Manipulation of the Spine, Thorax and Pelvis
- 5th Edition - June 16, 2026
- Latest edition
- Authors: Peter Gibbons, Philip Tehan
- Language: English
- Hardback ISBN:9 7 8 - 0 - 4 4 3 - 2 7 9 7 7 - 5
- eBook ISBN:9 7 8 - 0 - 4 4 3 - 1 2 6 5 0 - 5
Now reflecting the tremendous increase in knowledge and research evidence on the use of manipulative techniques in clinical practice, Manipulation of the Spine, Thorax and Pelvi… Read more
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Now reflecting the tremendous increase in knowledge and research evidence on the use of manipulative techniques in clinical practice, Manipulation of the Spine, Thorax and Pelvis, 5th Edition, helps you acquire and refine your skills on the safe use of high-velocity low-amplitude (HVLA) thrust techniques. This highly regarded resource advocates an approach that uses minimal leverage to achieve cavitation in a safe, comfortable and effective manner—supported by up-to-date, high-quality images and videos. In one comprehensive volume, you’ll find essential information on all aspects of the delivery of manipulation techniques, including important issues surrounding patient consent and safety issues in the broader context of relative risk.
- Provides step-by-step coverage of 43 commonly used manipulation (HVLA) thrust techniques, supported by 293 photographs/drawings and 60 videos—all fully updated in light of recent research evidence
- Includes concise technique summaries for quick review, a troubleshooting section that addresses difficulties with technique application, and a comprehensive review of spinal kinematics and spinal positioning for manipulation techniques
- Contains a new chapter on the possible biological and psychological mechanisms relating to the efficacy of manipulation in clinical practice, and a new section on rib cage HVLA techniques
- Offers detailed information on kinematics and coupled motion of the spine, minimal leverage positioning for HVLA thrust techniques, safety and minimising risk in the application of manipulation, and current evidence relating to the use of manipulation in paediatric and pregnant patient populations
- Examines evidence relating to cavitation and the clinical effectiveness of spinal manipulation
- Encourages you to reflect on how you are performing manipulative techniques in order to improve your skills
- An eBook version is included with purchase. The eBook allows you to access all of the text, figures, and references, with the ability to search, customize your content, make notes and highlights, and have content read aloud
Osteopaths and Osteopathic Physicians, Manual Medicine Practitioners
The website https://evolve.elsevier.com – accompanying this text includes video sequences of all the techniques described in Part B (with the exception of the last technique described in Chapter 12.) These are indicated in the text by the following symbol.
Part A HVLA thrust techniques – an osteopathic perspective
1 Introduction
2 Osteopathic history, principles and practice
3 Kinematics and coupled motion of the spine
4 Minimal leverage positioning for HVLA thrust techniques
5 Cavitation
6 Mechanisms of Effectiveness
7 Safety
8 Evidence-informed practice
9 Consent
Part B HVLA thrust techniques
10 Cervical and cervicothoracic spine
Note: Before reviewing up-slope and down-slope HVLA thrust techniques, the Introduction on the website should be viewed.
10.1 Atlanto-occipital joint C0–1: Contact point on occiput; Chin hold; Patient supine; Anterior and superior thrust in a curved plane; Ligamentous myofascial positioning
10.2 Atlanto-occipital joint C0–1: Contact point on atlas; Chin hold; Patient supine; Anterior and superior thrust in a curved plane; Ligamentous myofascial positioning
10.3 Atlanto-axial joint C1–2: Chin hold; Patient supine; Rotation thrust; Ligamentous myofascial positioning
10.4 Atlanto-axial joint C1–2: Cradle hold; Patient supine; Rotation thrust; Ligamentous myofascial positioning
10.5 Cervical spine C2–7: Up-slope; Chin hold; Patient supine
10.6 Cervical spine C2–7: Up-slope; Chin hold; Patient supine – variation
10.7 Cervical spine C2–7: Up-slope; Cradle hold; Patient supine
10.8 Cervical spine C2–7: Up-slope; Cradle hold; Patient supine; Reversed primary and secondary leverage
10.9 Cervical spine C2–7: Up-slope; Patient sitting; Operator standing in front
10.10 Cervical spine C2–7: Up-slope; Patient sitting; Operator standing to the side
10.11 Cervical spine C2–7: Down-slope; Chin hold; Patient supine
10.12 Cervical spine C2–7: Down-slope; Cradle hold; Patient supine
10.13 Cervical spine C2–7: Down-slope; Patient sitting; Operator standing to the side
10.14 Cervicothoracic spine C7–T3: Rotation; Patient prone; Operator at side of couch
10.15 Cervicothoracic spine C7–T3: Rotation; Patient prone; Operator at head of couch
10.16 Cervicothoracic spine C7–T3: Rotation; Patient prone; Operator at head of couch – variation
10.17 Cervicothoracic spine C7–T3: Sidebending; Patient sitting
10.18 Cervicothoracic spine C7–T3: Sidebending; Patient sitting; Ligamentous myofascial positioning
10.19 Cervicothoracic spine C7–T3: Sidebending; Patient sidelying
10.20 Cervicothoracic spine C7–T3: Sidebending; Patient sidelying; Ligamentous myofascial positioning
10.21 Cervicothoracic spine C7–T3: Extension; Patient sitting; Ligamentous myofascial positioning
11 Thoracic Spine
Note: Before reviewing thoracic spine techniques the Upper limb positioning for sitting and supine thoracic spine techniques on the website should be viewed.
