Top 5 Fridays! 5 MDT Exercises for the Cervical Spine | Modern Manual Therapy Blog

Top 5 Fridays! 5 MDT Exercises for the Cervical Spine

Here are 5 Basic WB Exercises for cervical rapid responders.

As usual, all of your magic hands hocus pocus means nothing if the patient cannot keep the improvements between visits. Here are 5 ways to self treat the cervical spine.

Don't think double chin, think triple chin!
1) The Good Ole Chin Tuck
  • for central or bilateral complaints
    • headaches in to the frontal cranium
    • bilateral neck pain radiating to upper traps
  • end range is sternal elevation
  • last year a little old lady asked me if this exercise would make her double chin worse
  • I said, "I don't know, but at least it helps your headaches and neck pain."
  • I saw her just this past summer for a completely different condition, the first thing she showed me was the lack of a double chin, she was so happy the chin tucks tightened everything up!

cervical neutral, "yes sir!"

Unilateral nod variation for right sided HA or upper cervical pain
2) The Good Ole Chin Tuck Part 2
  • For those who do not tolerate cervical retraction, possibly due to tighter upper cervical spine
  • this works a bit better for headaches than retractions
  • a variation for unilateral headaches is the same light nod with neutral cervical spine with a slight 5-10 deg rotation to the ipsilateral side of involvement
starting position, the retracting dead

rotation with self overpressure to end range, rotate toward the pain
3) Cervical retraction with rotation
  • If the above unilateral nod variation does not work with upper cervical pain or unilateral HA, try this
  • make sure to rotate but keep the contralateral shoulder from moving anteriorly too early
  • this works very well to restore lost rotation or keep it after your manual techniques

stock starting photo... "brains...."
end range overpressure to the painful/limited side, welcome to the gun show!
4) Cervical retraction with sidebending overpressure
  • it's the too simple to work for many upper quarter problems self treatment!
  • as always, end range is key here, remember to slack the contralateral upper trap if needed by passively elevating the scapula
  • try for any hand, forearm, elbow, shoulder, scapula, thoracic pain that is unilateral and not responding to traditional treatments
  • better yet, try this first for any of the above to rule out cervical involvement
start, triple chin!

finish, forehead parallel to ceiling

5) Cervical retraction with extension
  • a progression for improvement or plateau for central or bilateral complaints
  • I do not give this one out too often in lieu of self generated overpressure into cervical retraction
  • this may also work for Sx that are radiating to mid thoracic spine or scapula
  • make sure they get to end range, which normally is forehead parallel to the ceiling!
  • also check out this clinical pearl on this very technique!
Keeping it Eclectic!


  1. Am I watching an exorcist movie?

    Neurosurgeon Las Vegas -

  2. Hi Erson,
    I've been reading your blog for about 6 months now, and I have worked my way from the start of the blog to my current reading of March 2014. I find your ideas and techniques really good.

    One difficulty I have is teaching people the technique of Cervical Retraction, even with your ideas to improve it, some people still struggle.

    I was wondering for unilateral UQ complaints where you would normally Retract + SB, would just Side Bending get similar results? So this would avoid the hassle of teaching retraction for Unilateral complaints.

  3. I can tell you from my experience, it will not work as well. The directional preference normally has to do with loss of ability to load the spine (or fold the ipsilateral high tone tissues), and since the patient is often unloading, or "stretching" the involved side, doing SB without load is not novel enough for the CNS to modulate the perceived threat or pain. If they are not getting retraction as a verbal cue, use visual and tactile cues as well, practice with them until they get it right. It's what they do between visits that makes/keeps the rapid changes. Thanks for catching up! That's a lot of reading in 6 months!