Cervical Rotation Pattern Assisted Motor Control Progression | Modern Manual Therapy Blog

Cervical Rotation Pattern Assisted Motor Control Progression

Does your patient have limited and/or painful cervical rotation actively that changes significantly when measured passively? If so, they most likely do not need manual intervention.

Try the below progression
  • start the patient in supine
  • make sure their neck/head is not in extension
  • give them enough banding to make it feel like a challenge, but not so much that they are unable to speak or have to hold their breath
  • after the band loads the posterior upper quarter chain or scapula stabilizers, have them re-check rotation to see if the motion/pain improves
  • if so, have them repeat the now threat free pattern, with banding assist for a few minutes
  • progress from
    • supine
    • tall kneeling (or half kneeling for unilateral rotation - rot toward elevated arm in cross pattern)
    • standing

Thanks to Dr. David Tilley from The Hybrid Perspective for allowing me to video him!

Keeping it Eclectic....


  1. Yiannis Theocharis, PTMarch 7, 2015 at 11:33 AM

    Hello Erson,

    It's really helpful the posterior chain pattern assistance for the improvement of the motor control of the cervical rotation (especially if is combined with chin tuck) and if for the horizontal abduction is ok i would like to ask about the diagonals exercises.
    On the video Dr. David rotate his head to the ipsilateral side of the UE flexion(scaption) but i think the most physiological way (i learned it from the school like trick moves for improving the cervical rotation) to have a cervical rotation is on the side of the UE extension.You can try.

    So isn't it better to do the same pattern assistance exercise with the only difference that you have to rotate your head to the other side (ipsilateral side of the UE extension) or doesn't matter and why?
    Thank u for sharing your knowledge and cheers from Greece!

    all the best

  2. Technically, better is what works better for the patient. The SFMA is following neurodevelopmental patterns, if you think of a ATNR, the head would be rotated toward the arm that flexed at shoulder, extended at elbow, rather than flexed at elbow and extended at the shoulder. But if the opposite works as a novel strategy, go for it.

  3. I tried this in the clinic today with significant success. I was curious on how you document this exercise. I more or less described it how it was performed but is "pattern assisted motor control" the accepted term? If I were to research it would this be the name I search for in literature?

  4. Not sure if the FMS/SFMA has actual literature on their 4x4. This would be documented as a 3x1 corrective exercise for cervical rotation. 3 meaning kneeling/half kneeling and 1 being pattern assisted, no resistance. How you documented it is definitely acceptable, as long as you and others know how to replicate it.