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Deep Cervical Extensor Static Manual Release (Soft Tissue Mobilization)
Deep Cervical Extensor Static Manual Release (Soft Tissue Mobilization) is a gentle therapeutic technique that can help relieve pain and restore function to the neck. This technique is used to release tension in the cervical muscles, ligaments, and fascia, while also restoring range of motion in the neck and increasing blood flow to the soft tissues. During the procedure, a certified health care professional uses manual pressure and myofascial release techniques to gently stretch and release tight muscles and other
Transcript
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This is Brent of the Brookbush
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...blank
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Institute in this video we're bringing
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you another manual technique now if
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you're watching this video I'm assuming
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you're watching it for educational
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purposes and that you are a licensed
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manual therapists following the laws
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regarding scope of practice in your
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state or region that means athletic
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trainers chiropractors physical
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therapists osteopath licensed massage
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therapists you are likely in the clear
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to do these techniques personal trainers
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this probably does not fall within your
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scope of practice although you might be
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able to use the palpation portion of
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this video to aid in learning your
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functional anatomy in an educational
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setting supervised by a licensed manual
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therapists now before we place our hands
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on a patient or client it is important
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that we assess and have a good rationale
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for doing so and of course if we're
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going to assess then we should be
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reassessing to ensure that the manual
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technique we're using is effective and
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we have a good rationale for continuing
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to use that technique in this video
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we're going to go over static manual
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release of the deep cervical extensors
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that's the semispinalis capitis and
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cervicis as well as the transversospinales
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multifidus and rotatores
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muscles I'm gonna have my friend Melissa
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come out she's going to help me
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demonstrate now we're going to go
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through the same four step process we've
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gone through with all of our static
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manual release techniques the first
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being how do we differentiate and
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palpate these tissues well to palpate
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these tissues is actually not that hard
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if you have somebody extend their head
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then you really tilt their head back
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against some resistance you'll see these
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two column or at least feel these two
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columns of muscle pop up on either side
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of the spinous process what those two
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columns of muscles are is literally the
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semispinalis contracting and bulging
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up a little bit as well as the
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transversospinales muscles those
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rotatores sand multifidus muscles
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underneath it contracting and bulging up
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underneath them so that we push these
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two big columns of muscles up into my
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fairly thin upper trap all right so we
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know where these columns of muscles are
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we know where these muscles are as a
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group the question then becomes how do
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we differentiate them how do I know that
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I'm on
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a rotatores muscle versus my semispinalis
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muscle the truth is we probably can't
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differentiate we probably can't be
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accurate and reliable without palpation
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but we might not have to be right we if
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we're just trying to correct a movement
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if we're going back and putting our our
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thinking caps on with my assessment
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showed that I had a restriction and an X
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movement maybe its rotation to the left or
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extension or maybe it's a combination of
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flexion and rotation right we would need
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to show that these muscles do different
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things if we really needed to
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differentiate them and actually all of
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these muscles have a similar obliquity
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they all go from superior medial to
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inferior lateral now they have different
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fiber angles but they all somewhat
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contribute to extension because they're
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on the posterior side of the neck since
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they're on the side of the
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spinous process they all contribute to a
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little ipsilateral flexion and since
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they have this obliquity they all
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contribute to just a little bit of
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contralateral rotation so all these
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muscles do the same thing it's probably
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not that important for us to have to
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know exactly how I'm gonna get on
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semispinalis capitis or how I'm going to
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get on my multiifdus at c3 c4 I just
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need to know that I am on this column of
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muscle at the right segment where at
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least I've found the tissue density
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that's restricting me now second step is
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there anything close to these tissues
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that could be insulted abraded injured
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by compression well I'm posterior to the
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transverse processes right I'm posterior
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on the cervical spine most of the
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sensitive stuff is on the anterior side
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of the cervical spine so chances are i
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can't really injure a nerve or injure a
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vessel all I can do is is press here and
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trust me if you press hard enough you
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can you can mess somebody up pretty bad
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just by bruising
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and damaging some muscle tissue but if
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I'm careful and I only press as hard as
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I need to I shouldn't run into any
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issues okay so step three what about
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trigger points well trigger points occur
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in the middle of the muscle bellies of
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these muscles problem these muscles are
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tiny little muscles that run from
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segment to segments and are segmentallyl
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nnervated which means we can have
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trigger points between any segment so
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you don't really have to memorize where
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a trigger point is that's not
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necessarily going to be helpful but you
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may have to search the entire cervical
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spine and maybe even going all the way
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down to the mid thoracic spine if there
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happens to be trigger points in the
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semispinalis muscles which originated way
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down here all the way down to like t6
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number four positioning all right so how
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do I get us positioned in a way where I can
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hold the technique long enough to get a
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release and my client or patient is
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comfortable enough to relax to allow a
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release to happen while honestly sitting
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isn't the greatest way to go but you
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might be able to get away with having
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the patient's face away from you
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doing our forehead headlock position
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like so I think I showed you guys that
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in the previous video and I could use my
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thumb probably best in a downward
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direction this way to strum these
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tissues right so these tissues run kind
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of like this to like this i'm going to
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strum kind of downward as I maybe flex a
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little bit you'll contralaterally rotate
