The HVLA technique (also known as mobilization with impulse) is a direct, active technique in which the physician engages the pathological barrier of a joint restricted in a normal plane of movement. Once a restricted “barrier” is engaged, the physician employs a quick thrust over a short distance through the inhibited plane of motion. The movement is within a joint's normal range of motion and does not exceed the anatomic barrier or range of motion. With proper positioning of the patient, HVLA technique requires very little force and can be targeted to specific spinal segments. The goal of the treatment is to restore normal joint play or a desirable gap between articulating surfaces that permits free translational or gliding motion in addition to the usual angular motion. This is achieved by directly engaging the restrictive component of a joint’s somatic dysfunction. Of all the osteopathic techniques, HVLA technique most closely resembles the chiropractic technique and has the greatest number of contraindications. Contraindications include rheumatoid arthritic involvement of the cervical spine, carotid or vertebrobasilar vascular disease, the presence or possibility of bony metastasis or severe osteopenia, and a history of pathological fractures.
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