Here are 5 Considerations for the Cervical Retraction Exercise!
- some patients are "spring loaded" and after successfully performing a retraction, rapidly return to near full protraction
- if the DP is retraction, this defeats the purpose of end range loading in that direction
- have them start with their thumb on their sternum with their index keeping them in neutral
- have them retract away from their index finger, but not bash through it
- also make sure they're not just moving their index finger away - surprising how many do this!
2) End range, end range, end range!
- Just like REIL, end range is where the magic happens!
- with the above self generated overpressure performed hourly, I rarely have to use the progression to retraction with extension
- make sure they remain tucked - double/triple chin time!
- end range is sternum slightly raising
3) Just enough, but not too much!
- many patients may find this exercise uncomfortable, but are trying so hard to do it correctly, they tense their masseter, scalenes, and upper traps
- I learned the #3 consideration from a fellow mentee of mine, Dr. Kris Bosch, who successfully integrates pilates and OMPT
- make sure the movement gets to end range, but not through force
- range = range
4) They should be performing retractions (WB/loaded) with good posture
- it is easy enough on many patients to show cause/effects of posture by checking cervical rotation/extension in slouching, then rechecking in neutral
5) Do not forget about unloading, especially for headaches
- if loading (but more function) retractions are not tolerated for HEP, the patient may perform in supine over a pillow or cervical roll
- for headaches, they can hold this for 3-4 minutes to see if the referred Sx centralize
- after a few days of performing unloaded, try to progress back to loaded, which are easier to perform repeatedly throughout the day