Cervical Spine Anatomy

This course describes cervical spine anatomy, also known as the “bones of the neck”. The cervical vertebrae and joints include the atlanto-occipital joint (AO/C1), atlanto-axial joint (C1/C2), and the facet and disk joints of the middle and lower cervical vertebrae (C2 – C7). This course includes descriptions of the bones, synovial joints, disk/discs, joint actions, ligaments, bursae, relative location, the relationship between the bones of the cervical spine, and the muscles that cross the cervical spine. Further, this course discusses palpation and introduces cervical facet joint and neck muscle specific exercises, manual techniques, and interventions for dysfunction, pain, posture, and movement impairment. The cervical spine is included in the common compensation patterns known as forward head posture and upper crossed syndrome (UCS). Sports medicine professionals (personal trainers, fitness instructors, physical therapists, massage therapists, chiropractors, occupational therapists, athletic trainers, etc.) with advanced knowledge of the cervical spine and facet joints will improve their ability to analyze human movement and develop sophisticated exercise programs and therapeutic (rehabilitation) interventions. Further, this course is essential knowledge for future courses discussing injury prevention and physical rehabilitation/physical therapy (e.g. chronic neck pain, neck sprains, disc herniations, osteoarthritis, whiplash syndrome, cervicogenic headache), the relationship between the cervical spine, scapula and glenohumeral joints (e.g. over-activity of the upper trapezius can contribute to forward head posture, scapula dyskinesis, and shoulder dysfunction) and neck specific techniques for enhancing sports performance (e.g. cervical muscle release, facet joint mobilization, deep neck flexor activation).

Pre-approved credits for:

• Integrated Manual Therapist (IMT) Certification

Pre-approved for Continuing Education Credits for:

• Athletic Trainers
• Chiropractors
• Group Exercise Instructors
• Massage Therapists
• Occupational Therapists - Intermediate
• Personal Trainers
• Physical Therapists
• Physical Therapy Assistants
• Yoga Instructors

This Course Includes:

• AI Tutor
• Study Guide
• Text and Illustrations
• Audio Voice-over
• Technique Videos
• Practice Exam
• Pre-approved Final Exam

Brookbush Institute's most recommended techniques for the Cervical Spine (see videos below):

• Assess:
  • Muscle Testing: Deep Neck Flexor Endurance Test
• Self-administered Techniques:
  • Release: Self-administered Cervical Extensor Release
  • Activation:Deep Cervical Flexor Activation
  • Stretch: Levator Scapula Static Stretch
• Manual Techniques:
  • Release: Sternocleidomastoid Release
  • Mobilization: Mid-cervical Spine Mobilization
  • Manipulation: Cervical Spine Manipulation

1. Donald A. Neumann, “Kinesiology of the Musculoskeletal System: Foundations of Rehabilitation – 2nd Edition” © 2012 Mosby, Inc.
2. David B. Jenkins, Hollinshead’s Functional Anatomy of the Limbs and Back: Eighth Edition © 2002 Saunders
3. Cynthia C. Norkin, Pamela K. Levangie, Joint Structure and Function: A Comprehensive Analysis: Fifth Edition © 2011 F.A. Davis Company
4. Florence Peterson Kendall, Elizabeth Kendall McCreary, Patricia Geise Provance, Mary McIntyre Rodgers, William Anthony Romani, Muscles: Testing and Function with Posture and Pain: Fifth Edition © 2005 Lippincott Williams & Wilkins
5. Hislop, H. J., & Montgomery, J. (2007). Daniels and Worthingham's Muscle Testing Techniques of Manual Examination: 8th Edition © Saunders/Elsevier
6. Cynthia C. Norkin, D. Joyce White, Measurement of Joint Motion: A Guide to Goniometry – Third Edition. © 2003 by F.A. Davis Company
   • Joints, Joint Types, Bones and Articulating Surfaces
7. Mercer, S., & Bogduk, N. (1993). Intra-articular inclusions of the cervical synovial joints. Rheumatology, 32(8), 705-710.
8. Akobo, S., Rizk, E., Loukas, M., Chapman, J. R., Oskouian, R. J., & Tubbs, R. S. (2015). The odontoid process: a comprehensive review of its anatomy, embryology, and variations. Child's Nervous System, 31(11), 2025-2034.
