In a patient with spinal cord injury admitted to rehabilitation, which osteopathic manipulation technique should be avoided?

In a patient with spinal cord injury admitted to rehabilitation, which osteopathic manipulation technique should be avoided?

• A. HVLA
• B. Soft tissue
• C. Muscle energy
• D. Counterstrain

Answer: (A)

High-velocity, low-amplitude thrusts should be avoided in a spinal cord injury patient undergoing rehabilitation because the spine may be unstable and the bones can be weakened from disuse osteoporosis. A rapid spinal thrust risks worsening vertebral injury, compromising the spinal cord, or dislodging any fixation hardware. Safer osteopathic techniques in this setting emphasize gentler approaches like soft tissue methods to reduce fascial tension, muscle energy to improve ROM and neuromuscular efficiency through controlled contractions, and counterstrain to relieve tender points with minimal movement. These options provide therapeutic benefit while minimizing the risk of acute injury to an already vulnerable spine.

High-velocity, low-amplitude thrusts should be avoided in a spinal cord injury patient undergoing rehabilitation because the spine may be unstable and the bones can be weakened from disuse osteoporosis. A rapid spinal thrust risks worsening vertebral injury, compromising the spinal cord, or dislodging any fixation hardware. Safer osteopathic techniques in this setting emphasize gentler approaches like soft tissue methods to reduce fascial tension, muscle energy to improve ROM and neuromuscular efficiency through controlled contractions, and counterstrain to relieve tender points with minimal movement. These options provide therapeutic benefit while minimizing the risk of acute injury to an already vulnerable spine.