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.