9. Farrell, S. F., Osmotherly, P. G., Cornwall, J., & Rivett, D. A. (2015). The anatomy and morphometry of cervical zygapophyseal joint meniscoids. Surgical and Radiologic Anatomy, 37(7), 799-807.
10. Pal, G. P., Routal, R. V., & Saggu, S. K. (2001). The orientation of the articular facets of the zygapophyseal joints at the cervical and upper thoracic region. The Journal of Anatomy, 198(4), 431-441.
    • Palpation
11. Andrew Biel, Trail Guide to the Human Body: 4th Edition, © 2010
12. Robinson, R., Robinson, H. S., Bjørke, G., & Kvale, A. (2009). Reliability and validity of a palpation technique for identifying the spinous processes of C7 and L5. Manual therapy, 14(4), 409-414.
13. Shin, S., Yoon, D. M., & Yoon, K. B. (2011). Identification of the correct cervical level by palpation of spinous processes.Anesthesia & Analgesia, 112(5), 1232-1235.
14. Ferreira, A. P. A., Póvoa, L. C., Zanier, J. F., & Ferreira, A. S. (2017). Locating the Seventh Cervical Spinous Process: Accuracy of the Thorax-Rib Static Method and the Effects of Clinical Data on Its Performance. Journal of Manipulative & Physiological Therapeutics, 40(2), 98-105.
    • Capsule, Ligaments and Menisci (Non-contractile/passive tissue)
15. Tubbs, R. S., Hallock, J. D., Radcliff, V., Naftel, R. P., Mortazavi, M., Shoja, M. M., & Cohen-Gadol, A. A. (2011). Ligaments of the craniocervical junction: a review. Journal of Neurosurgery: Spine, 14(6), 697-709.
16. Dvorak, J., Schneider, E., Saldinger, P., & Rahn, B. (1988). Biomechanics of the craniocervical region: the alar and transverse ligaments. Journal of Orthopaedic Research, 6(3), 452-461.
17. Tubbs, R. S., Grabb, P., Spooner, A., Wilson, W., & Oakes, W. J. (2000). The apical ligament: anatomy and functional significance. Journal of Neurosurgery: Spine, 92(2), 197-200.
18. Pimenta, N. J. G., Gusmão, S. S., & Kehrli, P. (2014). Posterior atlanto-occipital and atlanto-axial area and its surgical interest. Arquivos de neuro-psiquiatria, 72(10), 788-792.
19. Mercer, S. R., & Bogduk, N. (2003). Clinical anatomy of ligamentum nuchae. Clinical Anatomy, 16(6), 484-493.
    • Nerves
20. Bogduk, N. (1985). The innervation of the vertebral column. Australian journal of Physiotherapy, 31(3), 89-94.
21. Moore, K. L., Dalley, A. F., & Agur, A. M. (2009). Clinically oriented anatomy: Sixth Edition. Lippincott Williams & Wilkins.
    • Osteokinematics
22. Busscher, I., van Dieën, J. H., Kingma, I., van der Veen, A. J., Verkerke, G. J., & Veldhuizen, A. G. (2009). Biomechanical characteristics of different regions of the human spine: an in vitro study on multilevel spinal segments. Spine, 34(26), 2858-2864.
23. Cook, C., Hegedus, E., Showalter, C., & Sizer, P. S. (2006). Coupling behavior of the cervical spine: a systematic review of the literature. Journal of Manipulative & Physiological Therapeutics, 29(7), 570-575.
24. Salem, W., Lenders, C., Mathieu, J., Hermanus, N., & Klein, P. (2013). In vivo three-dimensional kinematics of the cervical spine during maximal axial rotation. Manual therapy, 18(4), 339-344.
25. Youdas, J. W., Carey, J. R., & Garrett, T. R. (1991). Reliability of measurements of cervical spine range of motion—comparison of three methods. Physical therapy, 71(2), 98-104.
26. Youdas, J. W., Garrett, T. R., Suman, V. J., Bogard, C. L., Hallman, H. O., & Carey, J. R. (1992). Normal range of motion of the cervical spine: an initial goniometric study. Physical therapy, 72(11), 770-780.
