This is a simple technique to get to end range rotation and since you are tractioning quite a bit, there is a powerful neurophysiologic effect/reset as well.
I know this was one of the links that I posted on Monday, but it did not get a lot of hits, I thought I would review it here. This is a technique I learned while studying at the University of St. Augustine
- acutely locked facet
- painful block in sidebending or rotation
- unilateral loading loss
- high fear avoidance
- basically the same as any mobilization/manipulation
- supine, or hooklying, whatever has them more relaxed
- pt has tongue at the roof of their mouth and TMJ in closed packed position
- sitting above patient's head
- one hand on occiput, the other on inferior mandible bilaterally
- pt relaxes and a strong axial cervical traction is applied to the patient
- the traction is held all the way to end range rotation away from the pain first, then back to neutral
- relax the traction at neutral
- assess the patient verbally during the first part and at neutral
- then traction and slowly rotate the patient to end range to the painful side
- this may be painful, but only during the motion or at end range, and should not remain worse after
- this should only take 1-2 repetitions to rapidly restore ROM
Sorry for the rehash of something I just recently posted, but thought this would go along very well with Monday's popular post, plus my wife and I are really lacking in the sleep department for the past few days, and my creativity is waning!
Keeping it Eclectic....