Cervical Spine Rehab Flashcards
what can lead to forward head posture
continuous imbalances between deep and superficial muscles
FHP is the most common …
postural dysfunction causing chronic neck and shoulder pain
increased lordosis =
increased degeneration of joints
cervical spine requires
a lot of mobility
important for our senses
C0-C1 problems
H/A
vertigo
fatigue
poor concentration
irritability
physical attachment of dura
C0-C2 problems
most likely issue with fascial connections
muscle impairment with chronic neck pain
delayed cervical neck muscle contraction with upper body mvt
increased use of superficial cervical neck flexors during functional activities
increased fatigability of cervical neck flexors in pain pt
common injuries of the C/S
DDD
post disc herniation
spinal stenosis
upper cross syndrome
facet jnt irritation
strains of trap, SCM, etc.
sprains
**Whiplash, concussions
rehab of C/S
stability and strengthening
flexibility
postural awareness
traction
direction specific ex.
soft tissue mob
jnt mob
use all together for effective treatment
what happens when superficial muscle become overactive
excessive shear and compression
training the cervical core
reactivation of deep cervical m.
relaxation of scalenes and SCM
seated or gravity lessened position
example of progression for cervical core training
seated
laying down
chin tuck with combined mvt
4 point against gravity
standing with ball behind head
PNF patterning
proper positioning with functional mvt
intervention to manage disc lesion - early phase
decrease acute symptoms
teach awareness of neck position and mvt
passive cervical nods
traction
passive cervical nods
nod the pt head for them
traction
10 min
intermittent 15 min
15 lbs of force causes seperation
recommended for pt w/ neck pain
relieve pressure of neural structures
management of disc lesions - subacute/controlled phase
inc mobility in restricted m., jnt, fascia, n.
head nods
mvt of the head with proper awareness
add UE mvt
subacute phase
done when S/S of inflammatory process are under control and pain is no longer constant
proprioception ex.
laser pointer
moving eyes only
moving head with eyes fixated
tracing/drawing objects with cervical mvt
balancing objects on head while walking
cervical extensors
tend to be tonic and tight
compensatory m.
forward head posture because
neck and shoulders have to carry head with isometric contr.
FHP leads to
tension in TMJ
H/A
people with uncorrected FHP can potentially suffer
chronic conditions :
pinched n. and bv
TOS
muslce and tissue pain
fybromyalgia
strains
early degeneration
arthritis
cervicogenic (tension) H/A
referred pain to head of face from first 3-4 CN
tension H/A chain of events
bad posture, stress, fatigue
tightened muscles or misaligned vertebrae
irritated nerves
Tx for tension H/A
ROM for mobility
stretches
deep neck flexors activation
indications for spinal traction
nerve root impingement
disc herniation
spondylolisthesis
narrowing within the intervertebral foramen
osteophyte formation
degenerative joint disease
subacute pain
joint hypomobility
discogenic pain
muscle spasm or guarding
muscle strain
spinal ligament or capsular contractures
improvement in arterial, venous, and lymphatic flow
contraindication of spinal traction
acute sprains or strains
acute inflammation
fractures
vertebral joint instability
any condition which mvt exacerbates existing problem
bone disease
osteoporosis
infections in bones of joints
vascular conditions
cardiac or pulmonary problems
manual therapy is often used…
for pt with neck pain or without radicular symptoms
when to do neuromeningeal mobs
once symptoms have centralized
+ve slump
+ve ULTTs
positioning to point of tension
contraindications of neuromeningeal mobs
acute or unstable neuro signs
S/C injury or symptoms
neoplasm and infections
*watch for vascular compromise
relaxation techniques for cervical and upper thoracic regions
game plan
local intervention
global intervention
game plan - local intervention
deep cervical activation
suboccipital mobility
game plan - global intervention
posture
T/S
shoulder girdle (scap)
core stability
see exercises in ppt
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