    • Regional Interdependence:
27. Helgadottir, H., Kristjansson, E., Mottram, S., Karduna, A., & Jonsson Jr, H. (2010). Altered scapular orientation during arm elevation in patients with insidious onset neck pain and whiplash-associated disorder. journal of orthopaedic & sports physical therapy, 40(12), 784-791.
28. Thigpen CA, Padua DA, Michener LA, Guskiewicz K, Giuliani C, Keener JD, Stergiou N. (2010). Head and shoulder posture affect scapular mechanics and muscle activity in overhead tasks. Journal of Electromyography and Kinesiology. 20: 701-709.
29. Schüldt, K., Ekholm, J., Harms-Ringdahl, K., Nemeth, G., & Arborelius, U. P. (1986). Effects of changes in sitting work posture on static neck and shoulder muscle activity. Ergonomics, 29(12), 1525-1537.
30. Quek, J., Pua, Y. H., Clark, R. A., & Bryant, A. L. (2013). Effects of thoracic kyphosis and forward head posture on cervical range of motion in older adults. Manual therapy, 18(1), 65-71.
31. Hurwitz, E. L., Aker, P. D., Adams, A. H., Meeker, W. C., & Shekelle, P. G. (1996). Manipulation and mobilization of the cervical spine: a systematic review of the literature. Spine, 21(15), 1746-1759.
32. Krauss, J., Creighton, D., Ely, J. D., & Podlewska-Ely, J. (2008). The immediate effects of upper thoracic translatoric spinal manipulation on cervical pain and range of motion: a randomized clinical trial. Journal of Manual & Manipulative Therapy, 16(2), 93-99.
33. Masaracchio, M., Cleland, J., Hellman, M., & Hagins, M. (2013). Short-term combined effects of thoracic spine thrust manipulation and cervical spine nonthrust manipulation in individuals with mechanical neck pain: a randomized clinical trial. journal of orthopaedic & sports physical therapy, 43(3), 118-127.
34. Puentedura, E. J., Landers, M. R., Cleland, J. A., Mintken, P., Huijbregts, P., & Fernandez-De-Las-Peñas, C. (2011). Thoracic spine thrust manipulation versus cervical spine thrust manipulation in patients with acute neck pain: a randomized clinical trial. journal of orthopaedic & sports physical therapy, 41(4), 208-220.
35. Dunning, J. R., Cleland, J. A., Waldrop, M. A., Arnot, C., Young, I., Turner, M., & Sigurdsson, G. (2012). Upper cervical and upper thoracic thrust manipulation versus nonthrust mobilization in patients with mechanical neck pain: a multicenter randomized clinical trial. journal of orthopaedic & sports physical therapy, 42(1), 5-18.
36. Cleland, J. A., Glynn, P., Whitman, J. M., Eberhart, S. L., MacDonald, C., & Childs, J. D. (2007). Short-term effects of thrust versus nonthrust mobilization/manipulation directed at the thoracic spine in patients with neck pain: a randomized clinical trial. Physical therapy, 87(4), 431-440.
37. Cross, K. M., Kuenze, C., Grindstaff, T., & Hertel, J. (2011). Thoracic spine thrust manipulation improves pain, range of motion, and self-reported function in patients with mechanical neck pain: a systematic review. journal of orthopaedic & sports physical therapy, 41(9), 633-642.
38. Bruno PA, Murphy DR. (2011). An investigation of neck muscle activity in asymptomatic participants who show different lumbar spine motion patterns during prone hip extension. Journal of Manipulative and Physiological Therapeutics. 34(8): 525-532.
39. Manchikanti, L., Singh, V., Pampati, V., Damron, K. S., Beyer, C. D., & Barnhill, R. C. (2002). Is there correlation of facet joint pain in lumbar and cervical spine? An evaluation of prevalence in combined chronic low back and neck pain. Pain Physician, 5(4), 365-371.
40. Moustafa, I. M., & Diab, A. A. (2015). The Effect of Adding Forward Head Posture Corrective Exercises in the Management of Lumbosacral Radiculopathy: A Randomized Controlled Study. Journal of manipulative and physiological therapeutics, 38(3), 167-178.
41. De Laat, A., Meuleman, H., Stevens, A., & Verbeke, G. (1998). Correlation between cervical spine and temporomandibular disorders. Clinical oral investigations, 2(2), 54-57.
