Podcast
Questions and Answers
What is the primary goal of the Sub-Occipital Release technique?
What is the primary goal of the Sub-Occipital Release technique?
- To strengthen the cervical spine
- To relax the sub-occipital muscles (correct)
- To apply pressure directly onto the occiput
- To increase tension in sub-occipital muscles
What should be done after completing the Sub-Occipital Release technique?
What should be done after completing the Sub-Occipital Release technique?
- Apply heat to the occipital area
- Perform a series of neck stretches
- Allow the patient to rest their head on the table (correct)
- Sit the patient straight up immediately
How much pressure is typically applied during the Inion Traction technique?
How much pressure is typically applied during the Inion Traction technique?
- 10-15 pounds
- 2-5 pounds
- 15-20 pounds
- 5-10 pounds (correct)
Which position should the clinician start in while performing the Inion Traction technique?
Which position should the clinician start in while performing the Inion Traction technique?
What is a potential outcome for patients during the Sub-Occipital Release technique?
What is a potential outcome for patients during the Sub-Occipital Release technique?
What is the primary purpose of muscle energy techniques?
What is the primary purpose of muscle energy techniques?
During muscle energy techniques, the patient should contract at what percentage of their maximum strength?
During muscle energy techniques, the patient should contract at what percentage of their maximum strength?
Which technique is recommended to manage cervicogenic headaches effectively?
Which technique is recommended to manage cervicogenic headaches effectively?
What patient positioning is preferred for upper cervical spine stretching?
What patient positioning is preferred for upper cervical spine stretching?
What is one of the criteria for identifying patients likely to benefit from thoracic spine manual therapy?
What is one of the criteria for identifying patients likely to benefit from thoracic spine manual therapy?
How is the C1-C2 Self-Snag technique performed?
How is the C1-C2 Self-Snag technique performed?
Which of the following techniques is considered a last resort for cervical mobilization?
Which of the following techniques is considered a last resort for cervical mobilization?
Which compression technique helps prevent forward head posture?
Which compression technique helps prevent forward head posture?
What is the main goal of repeated retractions in treatment?
What is the main goal of repeated retractions in treatment?
What action should a patient take while performing the upper cervical spine stretch?
What action should a patient take while performing the upper cervical spine stretch?
What technique resulted in a 54% reduction in headache pain according to research?
What technique resulted in a 54% reduction in headache pain according to research?
Which mobilization technique is associated with the C7-T1 level?
Which mobilization technique is associated with the C7-T1 level?
When treating with thoracic spine thrust mobilization, what does the evidence suggest?
When treating with thoracic spine thrust mobilization, what does the evidence suggest?
What should a patient be instructed to avoid while performing retractions during treatment?
What should a patient be instructed to avoid while performing retractions during treatment?
Flashcards
Sub-Occipital Release (SOR)
Sub-Occipital Release (SOR)
A treatment technique involving applying continuous pressure to the sub-occipital muscles at the base of the skull, allowing relaxation and potential centralization of headache symptoms.
SOR Treatment Time
SOR Treatment Time
The duration of a Sub-Occipital Release (SOR) treatment typically ranges from 5 to 10 minutes.
SOR Technique Details
SOR Technique Details
The clinician cradles the patient's occiput with fingers, allowing the weight of the head to relax the muscles. It's a counterstrain approach.
Inion Traction
Inion Traction
A manual therapy technique where the clinician applies gentle traction to the cervical spine by pronating their forearm at the base of the occiput, using the weight of their forearm.
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Inion Traction Pressure
Inion Traction Pressure
The force applied during Inion Traction is typically around 5-10 pounds, providing a comfortable and effective stretch to the cervical spine.
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Muscle Energy Technique for Upper Cervical Spine
Muscle Energy Technique for Upper Cervical Spine
A manual therapy technique aimed at unlocking the upper cervical spine facets. It involves patient-generated isometric contractions, followed by clinician-assisted passive movements into greater flexion, side-bending, and rotation away from the affected side.
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Repeated Retractions for Cervicogenic Headaches
Repeated Retractions for Cervicogenic Headaches
A technique involving repeated cervical retractions (pulling the chin back) to address cervicogenic headaches. The patient performs 10 repetitions per hour, moving through various positions (sitting, supine, with and without traction) until symptom resolution.
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Upper Cervical Spine Stretching
Upper Cervical Spine Stretching
A technique that aims to elongate the upper cervical spine muscles. It involves both patient-generated and clinician-assisted stretching.
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Thoracic Spine Mobilization
Thoracic Spine Mobilization
A manipulation technique using a Grade V rotational thrust to mobilize the thoracic spine, aiming to reduce cervical spine pain.
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CPR for Thoracic Spine Manipulation
CPR for Thoracic Spine Manipulation
A clinical prediction rule (CPR) to help identify patients with cervical spine pain who may benefit from thoracic spine manipulation. It involves assessing several criteria like symptom duration, pain location, cervical ROM, and FABQPA score.
