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.
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.