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Osteopathic Manipulative Treatment: HVLA Procedure - Exhaled Ribs


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Osteopathic Manipulative Treatment,Structural and chiropractic

In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan.
2022 Aug 1.


Ahmed Nahian  , Shane R. Sergent 


High-velocity low-amplitude (HVLA) incorporates rapid thrust techniques over a short distance through a pathologic barrier. HVLA techniques require a physician to locate immobile or asymmetrical joints using his or her hands. The physician controls the pathologic barrier by setting it in motion and applying rapid but short thrusts until usually hearing an audible release, confirming the restoration of motion in the affected joint. HVLA techniques have been widely reported across medical literature and have been proven effective in subsiding neck and shoulder pain after their utilization in the cervicothoracic region.

Exhalation dysfunction, formerly known as inhalation restriction, refers to the caudad movement of a dysfunctional rib during exhalation with an absent cephalad rib movement during inhalation. The physician notices one (in some cases) but, generally, a class of ribs stuck in exhalation. OMT (Osteopathic Manipulative Therapy) tends to heal compromises within a joint’s normal range of motion via allocating the joint through the compromised pathologic barrier, generally not beyond the usual physiologic range of motion, which may justify the low incidence of harmful effects off OMT procedures. This review implores the usage of OMT in treating exhaled ribs under inhalation restriction.

Publication Date: 

2022 Aug



Nahian, A., Sergent, RS. (2022) 'Osteopathic Manipulative Treatment: HVLA Procedure - Exhaled Ribs', In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan. 2022 Aug 1.

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