So, I'll be demonstrating two main techniques for the release of the cervical thoracic. My name is Ryan Chile and I'm one of the fellows. Would it be okay if I demonstrate on you? Okay, perfect. Can I have you? Nice to pine for me on your back. So, I'll be demonstrating two main techniques, two soft tissue techniques. And the main target is to target the trapezius, to release of the trapezius. So, the first technique is called the first rib release. It's basically a myofascial release, but there are variations of it which I will demonstrate while we're on it. So, what I will do first is have you lift up your head and use the X technique here. And then I will take him to his barrier and give the trapezius a good stretch. Let me know if this bothers you or if it's uncomfortable. So, this would be just slowly giving a good take a deep breath in and out. Perfect. A nice stretch to the trapezius. All right. Go ahead and lift up your head slowly. Perfect. You could rest it down. Perfect. So, this is important because as we know, treating the cervical thoracic junction, trapezius plays a major role. It's a big muscle that starts off from the occiput all the way down through T2. And then in the front, it comes to the clavicle, which is one of the components of the thoracic inlet, as well as in the back, the spine of the scapula. So, it plays a major role. So, this one of the techniques, the main one was basically a soft tissue technique allowing the trapezius a good stretch for it to release. There's also another variation of this. We could actually turn this into a muscle energy technique. So, I'm going to actually stand up a little bit for it to be easier on my back. And if I had the ability of raising the table, I would actually do that also for it to be easier on my back. So, what I'm going to do is go through the same thing and have you rest your head on my forearm here. And then using the same method for any other, go ahead and lift up, any other muscle energy, I would slowly, gently take him to his barrier and then ask him to gently push back and meet my force. Perfect. One, two, and three, and relax. Allow him to take a deep breath in and out. And then I would take him to the next barrier. One more time. Please push back. One, two, and three, and relax. Perfect. Take a deep breath in and out. Perfect. And then take him one more time to the barrier. Take a deep breath in and out. And then push back. Perfect. One, two, and three, and relax. Good. And then final stretch. And then gently back on the table. How was that? You felt okay? Mm-hmm. So any questions, guys? Okay. So perfect. So that was one variation that was basically a muscle energy technique. Again, focusing mainly on trapezius, even though other muscles are involved, obviously. There is also, we could also engage the trapezius and other muscles by, if I could have you lift up your head one more time. Perfect. I find it easier to ask the patient to lift up their heads rather than lifting them up. It's much easier for me and for my patients, I've noticed. So I could actually do this as a side, using the side bending also. I could actually do the muscle energy this way. I could count the techniques three to five times and then have them push back through my arm this way. And then if I could have you lift up your head. Perfect. And then do the same thing here and relax. And then do the same here, either using my arm there or using my hands here as a technique. The same thing. Have them push back three to five times and then take them to the barrier. So that's another variation. Perfect. Thank you. Relax. So any questions about this? First, trapezius. Okay. Fantastic. The next technique is the trapezius inhibition. And so the way we will do this is to grab the belly of the trapezius using the thumb, index, and the middle finger. And then try to stay a little bit lateral to avoid carotids. So what I will do is gently pinch the trapezius belly from the back using thumb, index, and middle finger. You let me know if this is uncomfortable. Okay? All right. So I would start with not too much force and then hold about five seconds. So I would pinch the trapezius and hold about five seconds. Two, three, four, and five. And I would relax. Are you okay? We'll do one more time. So I would repeat that three to five times if the patient is able to tolerate it. Again, I would apply a little bit more force as I'm watching the patient's face. Watching for their reaction. I've gotten great feedback about this technique. A lot of people, even myself, who had a little muscle spasm the last couple of days. It felt really nice when my colleagues did it on me. So again, five more seconds and I release. Are you doing okay? Perfect. And then I would do one more time. So I could actually work myself medially also to engage the trapezius even further. Again, for five more seconds. I'm applying a little bit more pressure this time. Feels comfortable? Okay, perfect. And then gently release. And then after completing each treatment session, obviously I would be checking, as my colleague demonstrated, if my treatment was helpful at all. So I would always reassess. Okay. What questions do you guys have? Yeah? Okay. Thank you. Students, what did you think? Okay. I think it was a good demonstration. I think you did a good job of not only showing the techniques but describing everything you did since we couldn't see that well from that side, but I could visualize it in my mind's eye. So good job. Thank you. Good? Any other comments? Okay. Oh, thank God. I think you did a good job overall. I like that you kind of would explain what you were going to do, demonstrate the technique, and then kind of in between each technique you were explaining instead of just explaining and then doing each one back-to-back, I think that was a good way to do it so that we wouldn't get kind of mixed up or confused. Thank you. Okay. What did you think you did right? As you mentioned, I think demonstrating, asking the patient if I could touch them to demonstrate on them because I've been in his place. I know what it feels like for someone to just come forward and treat you. Also, making sure to have eye contact and make sure my audience was tuned in, following me every step of the way. Gave objectives, told them what I was about to do. And I was actually, I don't know if you noticed, going and actually treating the patient. So I think that was important. Yeah. What things did you think that you could improve on? Recap. I forgot to summarize at the end. Okay. And that's powerful for students to reinforce the learning. Okay. Anything else? Lots of feedback. One thing that I saw, I really enjoyed that. There was a couple of things that you've done that no one else has. You described what you were doing and then you repeated the description. So I'm going to do this and then now notice I'm doing this. You did that a couple of times and you probably didn't even know you were doing it. So it's very powerful for students to get that reinforcement. You were very calm and authoritative when you were doing this and the students could know that you knew what was going on just by the way you approached things. You did one thing that was probably you figured it out right at the beginning in that you started out and then you introduced yourself. Yes. In the future, introducing yourself first is probably a little easier. Get that out of the way. I always, in a professional environment, always introduce yourself as doctor, so and so. And the reason why is because that immediately credentials you, especially for students who sometimes they don't know who you are. And so now when you do that, they know who you are. And that says, oh, this person knows what they're doing. They follow in the program, so they have a little chow, so I better listen to what they're saying. Overall, everything, I really liked it. I think a couple of little stumbles here and there is part of the learning process and just keep teaching, keep teaching. No doubt you probably will be teaching a lot in the future. And so the way you learn is you just practice and practice and practice and you get really good just by doing the things that you're already doing. Excellent. Good shot. Thank you. Thanks a lot. Thank you, guys.

cervical thoracic tension

trapezius muscle techniques

first rib release

trapezius inhibition

myofascial release