Purpose: To treat lower quadrant dysfunction including foot, ankle, knee, hip, pelvic, lumbar, and thoracic areas

Procedure: With the patient in supine, stand at the foot of the table, grasp the patient’s calcaneus and plantar surface of the foot, and take the lower extremity into external rotation and dorsiflexion. As you apply traction, pay attention to any subtle barriers or resistance that you may feel and hold in that position until you feel the barrier release. Apply traction through the length of the limb and follow through a smooth arc into abduction, then abduction with hip flexion. Maintaining the traction and dorsiflexion, flex the leg into a straight-leg raise position. Maintain the traction until the posterior aspect of the lower extremity is stretched. Follow the tissue barrier upon barrier until the release occurs. Then, return the limb through the arc to a neutral position. For phase two, apply traction and dorsiflexion, then move the patient’s lower extremity into internal rotation and adduction. The hip will usually roll forward producing lower trunk rotation. As this happens, maintain traction through the leg and tune into the tissue. The end of this motion will affect a release through the hip, SI, and lumbar fascia. Return the limb through the arc to the neutral position. 

Notes: Exercise caution if using this technique on patients with irritable SI or hip joints.