Top 5 Fridays: My Top 5 Techniques for Cervicogenic HA | Modern Manual Therapy Blog

Top 5 Fridays: My Top 5 Techniques for Cervicogenic HA

Here are my Top 5 Treatments for Cervicogenic or Tension HA.

Many people are misdiagnosed with migraine HA or even have migraines that are triggered by cervicogenic HA.  These are my go-to treatments for mechanical HA.

1) Subcranial Shear Distraction
  • Gapping this area increases subcranial space as proven by pre and post test MRIs (unpublished but Rocabado has literally 100s of slides showing this) 
  • this relieves pressure on upper cervical spine and greater occipital nerve both of which refer to the cranium, cervical spine and upper traps




2) Unilateral OA nod
  • this is indicated when the patient has unilateral complaints and as a progression from the subcranial shear technique
  • also indicated with transverse ligament laxity as it does not stress the ligament being a unilateral technique
  • make sure to only perform 3-5 reps as it can be very uncomfortable
  • prep the area first with some ST techniques



3) 1st rib
  • TrPs in the upper traps also can refer superiorly to the cranium
  • prepping this area with IASTM or FR works well prior to the first rib releases



4) prolonged OA gapping/cervical retraction in supine



  • in supine, one hand on occiput, other on the forehead
  • have the patient retract into a pillow and hold at near or end range, progressing into end range if not starting there 2-3 minutes
  • for unilateral complaints, rotate head toward the involved side, SB the cranium away with the axis through the nose and gap the involved side for 2-3 minutes
  • easily taught to the patient at the onset of a HA, they may use over heat




5) upper thoracic thrust manipulation
  • shown by research to have similar effects to cervical thrust and mobilization
  • a safer alternative risk wise to cervical thrust
  • helps relieve thoracic and B upper trap "tightness"



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