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脊柱的高速低幅（HVLA）手法治疗
腰椎HVLA
Diagnosis:
Push TP either side to determine rotation which side won’t
spring anterior
Patient positioning:
1. T10-L5: bottom leg straight; L5-S1: lower
hip 20 degree flexion
2. palpate interspinous
space, flex both legs so that
pelvis recurt L4, straight bottom leg
3. switch hand, pull bottom arm up to extend
until L3 move without help pass segment
4. first rotate down feel L3 moving, rotate up
until feel L4 moving
Doctor positioning:
5. forearm contact back of glut muslce
not on great trochanter, moniter hand on pect
fossa
6. ready to go, face slightly to upper body
7. feet spread one behind, feet position
8. ASIS on ASIS not on thigh or upper
9. bring tissue as tight as possible, thrust
arm pull towards as far close
10. leg extend and up on toe
Thrust：
11. deep breath in and all the way out
12. tighten barrier, drop body final
thrust, heel back on ground, down on heel, keep head up
13. upper arm stabilizer, thrusting arm as
close to body
14. push a little more up and down, direction
of force down and slight pelvic rotation
 tighten
barrier
SI HVLA
Patient positioning:
1. lower leg and spine straight, upper heel
just anterior to the lower knee
2. patient’s upper knee placed between legs
Doctor positioning:
3. contact on inferior of PSIS
4. resist against upper pectoral and rib cage,
avoid pressure to GH
Thoracic T4-9 HVLA
Rule 3:
T1-3、T12：SP line straight with TP
T4-6、T11: SP go half segment up to TP
T7-9、T10: go up a whole segment
Spine of scapular: T3
Inferior angle of scapular: T7
Supine
1. hold elbows right to pop segment to build up
most tension, higher segment pull even tighter
2. shoulder problem hold arms behind neck put
force to elbow
3. start in over rotation twist to skin lock,
SP right down fist
4. pull in with upper hand to get pressure when
skin locking
5. roll over, underneath sternum
6. bring elbows under stomach, come over
patient lift head a little, got full control
7. flex up to the segment, get all weight on
top, take deep breath in all way out, drop
8. lower sternum or upper abdomen maintain
downward leverage, introduce a force in line with patient’s upper
arm, emphasis on primary leverage
9. the shoulder girdles and thorax are a sold
mass
10. HVLA downwards and cephalad via lower
sternum, hand against TP in upward and caudal
11. not breathing to surprise
Prone
1. Start here and there, 90 each other
2. Caudal with left hand, cephalal with right hand
3. a little more skin locking then push down towards end range
of available joint gliding
4. breath in and down, thrust
Guiding rule: most comfortably for patient and us
颈胸椎C7-T3 HVLA
1. the chin point resting on couch, arms
hanging over the edge, small amount of right sidebending
2. stand as erect, hypothenar eminence on left
TP of T3, caudad and downward force
3. head of couch, right hand against left side
of head and neck with fingers pointing towards right shoulder /
right head of couch, fingers towards couch
4. until a sense of tension is palpated at left
hypothenar
5. HVLA down towards couch and in direction of
left axilla, while a slight rapid increase of head and neck
rotation
  L shape
won't rotate over
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