Top 5 Fridays! 5 Considerations for Cervical Retractions

Here are 5 Considerations for the Cervical Retraction Exercise!

neutral/start position

cervical retraction

1) Start in neutral, end in neutral

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

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