Position of the therapist:
- Standing at the long edge of the bench
Position of the patient:
- Side-lying position on the side to be examined/treated
- Facing the examiner lying close to the edge of the bench
- Hip and knees bent to 90° and supported on the therapist’s lap
- Patient holds on to his wrist of the upper arm and performs slight adduction with the upper arm
Hand placement:
- One hand placed through the patients crossed arms
- Fixating hand palpates L4
- Patient’s torso rotated away until fixated level
- Other hand now palpates L3
- Fixating hand slipped under patient’s iliac crest
Movement:
- Maximal homonymous 3D movement with equal components of flexion, ipsilateral lateral flexion and ipsilateral rotation
This movement causes maximal opening of the facet joints of the lumbar spine on the side the patient is lying on
N.B:
It’s important to maintain the rotation from above by exerting pressure with your forearm in order to stabilize your fixation
- To test each component of intervertebral motion, slightly move out of the end-range and now test flexion between L3 and L4 by moving laterally with your body
- To assess the rotation component, squat down with your body
- For the lateral flexion component, gently lift the patient’s pelvis