11.1 Thoracic spine T4–9: Extension; Patient sitting; Ligamentous myofascial positioning
11.2 Thoracic spine T4–9: Flexion; Patient supine; Ligamentous myofascial positioning
11.3 Thoracic spine T4-9: Patient supine; Ligamentous myofascial positioning
11.4 Thoracic spine T4–9: Rotation; Patient supine; Ligamentous myofascial positioning
11.5 Thoracic spine T4–9: Rotation; Patient prone; Short-lever technique
12 Rib Cage
12.1 Ribs R1: Patient prone
12.2 Ribs R2–3: Patient prone
12.3 Ribs R4–10: Patient supine; Ligamentous myofascial positioning
12.4 Ribs R4–10: Patient prone; Short-lever technique
12.5 Ribs R4–10: Patient sitting; Ligamentous myofascial positioning
13 Lumbar and thoracolumbar spine
Note: Before reviewing sidelying HVLA thrust techniques in the lumbar and thoracolumbar spine, the Introduction the website should be viewed.
13.1 Thoracolumbar spine T10–L2: Neutral positioning; Patient sidelying; Rotation thrust
13.2 Thoracolumbar spine T10–L2: Flexion positioning; Patient sidelying; Rotation thrust
13.3 Lumbar spine L1–5: Neutral positioning; Patient sidelying; Rotation thrust
13.4 Lumbar spine L1–5: Flexion positioning; Patient sidelying; Rotation thrust
13.5 Lumbar spine L1–5: Neutral positioning; Patient sitting; Rotation thrust
13.6 Lumbosacral joint (L5–S1): Neutral positioning; Patient sidelying; Thrust direction is dependent on zygapophysial joint plane
13.7 Lumbosacral joint (L5–S1): Flexion positioning; Patient sidelying; Thrust direction is dependent on zygapophysial joint plane
14 Pelvis
14.1 Sacroiliac joint: Left innominate posterior; Patient prone; Ligamentous myofascial positioning
14.2 Sacroiliac joint: Right innominate posterior; Patient sidelying
14.3 Sacroiliac joint: Left innominate anterior; Patient supine
14.4 Sacroiliac joint: Sacral base anterior; Patient sidelying
14.5 Sacrococcygeal joint: Coccyx anterior; Patient sidelying
Part C Technique failure and analysis
Part A HVLA thrust techniques – an osteopathic perspective
1 Introduction
2 Osteopathic history, principles and practice
3 Kinematics and coupled motion of the spine
4 Minimal leverage positioning for HVLA thrust techniques
5 Cavitation
6 Mechanisms of Effectiveness
7 Safety
8 Evidence-informed practice
9 Consent
Part B HVLA thrust techniques
10 Cervical and cervicothoracic spine
Note: Before reviewing up-slope and down-slope HVLA thrust techniques, the Introduction on the website should be viewed.
