Cervical Spine Classification

Question 1

What grades for mobilizations are stretching and what grades are just for joint play

Answer 1

• Grade I and grade II are joint play
• Grade III and grade IV are stretching

Question 2

Describe a self SNAG stretch

Answer 2

-sit upright
- towel near most stiff part of neck
- one hand stabilizes towel across neck
- other hand pulls in upward & forward into direction with limited movement

Question 3

Describe a levator stretch

Answer 3

• supine with knees bent
• one hand under your hip
• rotate head to contralateral side
• place other hand on back of head & pull head toward armpit

Question 4

Describe a scalene stretch

Answer 4

• supine with knees bent
• one hand under hip
• don’t let head rotate while side bending to the contralateral side

Question 5

Describe McKenzie Derangement Syndrome

Answer 5

• reducible derangement
• one direction of repeated movement centralizes symptoms
• opposite direction of repeated movement peripheralize symptoms
• if flexion decreases symptoms: do chin tuck and cervical retraction
• if extension decreases symptoms: do cervical retraction with extension or cervical retraction with extension & towel assist, or if that did not work do retraction with ipsilateral side bend
• 10 reps every 2-3 hours or 5-6 times per day

Question 6

Interventions for neck pain with radiating pain

Answer 6

• mechanical/manual traction
• repeated movements
• manual therapy
• nerve glides
• McKenzie reducible derangement

Question 7

Interventions for neck pain with coordination deficit

Answer 7

• strengthening of neck muscles
• endurance training of neck muscles
• aerobic conditioning
• progression of flexors: cranial cervical flexion test, chin tuck against wall, cranial cervical flexion test endurance, deep flexor endurance test
• progression of extensors: chin tuck while standing facing wall & slide forearms up, tuck chin laying prone and extend, chin tuck laying prone and lift chest off of table, chin tuck laying prone and extend chest off of table and lift flex arms into scaption

Question 8

Interventions for neck pain with headache

Answer 8

• spinal manipulation/mobilization
• deep cervical flexor training
• soft tissue/muscle trigger point treatment
• postural education & training
• self SNAGs
• scalene stretch