Naturopathic Manipulation Spinal Column

Test Contact Movement Tester Hands Muscle Normal/ABnormal

C1-Occiput N= space smaller
(max 15 Flexion Fingertip in ant. AB = no closure
degrees) Ant. Space b/w TVP Space
C1 & ramus of Extension N= space larger
mandible AB = no opening
Rotation N= space larger
(away ) AB= no opening
Post. Space b/w TVP Lateral Flexion Posterior Space N=Space Larger
C1 & mastoid (away) AB = no opening
Occiput – C1 2 fingers on post. Rotate N= springy
(max 15 Aspect of mastoid (away~endpoint) AB = hard/fixation
degrees) (push)
Lateral aspect of Lateral Flexion N= springy
mastoid (toward) AB= hard/fixation
(push)
C1-C2 Thumb on SP of C2 Rotation (15deg) N= increase in gap
(max 15 Tip of finger on TVP (away from index AB = no increase
degrees) of C1 finger)
Lateral Flexion N= increase in gap
(away) AB = no increase
C2-C7 Thumb and index on Flexion AP moves into
articular pillars (AP) thumb and finger
Thumb and index on Extension Moves away from
articular pillars (AP) thumb and finger
Thumb and index on Rotation Rotate head away N= AP sinks away
articular pillars (AP) from AP tested from finger
AB = AP comes into
finger or no
movement
Move Thumb and Lateral Flexion Head to side AP N= AP moves away
finger laterally tested
Thoracic Fingertips in Flexion N=spaces open
interspace spaces AB= slight or none
Fingertips in Extension N = spaces close
interspace spaces AB= slight or none
Ref. thumb on one Lateral Flexion Opposite of N = SP moves away
side of SP lumbar b/c of from thumb
ribs AB = into thumb
Pt. arms crossed Rotation N=SP moves away
AB = into thumb
Lumbar Fingertips in Flexion N=spaces open
interspace spaces AB = don’t open
Fingertips interspace Extension N=spaces close
spaces AB = don’t close
Reference thumb on Lateral Flexion Towards you N=SP to thumb
side of SP near you (type I N or III)
(Lateral Flexion AB= SP moves
Lumbar Loves away (Type II or IV)
you)
SP towards I of III Lateral Flexion Spinal Challenge III: intertrans- N = Type I soft
versarii spasm AB = type III hard
Pt arms crossed Rotation Opp. Shoulder N= SP away thumb
towards you AB= Type IV = to

Test Contact Movement Tester Hands Muscle Normal/ABnormal

Costo- Fingers in Lateral Flexion Away from testing N= opening
Vertebral intercostals spaces side
1st 6 ribs up, last 6 Towards testing N = closing
ribs down side
• Thumb on NAT Rotation Away from testing AB = could be N= NAT forward and
• PT arms cross side intercostals or away from thumb
chest erector spinae AB= pushes back on
tightness thumb
Costosternal • Stand b/h patient • Ext. pt back N= rib moves up on
• Trap rib b/w 2 • Elevate arm ext & elevation
fingers • Rotate to palpate
Laterally on rotation
• Support pt’s arm side
Sterno- • Stand b/h patient • Ext pt back N= rib moves up on
clavicular • Trap rib b/w 2 • Elevate arm ext & elev
fingers • Rotate to
Laterally on rotation
• Support pt’s arm palpate side
1st Rib 2-3 fingers in apical Lateral Flexion Head toward N= sinking
space (press down testing side AB = none or back
into space) pressure
(poke from Rotation Head away from N= ant glide &
top) test side elevation of rib
AB= no motion
Acromio- Thumb and finger on Push Down N= clavical moves
clavicular lat. aspect of clavical down and bounces
back
AB= no down
movement
Superior Reference thumb on Raise Testing leg Examining thumb N= post & inf
Sacroiliac 1st/2nd sacral tubercle on PSIS movement of PSIS
AB= slight or no
movement of PSIS
Inferior Reference thumb on Raise Testing leg Examining thumb N= ant & sup
Sacroiliac sacro-coccygeal of medial aspect of movement of ischial
junction ischial tuberosity tuberosity
AB= slight or no
movement of ischial
tuberosity

* cervical spine -- rotation always move head away

* lateral flexion – SP always moves away, except Lumbar (Lumbar Loves you Lateral Flexion)
* Cervical rotation – move patient’s body away and SP moves away
* thoracic and lumbar rotation – SP moves away (if normal)