Chapter 9: Cervical Spine

This is a Chapter 9 summary of “Clinical Neurodynamics” by Michael Shacklock.

Physical Exam

The key tests you will want to perform include:

  • Slump test.
  • MNT 1.

You can tier your testing based on one’s dysfunctions, such as opening or closing, as well as using sensitizers for less severe problems.

Reduced Closing Dysfunction

Level 1a – Static opener to increase space and decrease pressure in the intervertebral foramen. In the picture below, we would open the right side by combining flexion, contralateral sidebend, and contralateral rotation.

So...tired...
So…tired…

Level 1b to 2b

Reduced Opening Dysfunctions

For these impairments, they are treated just the same as closing dysfunctions. The major difference is rationale. In closing dysfunction, the goal is to reduce stress on the nervous system. With opening dysfunctions, however, we are trying to improve the opening pattern.

Static openers will generally not be used because these treatments could potentially provoke symptoms.

Be careful with provoking.
Be careful with provoking.

Neural Dysfunction

The gentlest technique is the two-ended slider, in which an ipsilateral lateral glide and elbow extension are performed.

For tension dysfunctions, we go through the following progression: