Direct Treatments: Which of the following is a direct treatment?

• A. High Velocity Low Amplitude (HVLA)
• B. Counter strain
• C. Balanced ligamentous tension
• D. Scoliosis

Answer: (A)

Direct treatments move tissues toward the restrictive barrier to reset motion. HVLA is direct because it uses a rapid, targeted thrust that travels toward that barrier, quickly releasing tissue tension and restoring joint range. In contrast, counterstrain and balanced ligamentous tension are indirect techniques: they place the body in a position of ease or balance, away from the barrier, to reduce hypertonicity and tissue tension. Scoliosis is a condition, not a specific manual treatment, so it isn’t a direct technique by itself.