Thoracic Manipulation in Supine

Thoracic Manipulations have received a good amount of attention in the literature in recent years. Whether you are treating a shoulder, cervical spine, or lumbar spine, the thoracic manipulation has been shown to have positive effects on all of these regions. 

The exact science as to why a manipulation is beneficial is not yet understood, but the most recent evidence suggests that it is multi-factorial. Some proposed effects include:
1) Mechanical- breaking up intra-articular lesions
2) Neurological- stimulates mechanoreceptors & "resets" nocioceptive pathways
3) Hydraulic- change the viscosity of synovial fluid
4) Relaxation- decrease in muscle tone & restore normal blood flow
5) Psychological- both laying hands on the patient & hearing a "pop" are strong influences 

Below is a quick video on how to perform the the Thoracic Manipulation in Supine. With the supine technique you are flexing the thoracic spine, which makes it a facet gapping technique. The thoracic manipulation can also be performed in prone and seated positions, which can be utilized based on the patient's restriction and position of comfort.  

As with all manual therapy, it is important to reinforce the treatment with corrective exercises to maintain the positive effects gained from the manual technique.

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