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OMM Review — High Velocity Low Amplitude
Original OMM review notes for HVLA setup, indications, and contraindications.
Principles
HVLA applies a short, controlled thrust at the end of the restrictive barrier. The joint is positioned to localize forces and eliminate adjacent compensatory motion, often called stacking or locking.
Setup and Safety
- Explain the technique and obtain consent.
- Position the patient comfortably with the joint at the restrictive barrier.
- Use your body mechanics to generate a quick, low-amplitude impulse.
- Reassess motion after the thrust.
Contraindications
| Absolute / strong relative | Examples |
|---|---|
| Bone disease | Osteoporosis, osteopenia with fragility, Paget disease |
| Malignancy | Metastatic cancer involving bone |
| Trauma | Acute fracture, dislocation, severe sprain |
| Neurovascular | Unstable cervical artery disease, myelopathy |
| Infection | Osteomyelitis, septic arthritis |
Cervical HVLA carries additional risk; screen for vertebral artery insufficiency and avoid if cervical instability is suspected.
Q: What is the defining feature of HVLA?
A: A rapid, low-amplitude thrust applied through a restrictive barrier.
Q: Why is osteoporosis a contraindication to HVLA?
A: Reduced bone density increases fracture risk under thrust forces.