42. Falla, D., Jull, G., O’leary, S., & Dall’Alba, P. (2006). Further evaluation of an EMG technique for assessment of the deep cervical flexor muscles. Journal of Electromyography and Kinesiology, 16(6), 621-628.
43. Walczynska-Dragon, K., & Baron, S. (2011). The biomechanical and functional relationship between temporomandibular dysfunction and cervical spine pain. Acta of Bioengineering and Biomechanics, 13(4), 93-98.
44. Ayhan, C., Camci, E., & Baltaci, G. (2015). Distal radius fractures result in alterations in scapular kinematics: A three-dimensional motion analysis. Clinical Biomechanics.
45. Day, J. M., Bush, H., Nitz, A. J., & Uhl, T. L. (2015). Scapular Muscle Performance in Individuals With Lateral Epicondylalgia. Journal of Orthopaedic & Sports Physical Therapy, (Early Access), 1-35
46. Vicenzino, B., Collins, D., & Wright, A. (1996). The initial effects of a cervical spine manipulative physiotherapy treatment on the pain and dysfunction of lateral epicondylalgia. Pain, 68(1), 69-74.
47. Fernández-De-Las-Peñas, C., Pérez-De-Heredia, M., Brea-Rivero, M., & Miangolarra-Page, J. C. (2007). Immediate effects on pressure pain threshold following a single cervical spine manipulation in healthy subjects. Journal of Orthopaedic & Sports Physical Therapy, 37(6), 325-329.
48. Suter, E., & McMorland, G. (2002). Decrease in elbow flexor inhibition after cervical spine manipulation in patients with chronic neck pain. Clinical Biomechanics, 17(7), 541-544.
49. Behrsin, J. F., & Maguire, K. E. N. (1986). Levator scapulae action during shoulder movement: a possible mechanism for shoulder pain of cervical origin. Australian Journal of Physiotherapy, 32(2), 101-106.
50. Blouin, J. S., Siegmund, G. P., Carpenter, M. G., & Inglis, J. T. (2007). Neural control of superficial and deep neck muscles in humans. Journal of neurophysiology, 98(2), 920-928.
51. Thigpen CA, Padua DA, Michener LA, Guskiewicz K, Giuliani C, Keener JD, Stergiou N. (2010). Head and shoulder posture affect scapular mechanics and muscle activity in overhead tasks. Journal of Electromyography and Kinesiology. 20: 701-709.
52. Choi W, Cynn H, Lee C, et al. (2014). Shrug exercises combined with shoulder abduction improve scapular upward rotator activity and scapular alignment in subjects with scapular downward rotation impairment. Journal of Electromyography and Kinesiology. 25: 363-370.
53. Munoz-Munoz S, Munoz-Garcia MT, Alburquerque-Sendin, et al. (2012). Myofascial trigger points, pain, disability, and sleep quality in individuals with mechanical neck pain. Journal of Manipulative and Physiological Therapeutics. 35(8): 608-613.
54. Lluch, E., Nijs, J., De Kooning, M., Van Dyck, D., Vanderstraeten, R., Struyf, F., & Roussel, N. A. (2015). Prevalence, incidence, localization, and pathophysiology of myofascial trigger points in patients with spinal pain: a systematic literature review. Journal of manipulative and physiological therapeutics, 38(8), 587-600.
55. Johnson, G., Bogduk, N., Nowitzke, A., & House, D. (1994). Anatomy and actions of the trapezius muscle. Clinical biomechanics, 9(1), 44-50.
56. Harvey, R., & Peper, E. (1997). Surface electromyography and mouse use position. Ergonomics, 40(8), 781-789.
57. Jensen, C., Nilsen, K., Hansen, K., & Westgaard, R. H. (1993). Trapezius muscle load as a risk indicator for occupational shoulder-neck complaints. International archives of occupational and environmental health, 64(6), 415-423.
58. Vasseljen Jr, O., & Westgaard, R. H. (1997). Arm and trunk posture during work in relation to shoulder and neck pain and trapezius activity. Clinical Biomechanics, 12(1), 22-31.
59. Wegner, S., Jull, G., O’Leary, S., & Johnston, V. (2010). The effect of a scapular postural correction strategy on trapezius activity in patients with neck pain. Manual therapy, 15(6), 562-566.
