Joint Manipulation: Cervical Spine

Introduction

This course describes joint manipulation techniques for the cervical spine (neck manipulation). Various synonyms and definitions have been used to describe the term "manipulation". The Brookbush Institute uses one conventional definition of the term "manipulations;" implying low-amplitude (relatively small motions), high-velocity (quick) techniques, intended to target and reduce the stiffness of specific joints or segments, that exhibit a decrease in passive accessory range of motion (a.k.a. stiffness during arthrokinematic motion and specifically glide or slide). Research does imply that manipulations likely affect multiple joints simultaneously; however, the Brookbush Institute asserts that efforts to target the stiffest joints or segments will increase the likelihood that the stiffest segments are included in the "multiple joints" affected.

The Brookbush Institute has carefully selected manipulation techniques with the intent to increase the probability of practitioner success. That is, techniques have been chosen that are relatively easy to teach, reliably improve outcomes, and are the most commonly used. The Brookbush Institute does not wish to assert that these manipulation techniques are the only techniques that are effective, and/or that these are the best techniques for every outcome measure. It is possible that a highly complex, and/or advanced technique, may result in better outcomes, or that a particular pathology is better addressed with a relatively rarely used technique.

Note, that the term "mobilization" is reserved for low-velocity techniques that are taught in a separate set of courses.

This course includes mobilization techniques that intend to improve excessive stiffness of the cervical spine and upper thoracic spine stiffness, improve spine range of motion (ROM) restrictions, and reduce cervicothoracic and upper extremity dysfunction. For example, cervical dysfunction has been correlated with lateral epicondylitis, and manipulations of the cervical spine have been correlated with reduced pain and improved function, such as increased grip strength. These techniques may also be used in an integrated approach for cervicothoracic dysfunction, and upper body dysfunction (UBD) including cervicogenic headache, shoulder impingement syndrome (SIS), lateral epicondylitis (tennis elbow), chronic thoracic pain, chronic neck pain, and acromioclavicular dysfunction, and postural dysfunctions including rounded shoulder posture, forward head posture, thoracic kyphosis, or an anterior pelvic tilt. Some evidence and clinical outcomes even suggest that addressing cervical dysfunction and forward head posture can improve long-term outcomes for low back pain patients.

The techniques in this course are recommended for all clinical human movement professionals (physical therapists, physical therapy assistants, athletic trainers, massage therapists, chiropractors, occupational therapists, etc.) to develop an evidence-based, systematic, integrated, patient-centered, patient-centered, and outcome-driven approach.

Techniques Covered in this Course:

• Upper-cervical Manipulation
• Mid-cervical Manipulation
• Cervicothoracic Junction Manipulation

Sample Intervention (Chronic Neck Pain)

• Manual Release
  • Levator Scapulae
  • Upper Trapezius
  • Splenii Release
  • Deep Cervical Extensor Release
  • Scalene Release
  • Sternocleidomastoid Release
• Mobilization or Manipulation
  • Upper-cervical Manipulation
  • Mid-cervical Manipulation
  • Cervicothoracic Junction Manipulation
• Activation
  • Deep Cervical Flexor Activation
  • Serratus Anterior Activation
• Core Integration
  • Quadruped with DCF Activation

Related Courses

Additional Joint Mobilization Courses

• Joint Manipulation: Cervical Spine
• Joint Manipulation: Thoracic Spine
• Joint Manipulation: Lumbar Spine, Sacroiliac Joint, and Pubic Symphysis
• Joint Manipulation: Elbow (Radial Head) and Wrist
• Joint Manipulation: Ankle, Midfoot, and Tibiofibular Joint

For an introduction to joint mobilizations and manipulations:

• Joint Mobilization and Manipulation: Introduction
• Joint Mobilization and Manipulation: Reliability
• Joint Mobilizations and Manipulations: Effects
• Joint Mobilization and Manipulation: Risk of Adverse Effects
• Joint Mobilizations and Manipulations: Evidence-based Teaching and Learning