Thus, the best time to deliver the thrust is immediately after the beginning of exhalation. The effect on the patient's lungs, then, is only to increase the rate of normal passive exhalation. If the thrust is made at the end of exhalation, forced exhalation results and the effect is a sharp, automatic, protective contraction of the diaphragm, thoracic muscles, and perispinal musculature. The latter is likely to return the segment immediately to its abnormal but habitual position. Such poor timing is painful to the patient, and patients who suffer unanticipated pain are not inclined to refer their friends, relatives, and neighbors for such abuse.
Nobody enjoys unpleasant surprises.
In this manner, there are no surprises and no shocks to one's expectations. This explanation builds a logically designed image within the patient so that the patient's psyche is working with you, not in a contrary fashion. The adjuster need not tell the patient how to breathe. The patient knows how. All the adjuster has to do is feel the patient's thoracic cage rise and fall as the contact is taken to time the thrust properly.