Disclaimer: The assessment and treatment techniques depicted or described in this site are not intended to replace formal instruction in orthopaedic manual therapy or any other type of physical therapy. They are intended to review, augment and facilitate the knowledge and skills previously gained on manual therapy or other courses. The author takes no responsibility for the use of these techniques by users of this site.

11. Flexion and contralateral sideflexion from below using pelvis.

Stabilize L4 with cranial hand. Use caudal arm to draw pelvis and L5 caudal (arrow A). Also use caudal arm to produce a posterior sagittal rotation of the pelvis to induce flexion (arrow B). Push pelvis posterior with chest to induce a posterior translation (arrow C). This will induce a flexion, contralateral (left) sideflexion of L4/5. Flexion and left sideflexion combined produce maximum flexion at the right zygapophyseal joint. Therefore, this technique targets the right side (closest to ceiling) (symbol D).

12. Extension and ipsilateral sideflexion from above.

Stabilize L5 with caudal hand. Use cranial arm to push thorax and L4 caudal (arrow A). Also push thorax and L4 posterior (arrow B). This will induce extension, ipsilateral (right) sideflexion at L4/5. This technique targets the right side (closest to ceiling) (symbol).