Technique Highlight: Lateral Atlas Press | Modern Manual Therapy Blog

Technique Highlight: Lateral Atlas Press


This is a helpful technique to improve upper cervical/subcranial sidebending and rotation.

The lateral atlas press restores accessory motion of the atlas, which moves opposite the occipital condyles roll. Arthrokinematically, that means if the head SB left, the atlas relatively moves left as the condyles roll left and glide right. In cranial FB and BB, the condyles roll anteriorly and posteriorly (relatively), but glide in the opposite direction. Gliding in the opposite direction is relative atlas movement in the same direction.

Bottom line:

  • if your patient is limited in cervical SB left or right, press the atlas in the same direction you want to improve the motion
  • if your patient is limited in rotation, press the atlas in the opposite direction because rotation and SB occur in opposite directions at the upper cervical/subcranial spine
I love arthrokinematics! The upper cervical arthrokinematics is a post in itself, so any more Q&A, just comment below.

Pt: supine
PT:
  • sitting above patient's head
  • mob hand lat border of 2nd MCP on the lateral mass of the atlas
  • stabilizing hand flexed at wrist to cup mandible for head control
Tech:
  • slightly SB head toward the direction of the limitation, i.e. limited SB left, SB head left
  • mob hand on the contralateral lateral mass of atlas to push medially (it's called lateral atlas press for the area, not the direction of force), in this case pushing right to left improves OA SB left
  • oscillate grade 3-4 with forearm in line with force, perform for 30 seconds to 1 minute, 2-3 sets
  • the atlas often "sticks" and starts moving with relative ease
Use:
  • improves ipsilateral SB, contralateral rotation
  • helps to prep area with FR or IASTM to bony contours of occiput and postero lateral cervical spine C1-3 in proximal to distal direction
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