Evaluation and treatment of the cervical spine

Extension mobilization O - A

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Extension mobilization O - A

Same hand placement as in flexion. In this case, the delto- pectoral groove extends the head, the hand under occiput translates it in anterior direction. Gravity and soft tissue tension provide the stabilizing force for C 1. Very few indications for this technique, except when used as an indirect technique, or with people with flat necks.

Alternative: One hand on patient forehead, the thumb and indexfinger of the other hand stabilize C1. The hand on forehead produces upper cervical extension.

Unilateral distraction technique O - A

Patient supine. Occiput in slight left rotation, right sidebending and extension. Contact under mastoid process. Mobilize occiput cranially

Side bending O - A

One hand under occiput. Delto pectoral groove on forehead. Thumb of left hand stabilizes the left TP of C1. Sidebend head to the right

Mobilization C 1 - 2

For right rotation. Index finger left hand wraps around posterior aspect of C 1.Other hand around occiput. Side bend head maximally to the left. Then rotate right, mobilizing C1 on C2.

Mid cervical manual traction seated

Both hands under occiput. Patient leans back against therapist. Flex neck to segment targeted. Distract.

Mid cervical manual traction supine, 2 hand technique

One hand molds under patients chin, the other around SP above targeted segment. Flex down to the level. Distract.

Mid cervical manual traction, towel technique

Towel placed so that the inferior edge lies over the spinous process of the upper vertebra of level affected. Have patient tuck the chin.

Mid cervical flexion

Patient supine. Stabilize lower vertebra of affected segment by molding index finger and thumb around spinous process. Other hand molds around neck and vertebra above.

Place delto- pectoral groove on fore head. Flex up to level. Mobilizing hand draws vertebra up and forward.

C2 - 3 distraction, supine

Patient supine. Occiput/atlas/axis: slight left sidebending and right rotation. Contract: left inferior facet of C 2. Mobilize C 2 cranially, in the direction of the opposite eye. This technique can be done in similar fashion for all the facet joints in the mid cervical spine.

Down and back unilaterally, supine

Side glide segment up to barrier. Then approach posterolateral part of articular process of upper vertebra with antero- lateral part of MCP 1. Mobilize down and back, in the direction of the opposite shoulder.

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