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Thoracic Spine Load Transfer Tests

Physical Therapy First demonstration of Thoracic Spine Load Transfer Tests What you’ll see in the video • Setup & landmarks — Patient positioning, breathing baseline, and how to find lateral rib angles and sternal references for consistent palpation. • Functional load‑transfer screens — Example tasks such as arm elevation, a light press/row pattern, and seated trunk rotation to observe ring motion, rib flare, or asymmetry under load. • Ring correction & retest — Gentle “stack and breathe” cues or manual facilitation to improve ring alignment/control; immediate retest of the same task to check for changes in symptoms, range, or ease. • Clinical synthesis — How to document findings (what changed, where, and why) and decide whether to prioritize thoracic mobility, control, or downstream regions. Why it matters • The thoracic region is a key hub for force and load transfer between the upper and lower body; subtle ring dysfunction can influence neck, shoulder, rib, and lumbar mechanics. • Load‑transfer testing with ring palpation/correction helps determine whether the thorax is contributing meaningfully (“the driver”) and whether a thoracic‑focused intervention is likely to help. Step‑by‑step (clinician quick guide) 1) Position & cue: Neutral sit/stand, relaxed shoulders, quiet breath; establish a symptom and motion baseline. 2) Palpate: Place broad finger pads at the lateral rib angles of the target rings. 3) Task: Have the patient perform a meaningful movement (e.g., reach/press/rotate) while you feel for non‑optimal translation, flare, or control. 4) Correct: Apply a small manual “ring correction” and/or cue stacking and lateral rib expansion. 5) Retest: Repeat the exact task—note change in pain, range, control, and effortless quality. 6) Decide & dose: If improved, target the implicated ring(s) with mobility/control drills; if unchanged, sample adjacent rings or another region. Clinician tips • Use light, sustained contacts and follow the breath—don’t over‑compress the ribs. • Compare sides and adjacent rings; meaningful change can be subtle. • Pair positive findings with a simple home drill (e.g., self “stack and breathe,” thoracic rotation/extension) to reinforce control. Common errors to avoid • Pushing on rib angles too firmly (provokes guarding). • Changing the task between test and retest (muddy data). • Chasing force instead of control—prioritize smooth breath‑supported motion. https://physicaltherapyfirst.com/