60. Szeto, G. P., Straker, L. M., & O’Sullivan, P. B. (2005). A comparison of symptomatic and asymptomatic office workers performing monotonous keyboard work—1: neck and shoulder muscle recruitment patterns. Manual therapy, 10(4), 270-280.
61. Cools, A.M., Witvrouw, E.E., Declercq, G.A., Danneels, L.A., Cambier, D.C. (2003) Scapular muscle recruitment patterns: Trapezius muscle latency with and without impingement symptoms. The American Journal of Sports Medicine 31(4). 542-549
62. Kwon JW, Son SM, Lee NK. (2015). Changes in upper-extremity muscle activities due to head position in subjects with a forward head posture and rounded shoulders. J Phys Ther Sci. 27: 1739-1742.
63. Weon, J. H., Oh, J. S., Cynn, H. S., Kim, Y. W., Kwon, O. Y., & Yi, C. H. (2010). Influence of forward head posture on scapular upward rotators during isometric shoulder flexion. Journal of Bodywork and movement therapies, 14(4), 367-374.
64. Cools, A. M., Witvrouw, E. E., Declercq, G. A., Vanderstraeten, G. G., & Cambier, D. C. (2004). Evaluation of isokinetic force production and associated muscle activity in the scapular rotators during a protraction-retraction movement in overhead athletes with impingement symptoms. British journal of sports medicine, 38(1), 64-68.
65. Petersen, S. M., & Wyatt, S. N. (2011). Lower trapezius muscle strength in individuals with unilateral neck pain. journal of orthopaedic & sports physical therapy, 41(4), 260-265.
66. Falla, D., & Farina, D. (2005). Muscle fiber conduction velocity of the upper trapezius muscle during dynamic contraction of the upper limb in patients with chronic neck pain. Pain, 116(1-2), 138-145.
67. Szeto, G. P. Y., Straker, L. M., & O’Sullivan, P. B. (2005). EMG median frequency changes in the neck–shoulder stabilizers of symptomatic office workers when challenged by different physical stressors. Journal of electromyography and kinesiology, 15(6), 544-555.
68. Larsson, R., Cai, H., Zhang, Q., Öberg, P. Å., & Larsson, S. E. (1998). Visualization of chronic neck—shoulder pain: Impaired microcirculation in the upper trapezius muscle in chronic cervico-brachial pain. Occupational medicine, 48(3), 189-194.
69. Larsson, S. E., Ålund, M., Cai, H., & Öherg, P. Å. (1994). Chronic pain after soft-tissue injury of the cervical spine: trapezius muscle blood flow and electromyography at static loads and fatigue. Pain, 57(2), 173-180.
70. Kadi, F., Waling, K., Ahlgren, C., Sundelin, G., Holmner, S., Butler-Browne, G. S., & Thornell, L. E. (1998). Pathological mechanisms implicated in localized female trapezius myalgia. Pain, 78(3), 191-196.
71. Vasavada, A. N., Li, S., & Delp, S. L. (1998). Influence of muscle morphometry and moment arms on the moment-generating capacity of human neck muscles. Spine, 23(4), 412-422.
72. Blouin, J. S., Siegmund, G. P., Carpenter, M. G., & Inglis, J. T. (2007). Neural control of superficial and deep neck muscles in humans. Journal of neurophysiology, 98(2), 920-928.
73. Falla, D., Bilenkij, G., & Jull, G. (2004). Patients with chronic neck pain demonstrate altered patterns of muscle activation during performance of a functional upper limb task. Spine, 29(13), 1436-1440.
74. Falla, D., Jull, G., Edwards, S., Koh, K., & Rainoldi, A. (2004). Neuromuscular efficiency of the sternocleidomastoid and anterior scalene muscles in patients with chronic neck pain. Disability and rehabilitation, 26(12), 712-717.
75. Falla, D., Jull, G., & Hodges, P. W. (2004). Feedforward activity of the cervical flexor muscles during voluntary arm movements is delayed in chronic neck pain. Experimental brain research, 157(1), 43-48.
76. Helgadottir, H., Kristjansson, E., Einarsson, E., Karduna, A., & Jonsson, H. (2011). Altered activity of the serratus anterior during unilateral arm elevation in patients with cervical disorders. Journal of electromyography and kinesiology,21(6), 947-953.
