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On the Frontal Occipital Manual Technique…

The TMCC pattern says the sphenoid is in right rotation and that we want to promote left sphenoid rotation, but the frontal occipital manual technique seems like it is also promoting right sphenoid rotation. I am unclear on what I am trying to achieve with this manual technique. Also, upon the exhalation phase it says to guide the left wing of the sphenoid anteriorly with the right thumb as the index/middle finger drives the right wing of the sphenoid caudally. This seems awkward and difficult to coordinate. (I feel comfortable with the inhalation phase of pulling and supinating). Any clarification on the technique would be greatly appreciated.

The mastoid (temporal bone) is anterior (posteriorly rotated) on the right side and the occiput is in flexion on C1, or in anterior rotation.  So essentially the posterior temporal bone is in extension on the occiput and the occiput is flexed at the OA joint.
The right frontal occipital manual technique promotes right occipital posterior rotation and therefore left sphenoid rotation as the sphenobasilar joint on the right is directed into flexion and the OA joint into extension.
Consider the right thumb as a stabilizer of the sphenoid on exhalation and remember the sphenoid is not your main manual point of interest; the temporal bones are.

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