|Yes Carl, I will recycle this picture forever|
Is you cervical or TMD patient benefiting from your OA distractions and/or subcranial shear distractions, but the same technique performed via HEP flares them up?
Here are a few tips to try before you abandon this great reset.
1) Make sure they're sitting or standing upright
- even a slightly depressed sternum makes this exercise difficult to do
- also make sure their scapula are set, but only using just enough effort, not maximal
|image from http://traylbodywork.com/technique/thoraic-spine-mobility/|
- a good end range cervical retraction needs the upper thoracic and some mid thoracic ability to handle loading
- try some light IASTM to the upper and mid thoracic paraspinals, then have the patient try the movement again
3) The patient is not relaxed during the movement
- I use the cue, "push farther" not "push harder" for self generated overpressure
- with or without overpressure, often, the patient struggles to get to end range and irradiation of the cervical flexors along with the upper traps occur
- make sure these muscles are relaxed during the movement
- the overpressure should be given at their active end range, not throughout the range, as this often facilitates the cervical flexors
If I could think of two more quick tips, I would have posted this on Friday! Remember to exhaust other options prior to abandoning what may be the patient's directional preference.
Keeping it Eclectic...