NonNeutral Dysfunction
FRS-Left
Diagnosis -- With your thumbs on the posterior aspects of the transverse processes of a lumbar segment that is suspected of being dysfunctional, you have the patient bend backward at the waist. As the patient increases the amount of backward-bending, the left transverse process becomes more prominent and moves inferior when compared to the right. When you have the patient bend forward, the position of both transverse processes become more symmetric. We know that in flexion the facets are supposed to open, and in extension the facets are supposed to close. Knowing this we suspect the following:
- When the patient bends forward, both facets are opened appropriately. The position of the transverse processes is symmetric because there is no rotational component associated with forward-bending.
- When the patient bends backward, the left transverse process moves posterior and inferior, indicating that the right facet has not closed properly.
- Because the right facet has not closed properly, we see left rotation (with left sidebending) of the vertebra, with the right facet functioning as a pivot point.
- This condition is usually due to hypertonicity of the short muscles, although there may be other myofascial components contributing to the somatic dysfunction.
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