Downslope gliding Chin hold Patient supine

• Contact point. Lateral aspect of the right C4 articular pillar.

• Applicator. Lateral border, proximal or middle phalanx.

• Patient positioning. Supine with the neck in a neutral relaxed position.

• Operator stance. Head of couch, feet spread slightly.

• Palpation of contact point.

• Fixation of contact point.

• Chin hold. Ensure your left forearm is over or slightly anterior to the ear.

• Vertex contact. Optional but often useful.

• Positioning for thrust. Step slightly to the right. Introduce primary leverage of sidebending right (Fig. B1.10.1) and a small degree of secondary leverage of rotation left (Fig. B1.10.2). Align your body and right arm for the thrust plane, which is caudad in the direction of the patient's left shoulder and downwards towards the couch.

• Adjustments to achieve appropriate pre-thrust tension.

• Immediately pre-thrust. Relax and adjust your balance.

• Delivering the thrust. The thrust is directed towards the patient's left shoulder and downwards towards the couch. Simultaneously, apply a slight, rapid increase of sidebending of the head and neck to the right with no increase of rotation to the left (Fig. B1.10.3).

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