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C7-T1 Mobilization
C7-T1 Mobilization
A manual therapy technique involving a Grade V traction mobilization of the C7-T1 joint, often performed in a seated position. This technique aims to achieve a 'cavatation' and improve cervical pain.
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C1-C2 Self-SNAG Technique
C1-C2 Self-SNAG Technique
A self-sustained natural apophyseal glide (SNAG) technique using a towel to address pain and improve ROM in the upper cervical spine. It involves a specific head movement, often with a towel aiding the motion.
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Cervical Spine Mobilization (Grade IV)
Cervical Spine Mobilization (Grade IV)
A technique involving Grade IV rotational mobilization of the cervical spine. It is less commonly used due to risks of vertebral artery injury, and often combined with exercise.
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Postural Education and Correction
Postural Education and Correction
A comprehensive approach to address poor posture, specifically forward head posture, often seen in people who work at computers or use phones frequently.
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Lumbar/Cervical Roll for Posture
Lumbar/Cervical Roll for Posture
A simple tool used in postural correction. A lumbar roll placed at the waistline aims to improve lumbar spine posture, which indirectly benefits cervical spine alignment.
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Headrest Usage for Driving
Headrest Usage for Driving
An important aspect of postural correction while driving. Proper headrest adjustment helps maintain good cervical spine alignment and reduces strain.
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Slouch-Overcorrect Technique
Slouch-Overcorrect Technique
A technique involving actively slouching and then overcorrecting to improve posture. It is performed 15 times per hour to remind the body of good posture.
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Ergonomic Workstation Assessment
Ergonomic Workstation Assessment
A critical step in postural correction, involving assessing the workplace setup to identify potential ergonomic problems and address them for improved posture.
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Visual Cues for Posture
Visual Cues for Posture
Simple visual reminders to enhance posture. For example, a green dot on a computer screen serves as a cue to maintain good head posture.
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Cervicogenic Headache Treatment Techniques
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Sub-Occipital Release (SOR): A 5-10 minute technique where the clinician cradles the patient's occiput, applying continuous pressure on sub-occipital muscles. Dim lighting in a private room is recommended. The goal is muscle relaxation, potentially centralizing headache pain. The patient should rest after the release.
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Inion Traction: Involves 5-10 pounds of pressure and a 5-15 minute treatment duration. The clinician positions their forearm at the base of the patient's occiput, transitioning from a supinated to a neutral position to create traction.
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Muscle Energy Techniques: Used to unlock upper cervical spine facets. The patient, seated or supine, performs a 50% sub-maximal isometric contraction, then the clinician moves the patient into further flexion, side-bending, and rotation away from the involved side. This is repeated 3-5 times, potentially unlocking (or mobilizing) the facet.
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Repeated Retractions: A highly effective technique for treating cervicogenic headaches. The technique progresses from simple retractions in sitting to supine variations, and finally traction/retraction/extension off the end of the table. Instructions include preventing nose contact to ensure full range of motion. This is crucial for maximal benefit.
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Upper Cervical Spine Stretching: Involves patient-generated and clinician-assisted stretches to elongate upper cervical spine muscles. This includes a nodding movement (minor flexion) with overpressure to reach end range, or using a fist under the chin while performing the same nodding motion. 2-3 repetitions, held for 30-60 seconds, are recommended.
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Thoracic Spine Mobilization: Grade V rotational mobilizations/manipulations of the thoracic spine are often effective in decreasing both upper and lower cervical spine pain.
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C7-T1 Mobilization/Manipulation: A seated traction/lifting technique targeting the C7-T1 region. This technique is seen as beneficial for upper and lower cervical spine pain. A study on college students showed decreased pain and pain pressure threshold post-treatment.
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C1-C2 Self-Snag Technique (SNAG): A self-sustained natural apophyseal glide (SNAG) technique using a towel that aims to decrease pain in the upper cervical spine and increase range of motion in locked or inflamed facets. Studies show this technique can reduce headache pain by 54% compared to a placebo.
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Cervical Spine Mobilization (Limited Use): Grade IV rotational mobilizations are a last resort due to potential vertebral artery injury risk. Combining with therapeutic exercises is recommended.
Postural Correction and Education
- Postural Education is essential. Common issues include poor posture and forward head posture often seen in students and those working at computers or phones. Techniques include:
- Lumbar Roll/Cervical Roll: Positioning a roll at the belt to address lumbar posture that impacts cervical posture.
- Headrest While Driving: Proper use of headrests and mirror adjustment.
- Slouch-Overcorrect: Practicing postural correction through repetition (15 times/hour).
- Ergonomic Workstation Assessment: Evaluating and improving workstation ergonomics.
- Visual Cues: Using visual cues (e.g., green dot) to remind individuals of appropriate posture.
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