The Easiest Cervical Screen Ever | Modern Manual Therapy Blog

The Easiest Cervical Screen Ever


By the time this is auto posted, I will be back on a plane from Santiago, Chile, after another amazing weekend teaching The Eclectic Approach to Spinal Manipulation for TherAdvance Group.

I will post a few mini cases from the course later this week, but I wanted to share what I consider a very easy cervical passive motion screen that I do if a WB position is too painful/threatening.

The Screen: Cervical Retraction and sidebending with passive overpressure in supine

Patient:
  • patient maximally relaxed, may need a pillow or two if kyphotic
Clinician:
  • Sitting or standing cranially in relation to patient
  • one hand on occiput, the other hand on forehead
Technique:
  • pull cranially on the occiput with one hand
  • push A/P with the hand on the forehead
  • both of these together should case cervical retraction
  • keeping the retraction, sidebend the head to the left and right, noting asymmetries
Pattens:
  • typically, any relevant UQ issue that is cervicogenic will have a loss of retraction and SB to the involved side
  • this is also seen if the patient needs to flex or protract earlier on on side
  • full passive motion with overpressure pain free is needed to pass the screen bilaterally
If limited to the involved side, this needs to be restored via treatment of your choice
  • repeated cervical retraction with SB to the limited side
  • light IASTM to cervical and upper trap patterns on the ipsilateral side
  • cervical downglide thruston the involved side
After restoring symmetry, look at their original pain/limitation or * sign. If rapidly improvement occurs, the cervical retraction with SB in sitting is their HEP.



Keeping it Eclectic....

4 comments:

  1. Thanks Dr. E, I have attempted many times to learn the PIVM and individual spinal moblity assessment but became very frustrated when I was able to feel a restriction but was unsure exactly what spinal segment the restriction was coming from. This makes me feel a bit better about my short-comings and a bit more confident in my treament knowing that despite not knowing exactly what segment the patient was restricted on I was still helping them.

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  2. At least you didn't convince yourself you were feeling something you weren't like I did for years!

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  3. For HEP per your example, do you tell them 10x per hour, as much as you want during the day, it varies? Just curious.

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  4. I generally start with 10x hourly, but also explain it may be more or less depending on how long they're able to maintain the improvements.

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