Top 5 Fridays! 5 Considerations for Cervical Retractions | Modern Manual Therapy Blog - Manual Therapy, Videos, Neurodynamics, Podcasts, Research Reviews

Top 5 Fridays! 5 Considerations for Cervical Retractions

Here are 5 Considerations for the Cervical Retraction Exercise!

neutral/start position
cervical retraction
 1) Start in neutral, end in neutral

  • some patients are "spring loaded" and after successfully performing a retraction, rapidly return to near full protraction
  • if the DP is retraction, this defeats the purpose of end range loading in that direction
  • have them start with their thumb on their sternum with their index keeping them in neutral
  • have them retract away from their index finger, but not bash through it
    • also make sure they're not just moving their index finger away - surprising how many do this!

2) End range, end range, end range!

  • Just like REIL, end range is where the magic happens!
  • with the above self generated overpressure performed hourly, I rarely have to use the progression to retraction with extension
  • make sure they remain tucked - double/triple chin time!
  • end range is sternum slightly raising
3) Just enough, but not too much!
  • many patients may find this exercise uncomfortable, but are trying so hard to do it correctly, they tense their masseter, scalenes, and upper traps
    • I learned the #3 consideration from a fellow mentee of mine, Dr. Kris Bosch, who successfully integrates pilates and OMPT
  • make sure the movement gets to end range, but not through force 
    • range = range
4) They should be performing retractions (WB/loaded) with good posture
  • it is easy enough on many patients to show cause/effects of posture by checking cervical rotation/extension in slouching, then rechecking in neutral
5) Do not forget about unloading, especially for headaches
  • if loading (but more function) retractions are not tolerated for HEP, the patient may perform in supine over a pillow or cervical roll
  • for headaches, they can hold this for 3-4 minutes to see if the referred Sx centralize
  • after a few days of performing unloaded, try to progress back to loaded, which are easier to perform repeatedly throughout the day

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