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to lengthen or maybe I'll shorten up a
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little bit so you get the traps out of
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the way I can definitely control a
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little bit this way but I got to tell
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you over all guys standing with your
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patient and sitting isn't really an easy
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way to do these techniques I think
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probably the best way to do these
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techniques is in supine if you lay down
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I think you guys have seen a lot of neck
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massage maybe neck manual techniques
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cervical neck static release techniques
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by various manual practitioners and
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various professions and they all kind of
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do this thing well chances are they're
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on the cervical extensors and as long as
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there's a good reason for them to be
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releasing the cervical extensors we're
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on the right track this is actually a
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very comfortable position to do this
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because I can just let my hands relax
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into that natural curl position that our
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hands kind of get into and I can let the
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weight of Melissa's head do all the work
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now of course I need to do my my
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strumming here taking some short strokes
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so I don't take so much skin with me I'm
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going to be kind of going from medial to
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lateral as I as I do these short strokes
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from inferior to superior so I'm just
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kind of going through this way
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to see where my densest fascicles are and
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I have a couple good ones right there
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and it's once I find a good good
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fascicle here I can look for any nodules
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within that fascicle and then I'm just
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going to hold this position until I get
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a release once i get a release i can
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continue searching remember with these
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muscles since we're not just dealing with
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a single muscle since we are dealing
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with a group of muscles it's probably
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worth continuing your search to make
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sure you clear the entire deep cervical
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extensor group from mid thoracic spine
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all the way up to the occiput look feel
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good so then I would continue on alright
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and I can even get down in here right
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and I got to work my hands underneath a
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little bit but maybe right in here start
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feeling some stuff it's a little harder
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in your hands in this position and
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actually the lower fibers you might be
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able to go back to that seated position
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and and you get better leverage and be
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more comfortable as the practitioner
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since I have large hands are still fine
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with this technique is a little bit more
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comfortable for me stay tuned for the
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close-up of recap this is our close-up
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recap of deep cervical extensor release
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that's my semispinalis multifidus
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and rotatores muscles I wanted to
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show you guys close up what that column
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a muscle looks back looks like so we
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also go ahead and extend your head right
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you guys see that pop up right there all
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yeah that's that's all the deep cervical
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extensors right there so that's a that's a
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good start for knowing where to put your
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hands now these muscles have a slight
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obliquity from like ear to shoulder
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alright so that superior medial to inferior
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lateral so as i stroke I want to stroke
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from lateral to medial superior to
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inferior so in opposition
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to that fiber direction so that I
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stroke across those fibers and I'm just
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going to gently kind of stroke across
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those fibers with both hands until I
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find some tight fascicles some dense fascicles
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and then I can move medial and
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lateral to kind of narrow in on the the
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tightest part of those fascicles the
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nodule trigger point point of
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hyperactivity and then I can just use
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that kind of curled finger position and
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the weight of Melissa's head to add a
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little compression until I get a nice
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release and then i can reassess
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once again guys I will turn Melissa's head
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here a little bit which is not
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necessarily I would some not necessarily
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something i would suggest for this
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technique but all I was doing was
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stroking this way in towards the
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spinous process as I moved superior to
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inferior and wait until i found the
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tightest fascicles once I found some
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tight fascicles and I can move medial
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and lateral superior to inferior really
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try to narrow in to any sort of knot and
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then I'm just using the weight of
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Melissa's head to apply compression to
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this kind of curled finger hand position
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and I can wait for a release so there you
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have it knowing your functional Anatomy
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will definitely help your manual
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technique it'll help you differentiate
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structure so that you can place your
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hands where they need to be as well as
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make you aware of these sensitive
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structures around the tissue that you're
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trying to target things like nerves and
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lymph nodes and arteries make sure that if
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you're going to place your hands on a
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patient that you have done an assessment
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and have a good rationale for placing
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your hands on that patient and if you're
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going to assess make sure you reassess
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to ensure that your technique was
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effective and you have a good rationale
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for using that technique again now with
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manual therapy one-on-one live education
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is incredibly important please be
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looking for opportunities like workshops
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and mentorship and maybe even classes at
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your local university
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that can get you some one on one
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individual instruction or at least some
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live classroom instruction so you've had
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a chance to be critiqued and mentored by
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somebody senior to you with some
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experience in manual therapy techniques
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and before you bring this stuff back to
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your rehab fitness or performance
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setting please practice on colleagues
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there is no substitute for practice and
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it is going to take a while to get accustomed
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to some of the techniques that
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we show in these manual techniques
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videos don't expect to learn them in two
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or three or even five minutes you want
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to have hours of experience under your
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belt working on various different body
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sizes and shapes so that when you do get
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that first paying client first paying
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customer and you're really trying to
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make a good positive impact really
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trying to promote better outcomes you
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feel comfortable with that technique I
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look forward to hearing about your
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outcomes and hearing your questions in
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the comments section of this video I'll
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talk with you soon
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