate are commonly used palpation methods? 544(1)

Red reflex assessment (reactive hyperemia) 545(1)

Biomechanics of rotation in the thoracic spine 546(1)

Coupling test 547(1)

Observation of restriction patterns in thoracic spine (C-curve observation test) 547(1)

Breathing wave assessment 547(1)

Breathing wave - evaluation of spinal motion during inhalation/exhalation 548(1)

Passive motion testing for the thoracic spine 548(1)

Flexion and extension assessment of T1-4 548(1)

Flexion and extension assessment of T5-12 548(1)

Sideflexion palpation of thoracic spine 549(1)

Rotation palpation of thoracic spine 549(1)

Prone segmental testing for rotation 550(1)

Anterior thorax 550(7)

Respiratory function assessment 550(4)

Palpation for trigger point activity 554(1)

Alternative categorization of muscles 554(1)

Rib palpation 554(1)

Specific 1st rib palpation 554(1)

Test and treatment for elevated and depressed ribs 554(1)

Rib motion 554(1)

Tests for rib motion restrictions 554(2)

Discussion 556(1)

Thoracic treatment techniques 557(22)

Posterior superficial thoracic muscles 557(3)

NMT: posterior thoracic gliding techniques 560(2)

NMT for muscles of the thoracic lamina groove 562(1)

Spinalis thoracis 563(1)

Semispmalis thoracis 563(1)

Multifidi 563(1)

Rotatores longus and brevis 564(1)

NMT for thoracic (and lumbar) lamina groove muscles 565(1)

PR method for paraspinal musculature: induration technique 566(1)

Muscles of respiration 567(1)

Serratus posterior superior 567(1)

Serratus posterior inferior 568(1)

Levatores costarum longus and brevis 568(2)

Intercostals 570(1)

NMT for intercostals 571(1)

Influences of abdominfl muscles 571(1)

NMT assessment 571(1)

PR of diaphragm 572(1)

MET release for diaphragm 572(1)

Interior thorax 572(1)

Diaphragm 572(1)

NMT for diaphragm 573(1)

Transversus thoracis 574(1)

Thoracic mobilization with movement - SNAGs method 575(4)
Index 579