Rib Raising

Purpose: This technique is helpful in loosing thick mucus and improving rib motion.

Technique:
1. The patient should lie down on their back, or be seated with their hands over one side of the caregiver’s shoulder.
2. Caretaker should slide both hands under patient’s back, with palms up until fingertips are on muscular area to
one side of the boney spine.
3. Caretaker should press into this muscular area until ribs are noted to move upward. The rhythm of movement is
slow, and mimics a deep breath for the patient.
4. This should be repeated up and down the spine.
5. Once finished with one side of the spine, the technique should be repeated on the opposite side. If the patient is
seated, both hands may be used on either side of the spine at the same time.

Prescription:
Do this technique_______ times per day.

If using an inhaler or nebulizer, perform rib raising after medication is given.

Rib Raising - Figure A Rib Raising - Figure B Rib Raising - Figure C

hand position hand placement lifting rib angles (supine)

Rib Raising - Figure D Rib Raising - Figure E

infants & small children patient seated
 Lymphatic Pump

Purpose: This technique assists in moving lymph around the body and emptying it through the thoracic duct in the
upper chest. This is necessary to carry immune cells to sites needed to fight infection.

Technique:
1. Patient should lie down on their back.
2. Caretaker should stand a patient’s head.
3. Caretaker should place hands on patient’s chest wall with finger tips point towards patient’s feet.
4. Caretaker should gentle compress the patient’s chest and then release in a rhythmic fashion for approximately 2
minutes. The rate movement is slightly faster than the patient’s breathing pattern. If it is an infant, it would
match their breathing rate. This can be done once a day during illness.

Lymphatic Pump - Figure B

anterior chest wall (sternal) pump

Images reprinted from One-Minute Osteopathic Techniques for the busy Clinician 1997. Shaw and Dyer