Craniocervical Mobility | Muscle Energy Techniques to Increase Craniocervical Mobility

Muscle Energy Techniques to Increase Craniocervical Mobility

Muscle energy (ME) uses the application of sub maximum, isometric contractions of muscles whose line of pull can cause the desired accessory motion of a joint:

 ME techniques are designed to improve joint mobility. The patient holds the gentle muscle contraction against the therapist's graded resistance for 3 to 5 seconds and then relaxes.

This process is repeated for three to five repetitions. When performed correctly, ME techniques are extremely safe and are indicated for most joint restrictions resulting from  musculoskeletal disorders.

PRECAUTION: 

Great care should be used when applying the following techniques so as not to occlude the vertebral artery The therapist should test the integrity of the vertebral artery prior to performing the following ME techniques.

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 Do not perform ME techniques if the patient reports an altered sensation in either upper extremity or a feeling of dizziness or light-headedness during the set-up of these techniques.

To Increase Craniocervical Flexion⏩⏩⏩

Patient position: Supine, with hands placed comfortably at the side.

Therapist position, hand placement, and patient effort: Stand at the head of the treatment table. Support the occiput with one hand and place the other hand across the forehead.

 Ask the patient to look upward gently as if nodding the head back wards and apply resistance against the patient's occiput, creating a gentle isometric contraction in the suboccipital muscles. 

When the patient relaxes, take up the slack by passively nodding the head through any new range.

Alternate technique:

 Sit on a stool at the head of patient with your forearms resting on the treatment table. One hand stabilizes the C2 vertebra by grasping the transverse processes between the proximal portions of the thumb and index finger; 

the other hand supports the occiput. Passively nod the patient's head with the hand under the occiput to take up the slack of the suboccipital muscles; then

ask the patient to roll the eyes up ward. This causes a gentle isometric contraction of the subococcipital muscles. The patient keeps looking upwards for 3 to 5 seconds and then relaxes. 

After the patient relaxes, take up the slack by passively nodding the head through any new range,

Repeat this procedure three to five times or until the desired outcome is achieved. Only motion between the occiput and C2 should occur. 

The contraction is gentle in order not to cause overflow into the multi-segmental erector spinae and upper trapezius muscles. This technique uses a gentle hold-relax, of the rectus capitis posterior minor muscle.