77. Dean, N.A. and B.S. Mitchell 2002. Anatomic relation between the nuchal ligament (ligamentum nuchae) and the spinal dura mater in the craniocervical region. Clin. Anat. 15:182-185.
    • Postural Dysfunction
78. Picavet, H. S. J., & Schouten, J. S. A. G. (2003). Musculoskeletal pain in the Netherlands: prevalences, consequences and risk groups, the DMC3-study. Pain, 102(1-2), 167-178.
79. Mäkela, M., Heliövaara, M., Sievers, K., Impivaara, O., Knekt, P., & Aromaa, A. (1991). Prevalence, determinants, and consequences of chronic neck pain in Finland. American journal of epidemiology, 134(11), 1356-1367.
80. Côté, P., Cassidy, J. D., Carroll, L. J., & Kristman, V. (2004). The annual incidence and course of neck pain in the general population: a population-based cohort study. Pain, 112(3), 267-273.
81. Bovim, G., Schrader, H., & Sand, T. (1994). Neck pain in the general population. Spine, 19(12), 1307-1309.
82. Côté, P., Cassidy, J. D., & Carroll, L. (2000). The factors associated with neck pain and its related disability in the Saskatchewan population. Spine, 25(9), 1109-1117.
83. Hogg-Johnson, S., Van Der Velde, G., Carroll, L. J., Holm, L. W., Cassidy, J. D., Guzman, J., … & Hurwitz, E. (2008). The burden and determinants of neck pain in the general population. European Spine Journal, 17(1), 39-51.
84. Ariens, G. A. M., Bongers, P. M., Douwes, M., Miedema, M. C., Hoogendoorn, W. E., van der Wal, G., … & van Mechelen, W. (2001). Are neck flexion, neck rotation, and sitting at work risk factors for neck pain? Results of a prospective cohort study. Occupational and environmental medicine, 58(3), 200-207.
    • Forward Head
85. Schüldt, K., EKHOLM, J., HARMS-RINGDAHL, K. A. R. I. N., NÉMETH, G., & ARBORELIUS, U. P. (1986). Effects of changes in sitting work posture on static neck and shoulder muscle activity. Ergonomics, 29(12), 1525-1537.
86. Szeto, G. P., Straker, L., & Raine, S. (2002). A field comparison of neck and shoulder postures in symptomatic and asymptomatic office workers. Applied ergonomics, 33(1), 75-84.
87. Szeto, G. P., Straker, L. M., & O’Sullivan, P. B. (2005). A comparison of symptomatic and asymptomatic office workers performing monotonous keyboard work—2: neck and shoulder kinematics. Manual therapy, 10(4), 281-291.
88. Haughie, L. J., Fiebert, I. M., & Roach, K. E. (1995). Relationship of forward head posture and cervical backward bending to neck pain. Journal of Manual & Manipulative Therapy, 3(3), 91-97.
    • Defining Forward Head
89. Harrison, D. D., Janik, T. J., Troyanovich, S. J., & Holland, B. (1996). Comparisons of lordotic cervical spine curvatures to a theoretical ideal model of the static sagittal cervical spine. Spine, 21(6), 667-675.
90. Harrison, D. D., Harrison, D. E., Janik, T. J., Cailliet, R., Ferrantelli, J. R., Haas, J. W., & Holland, B. (2004). Modeling of the sagittal cervical spine as a method to discriminate hypolordosis: results of elliptical and circular modeling in 72 asymptomatic subjects, 52 acute neck pain subjects, and 70 chronic neck pain subjects. Spine, 29(22), 2485-2492.
91. Griegel-Morris, P., Larson, K., Mueller-Klaus, K., & Oatis, C. A. (1992). Incidence of common postural abnormalities in the cervical, shoulder, and thoracic regions and their association with pain in two age groups of healthy subjects. Physical therapy, 72(6), 425-431.
92. Harms-Ringdahl, K. (1986). On assessment of shoulder exercise and load-elicited pain in the cervical spine. Biomechanical analysis of load--EMG--methodological studies of pain provoked by extreme position. Scandinavian journal of rehabilitation medicine. Supplement, 14, 1-40.
93. Hurwitz, E. L., Aker, P. D., Adams, A. H., Meeker, W. C., & Shekelle, P. G. (1996). Manipulation and mobilization of the cervical spine: a systematic review of the literature. Spine, 21(15), 1746-1759.