10.1 Atlanto-occipital joint C0–1: Contact point on occiput; Chin hold; Patient supine; Anterior and superior thrust in a curved plane; Ligamentous myofascial positioning
10.2 Atlanto-occipital joint C0–1: Contact point on atlas; Chin hold; Patient supine; Anterior and superior thrust in a curved plane; Ligamentous myofascial positioning
10.3 Atlanto-axial joint C1–2: Chin hold; Patient supine; Rotation thrust; Ligamentous myofascial positioning
10.4 Atlanto-axial joint C1–2: Cradle hold; Patient supine; Rotation thrust; Ligamentous myofascial positioning
10.5 Cervical spine C2–7: Up-slope; Chin hold; Patient supine
10.6 Cervical spine C2–7: Up-slope; Chin hold; Patient supine – variation
10.7 Cervical spine C2–7: Up-slope; Cradle hold; Patient supine
10.8 Cervical spine C2–7: Up-slope; Cradle hold; Patient supine; Reversed primary and secondary leverage
10.9 Cervical spine C2–7: Up-slope; Patient sitting; Operator standing in front
10.10 Cervical spine C2–7: Up-slope; Patient sitting; Operator standing to the side
10.11 Cervical spine C2–7: Down-slope; Chin hold; Patient supine
10.12 Cervical spine C2–7: Down-slope; Cradle hold; Patient supine
10.13 Cervical spine C2–7: Down-slope; Patient sitting; Operator standing to the side
10.14 Cervicothoracic spine C7–T3: Rotation; Patient prone; Operator at side of couch
10.15 Cervicothoracic spine C7–T3: Rotation; Patient prone; Operator at head of couch
10.16 Cervicothoracic spine C7–T3: Rotation; Patient prone; Operator at head of couch – variation
10.17 Cervicothoracic spine C7–T3: Sidebending; Patient sitting
10.18 Cervicothoracic spine C7–T3: Sidebending; Patient sitting; Ligamentous myofascial positioning
10.19 Cervicothoracic spine C7–T3: Sidebending; Patient sidelying
10.20 Cervicothoracic spine C7–T3: Sidebending; Patient sidelying; Ligamentous myofascial positioning
10.21 Cervicothoracic spine C7–T3: Extension; Patient sitting; Ligamentous myofascial positioning
11 Thoracic Spine
Note: Before reviewing thoracic spine techniques the Upper limb positioning for sitting and supine thoracic spine techniques on the website should be viewed.
11.1 Thoracic spine T4–9: Extension; Patient sitting; Ligamentous myofascial positioning
11.2 Thoracic spine T4–9: Flexion; Patient supine; Ligamentous myofascial positioning
11.3 Thoracic spine T4-9: Patient supine; Ligamentous myofascial positioning
11.4 Thoracic spine T4–9: Rotation; Patient supine; Ligamentous myofascial positioning
11.5 Thoracic spine T4–9: Rotation; Patient prone; Short-lever technique
12 Rib Cage
12.1 Ribs R1: Patient prone
12.2 Ribs R2–3: Patient prone
12.3 Ribs R4–10: Patient supine; Ligamentous myofascial positioning
12.4 Ribs R4–10: Patient prone; Short-lever technique
12.5 Ribs R4–10: Patient sitting; Ligamentous myofascial positioning
13 Lumbar and thoracolumbar spine
Note: Before reviewing sidelying HVLA thrust techniques in the lumbar and thoracolumbar spine, the Introduction the website should be viewed.
13.1 Thoracolumbar spine T10–L2: Neutral positioning; Patient sidelying; Rotation thrust
13.2 Thoracolumbar spine T10–L2: Flexion positioning; Patient sidelying; Rotation thrust
13.3 Lumbar spine L1–5: Neutral positioning; Patient sidelying; Rotation thrust
13.4 Lumbar spine L1–5: Flexion positioning; Patient sidelying; Rotation thrust
13.5 Lumbar spine L1–5: Neutral positioning; Patient sitting; Rotation thrust
13.6 Lumbosacral joint (L5–S1): Neutral positioning; Patient sidelying; Thrust direction is dependent on zygapophysial joint plane
13.7 Lumbosacral joint (L5–S1): Flexion positioning; Patient sidelying; Thrust direction is dependent on zygapophysial joint plane
14 Pelvis
14.1 Sacroiliac joint: Left innominate posterior; Patient prone; Ligamentous myofascial positioning
14.2 Sacroiliac joint: Right innominate posterior; Patient sidelying
14.3 Sacroiliac joint: Left innominate anterior; Patient supine
14.4 Sacroiliac joint: Sacral base anterior; Patient sidelying
14.5 Sacrococcygeal joint: Coccyx anterior; Patient sidelying
Part C Technique failure and analysis
- Edition: 5
- Latest edition
- Published: June 16, 2026
- Language: English
PG
Peter Gibbons
Affiliations and expertise
Associate Professor Osteopathic Medicine, Head of the School of Health Sciences, Victoria University, Melbourne, AustraliaPT
Philip Tehan
Affiliations and expertise
Senior Lecturer, Osteopathic Medicine, School of Health Sciences, Victoria University, Melbourne, Australia