00:00:0400:00:07
This is Brent of the Brookbush
00:00:0400:00:07
Institute, and in this video we're going to go
00:00:0700:00:11
over the cervical flexion and rotation test for cervicogenic headache. I'm
00:00:1100:00:15
going to have my friend Sonya come out, she's going to help me demonstrate. Now what
00:00:1500:00:21
we're trying to figure out, is Sonja's headache related to cervical dysfunction.
00:00:2100:00:24
This is pretty cool stuff, you should look up some of the research on
00:00:2400:00:27
cervicogenic headache, there's a good chance that physical therapy, athletic
00:00:2700:00:32
training, chiropractic could be a good resource for individuals who get certain
00:00:3200:00:37
types of headaches. Now the way we're going to test to see if Sonja's headache is
00:00:3700:00:42
cervicogenic in nature, is we're going to see if we can bring on her concordant
00:00:4200:00:46
signs, the signs that she came in complaining about, with a particular
00:00:4600:00:53
motion of her cervical spine, and that would be maximal flexion with maximal
00:00:5300:00:58
rotation; and what we're probably doing here is ligamentous lock of the
00:00:5800:01:02
cervical spine at the bottom. So we're tightening up all of these passive
00:01:0200:01:07
tissue structures so they can't move as much, and then rotating the upper-
00:01:0700:01:13
cervical spine, mostly C1 on C2 to see if that increased afferentation from our
00:01:1300:01:19
upper-cervical spine will bring on these cervicogenic headache symptoms;
00:01:1900:01:23
which if you get into the research on cervicogenic headaches, you'll start
00:01:2300:01:28
seeing that there's a lot about the upper-cervical spine and this
00:01:2800:01:32
nucleus called the cervical trigeminal nucleus that's up there that'll get a
00:01:3200:01:38
afferentation from all of this. Alright but the test itself, very simple,
00:01:3800:01:46
assess for symptoms in this position. If maximal flexion and rotation makes those
00:01:4600:01:51
symptoms worse or brings on symptoms then you know that cervicogenic
00:01:5100:01:56
headache is a possibility. The last thing to consider is more of a correlation and
00:01:5600:02:01
is worth investigating, which would be, okay she came in complaining about
00:02:0100:02:06
headache symptoms, when I did this test it didn't bring on her symptoms, but her
00:02:0600:02:11
range of motion was severely limited. In this case we're considering it
00:02:1100:02:17
a positive test, but only because we know she has headache and cervical
00:02:1700:02:20
dysfunction, which I think the being that
00:02:2000:02:24
physical-therapy, athletic training, chiropractice is such conservative treatment,
00:02:2400:02:28
I think it is worth exploring that we do some treatments and intervention on her
00:02:2800:02:31
neck, and see if we can reduce her headache symptoms anyway, even though the
00:02:3100:02:36
test itself didn't bring on concordant signs. So there you have it, maximal
00:02:3600:02:41
flexion, maximal rotation in both directions. Make sure you're assessing