Purpose: To increase mobility and decrease pain in lumbar and sacral spinal regions.  

Start: Patient starts in supine with their hands interlocked behind their neck so that the elbows are pointed toward the ceiling.  The therapist stands to the non-symptomatic side of the patient.  

Procedure:  The therapist side bends patient toward the opposite side of the plinth to close down on the symptomatic side (patient should be in the shape of a banana with head and legs bent away from the therapist).  The therapist places one hand on the ASIS of the symptomatic side and maintains the position of the ASIS while using  the opposite hand to passively rotate the patient’s upper torso toward the therapist until the ASIS comes slightly up off the table..  At end range the therapist provides a posterior-inferior HVLA thrust through the ASIS.  

Comments:  Patient should have direct skin contact with the plinth to prevent slipping forward and out of position.  Dycem can also be used to prevent slipping.