This document discusses the coupled motions of the thoracic and lumbar spine during sidebending and rotation. It explains that when the spine is in a neutral position, sidebending and rotation occur in opposite directions (Type I somatic dysfunction). However, when the spine is flexed or extended, sidebending and rotation occur in the same direction (Type II somatic dysfunction). It also notes that initiating motion in one plane will modify motion in other planes. The document is presented by Joel Berenbeim, DO and thanks Michael Kuchera, DO and Phillip Greenman, DO.

1. AAOM Cervical & Thoracic Lab
for MD’s
Joel Berenbeim, DO
CSPOMM

6. I. When the thoracic and lumbar spine are in a
neutral position, the coupled motions of
sidebending and rotation for a group of
vertebrae are such that sidebending and
rotation occur in opposite directions

7. Type I Somatic Dysfunction
• Group Mechanics of Three or More Vertebral
Segments, When Neutral Sidebending is
Introduced, Rotation Occurs To The Opposite
Side
• Maintained By Long Postural Muscles
• Treat in Neutral

9. II. When the thoracic and lumbar spine are
sufficiently flexed or extended (non-neutral), the
coupled motions of sidebending and rotation in a
single vertebral unit are such that sidebending and
rotation occur in the same direction.

10. Type II Somatic Dysfunction
• Maintained By Short Muscles
• With Hyper Flexion or Extension, Rotation and
Sidebending Occur To The Same Side
• Rotation Occurs Around The “Locked” Facet
• The Facet, “Opened or Closed”, Describes the
Motion and Is Not The Lesion
• FRS/ERS

13. III. 1. Initiating motion of a vertebral segment in
any plane of motion will modify the movement
of that segment in other planes of motion.
.

15. Thank You
• Michael Kuchera, DO
• Phillip Greenman, DO