94. Rudolfsson, T., Björklund, M., & Djupsjöbacka, M. (2012). Range of motion in the upper and lower cervical spine in people with chronic neck pain. Manual therapy, 17(1), 53-59.
95. Dvorak, J., Froehlich, D., Penning, L., Baumgartner, H., & Panjabi, M. M. (1988). Functional radiographic diagnosis of the cervical spine: flexion/extension. Spine, 13(7), 748-755.
96. Hanten, W. P., Olson, S. L., Russell, J. L., Lucio, R. M., & Campbell, A. H. (2000). Total head excursion and resting head posture: normal and patient comparisons. Archives of physical medicine and rehabilitation, 81(1), 62-66.
97. Hagen, K. B., Harms-Ringdahl, K., Enger, N. O., Hedenstad, R., & Morten, H. (1997). Relationship between subjective neck disorders and cervical spine mobility and motion-related pain in male machine operators. Spine, 22(13), 1501-1507.
98. Okawa, A., Shinomiya, K., Komori, H., Muneta, T., Arai, Y., & Nakai, O. (1998). Dynamic motion study of the whole lumbar spine by videofluoroscopy. Spine, 23(16), 1743-1749.
99. Kanayama, M., Abumi, K., Kaneda, K., Tadano, S., & Ukai, T. (1996). Phase lag of the intersegmental motion in flexion-extension of the lumbar and lumbosacral spine: an in vivo study. Spine, 21(12), 1416-1422.
100. Teyhen, D. S., Flynn, T. W., Childs, J. D., & Abraham, L. D. (2007). Arthrokinematics in a subgroup of patients likely to benefit from a lumbar stabilization exercise program. Physical therapy, 87(3), 313-325.
101. Panjabi, M. M. (1992). The stabilizing system of the spine. Part I. Function, dysfunction, adaptation, and enhancement. Journal of spinal disorders, 5(4), 383-9.
102. Panjabi, M. M. (1992). The stabilizing system of the spine. Part II. Neutral zone and instability hypothesis. Journal of spinal disorders, 5, 390-390.
103. Boden, S. D., & Wiesel, S. W. (1990). Lumbosacral segmental motion in normal individuals. Have we been measuring instability properly?. Spine, 15(6), 571-576.
104. Grimmer, K. (1996). The relationship between cervical resting posture and neck pain. Physiotherapy, 82(1), 45-51.
105. Grob, D., Frauenfelder, H., & Mannion, A. F. (2007). The association between cervical spine curvature and neck pain. European Spine Journal, 16(5), 669-678.
     • Muscles
106. Blouin, J. S., Siegmund, G. P., Carpenter, M. G., & Inglis, J. T. (2007). Neural control of superficial and deep neck muscles in humans. Journal of neurophysiology, 98(2), 920-928
107. Keshner, E. A., Campbell, D., Katz, R. T., & Peterson, B. W. (1989). Neck muscle activation patterns in humans during isometric head stabilization. Experimental Brain Research, 75(2), 335-344.
108. Conley, M. S., Meyer, R. A., Bloomberg, J. J., Feeback, D. L., & Dudley, G. A. (1995). Noninvasive analysis of human neck muscle function. Spine, 20(23), 2505-2512.
109. Madeleine, P., Lundager, B., Voigt, M., & Arendt-Nielsen, L. (1999). Shoulder muscle co-ordination during chronic and acute experimental neck-shoulder pain. An occupational pain study. European journal of applied physiology and occupational physiology, 79(2), 127-140.
110. Falla, D., Farina, D., Dahl, M. K., & Graven-Nielsen, T. (2007). Muscle pain induces task-dependent changes in cervical agonist/antagonist activity. Journal of Applied Physiology, 102(2), 601-609.
111. Falla, D., Rainoldi, A., Merletti, R., & Jull, G. (2003). Myoelectric manifestations of sternocleidomastoid and anterior scalene muscle fatigue in chronic neck pain patients. Clinical Neurophysiology, 114(3), 488-495.
112. Uhlig, Y., Weber, B. R., Grob, D., & Müntener, M. (1995). Fiber composition and fiber transformations in neck muscles of patients with dysfunction of the cervical spine. Journal of Orthopaedic Research, 13(2), 240-249.
