Technique Highlight: Cervical Functional Mobilization | Modern Manual Therapy Blog

Technique Highlight: Cervical Functional Mobilization


A reader who is currently finishing up MDT Credentialing requested a functional mobilization vid. These are my modifications to this very useful treatment.




Functional Mobilization Advantages

1) It's in WB, so the improvements carry over to functional positions
2) It is a 100% pain free technique - per Mulligan's rules
3) The force used is normally much lighter than traditional mobs/manips
4) Easily integrated into the MDT approach for home self treatment of derangements/dysfunction

Pt: sitting/standing
PT: behind the pt
Tech:

  • use side of dummy thumb and place mob thumb pad over the dummy thumb. If from C2-7, mob is applied in 45 deg angle to the horizontal up and forward
  • If on C1-2, apply mob directly P/A
  • the mob should be sustained through the motion toward the restriction and on the way back
  • repeat each technique for about 3-4 sets of 10 reps
  • if no improvement is seen, you may 
    • increase the force
    • decrease the force
    • try one level superiorly, inferiorly
    • try the other side despite still moving toward the restriction
HEP: I don't use a towel or strap as long as the pt has enough ROM in their UEs to reach their own neck. They can use MDT like guidelines for derangement reduction of 10 reps/hour or repeatedly throughout the day.




Keeping it Eclectic...

2 comments:

  1. Thanks for the video! Do you follow the MDT guidelines of patient generated forces first, then move to PT generated forces? Do you use MDT retraction mobs more or the extension SNAGs? And last but not least, do you try to stay sagittal until something tells you to move frontal?

    ReplyDelete
  2. I use MDT exercises for HEP only. I show them how to do it in the clinic, but I don't have them do more than a few sets and that's only after manual. I tend to use IASTM and joint mobs/manip to increase their pain free ROM, then instruct something like self SNAGs only if standard retraction and retraction with extension are not reducing the derangement. For instance, if they can't keep it reduced and may not be getting to end range, a technique like this for HEP may help them achieve end range, thus reducing the derangement. I stick to sagittal first unless someone has an acutely locked facet and is limited in a capsular pattern. I find frontal plane with quite a bit of self generated OP helps then.

    ReplyDelete