Muscle Energy Technique for FRS Dysfunctions T6-10

For an FRS R from T6-10:

The patient places their R hand on their L shoulder and the therapist reaches under the patient’s R arm and grasps the patient’s L shoulder.
The therapist palpates the L side of the interspinous space monitoring the superior aspect of the inferior spinous process, ie., FRS R T8,9 the therapist monitors the superior aspect of the spinous process of T9 on the L side.
Initially the patient is sitting with their spine flexed and the therapist asks the patient to slowly sit up by pushing the belly forward to introduce extension from below up to the palpated interspinous space.
The therapist introduces slight L rotation down to the palpating finger.
The therapist then translates the patient from L to R to introduce L side bending without closing down and pinching at the interspinous space.
The patient attempts to R SB for 5-7 seconds which the therapist blocks.
When the patient relaxes the therapist repositions the patient to the new motion barrier by first standing up to decompress the segment, then rotating the patient to the L and finally translating the patient from L to R to the new L side bending barrier.
No pinching should be felt at the palpated segment by the therapist or the patient.
This entire sequence is repeated 3 to 4 times then mobility is reassessed.

Muscle Energy Technique for ERS Dysfunctions of the Upper Thoracic Spine

For an ERS R from C7 to T5:

Patient places their R arm on your R leg with their whole arm resting and supported on your R thigh.
Place your R hand gently on top of their head and your L thumb on the L side of the interspinous space of the dysfunctional segment to monitor the motion barriers.
The patient is initially sitting in a slumped position, but with their head up. Ask the patient to sit up tall from below up by pushing their belly forward until you feel motion at your palpating L thumb.
Then with your R hand move the patient’s head from an extended position into flexion introducing flexion from above down to your palpating L thumb so that you create an apex for flexion at the dysfunctional segment.
L side bending is then introduced by translating your R leg to the R to create an apex for L side bending at your palpating L thumb.
The therapist then adds L rotation thru the head from above down to the dysfunctional segment making sure to go to just the feather edge and not beyond the motion barrier.
The patient is instructed to gently side bend their head to the R or pull their R arm down on your leg for 5-7 seconds.
When the patient relaxes you introduce additional L side bending to the new motion barrier by translating your R leg further to the R.
You repeat 3 to 4 times then reassess.

To Stretch the Left Quadratus Lumborum

The patient is lying supine and crosses the right leg over the left.
Instruct the patient to drop both legs to the right.
Have the patient push their knees together for 5 to 7 seconds and then relax. Upon relaxation the right leg pulls the left leg further over to the right to increase the stretch.
Repeat 3-4 times progressively.
Goal – try to touch the inside of the left knee to the floor without raising the left shoulder off the floor.
Repeat on the opposite side.