113. Falla, D., Jull, G., Hodges, P., & Vicenzino, B. (2006). An endurance-strength training regime is effective in reducing myoelectric manifestations of cervical flexor muscle fatigue in females with chronic neck pain. Clinical Neurophysiology, 117(4), 828-837.
114. Jordan, A., Mehlsen, J., & Ostergaard, K. (1997). A comparison of physical characteristics between patients seeking treatment for neck pain and age-matched healthy people. Journal of manipulative and physiological therapeutics, 20(7), 468-475.
     • DCFs
115. O’Leary, S., Jull, G., Kim, M., & Vicenzino, B. (2007). Cranio-cervical flexor muscle impairment at maximal, moderate, and low loads is a feature of neck pain. Manual therapy, 12(1), 34-39.
116. Falla D. L., Jull G. A., Hodges P. W. (2004). Patients with neck pain demonstrate reduced electromyographic activity of the deep cervical flexor muscles during performance of the craniocervical flexion test. Spine, 29(19), 2108-2114.
117. Jull G, Falla D. Does increased superficial neck flexor activity in the craniocervical flexion test reflect reduced deep flexor activity in people with neck pain? Manual Therapy. 2016; 25: 43-47
118. Falla, D., Jull, G., & Hodges, P. W. (2004). Feedforward activity of the cervical flexor muscles during voluntary arm movements is delayed in chronic neck pain. Experimental brain research, 157(1), 43-48.
119. Mayoux-Benhamou, M. A., Revel, M., Vallee, C., Roudier, R., Barbet, J. P., & Bargy, F. (1994). Longus colli has a postural function on cervical curvature. Surgical and Radiologic Anatomy, 16(4), 367-371.
120. Boyd-Clark, L. C., Briggs, C. A., & Galea, M. P. (2001). Comparative histochemical composition of muscle fibres in a pre-and a postvertebral muscle of the cervical spine. The Journal of Anatomy, 199(6), 709-716.
121. Boyd-Clark, L. C., Briggs, C. A., & Galea, M. P. (2002). Muscle spindle distribution, morphology, and density in longus colli and multifidus muscles of the cervical spine. Spine, 27(7), 694-701.
122. Fountain, F. P., Minear, W. L., & Allison, R. D. (1966). Function of longus colli and longissimus cervicis muscles in man. Archives of physical medicine and rehabilitation, 47(10), 665.
123. Falla, D., Jull, G., O’leary, S., & Dall’Alba, P. (2006). Further evaluation of an EMG technique for assessment of the deep cervical flexor muscles. Journal of Electromyography and Kinesiology, 16(6), 621-628.
124. Falla, D., Jull, G., Dall'Alba, P., Rainoldi, A., & Merletti, R. (2003). An electromyographic analysis of the deep cervical flexor muscles in performance of craniocervical flexion. Physical Therapy, 83(10), 899-906.
125. O’Leary, S., Falla, D., Jull, G., & Vicenzino, B. (2007). Muscle specificity in tests of cervical flexor muscle performance. Journal of Electromyography and Kinesiology, 17(1), 35-40.
126. Jull, G.A., Falla, D., Vicenzino, B., Hodges, P.W. (2009). The effect of therapeutic exercise on activation of the deep cervical flexor muscles in people with chronic neck pain. Manual Therapy. 14: 696-701.
127. Falla, D., Jull, G., Russell, T., Vicenzino, B., & Hodges, P. (2007). Effect of neck exercise on sitting posture in patients with chronic neck pain. Physical therapy, 87(4), 408-417.
128. O’Leary, S., Falla, D., Hodges, P. W., Jull, G., & Vicenzino, B. (2007). Specific therapeutic exercise of the neck induces immediate local hypoalgesia. The Journal of Pain, 8(11), 832-839.
129. Falla, D., O’Leary, S., Fagan, A., & Jull, G. (2007). Recruitment of the deep cervical flexor muscles during a postural-correction exercise performed in sitting. Manual therapy, 12(2), 139-143.
     1. Additional Research
130. Skubick, D. L., Clasby, R., Donaldson, C. S., & Marshall, W. M. (1993). Carpal tunnel syndrome as an expression of muscular dysfunction in the neck. Journal of Occupational Rehabilitation, 3(1), 31-44.