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Cervical Mobilizations

FOR THE OA JOINTS: MIA: medial-inferior-anterior LPS: lateral-posterior-superior During OA flexion, the occipital condyles glide LPS on C1 condyles. During OA extension, the occipital condyles glide MIA on C1. During right (R) OA sidebending, the R occipital condyle glides MIA, and the left (L) occipital condyle glides LPS. During L OA sidebending, the L occipital condyle glides MIA, and the R occipital condyle glides LPS. If R sidebending (R-MIA, L-LPS) appears restricted, and the restriction is the same or worse in extension (when both need to glide MIA) and/or better in flexion (when both need to glide LPS), it can be assumed the R OA joint is at fault (unable to glide MIA). If R sidebending (R-MIA, L-LPS) appears restricted, and the restriction is better/lessens in extension (when both need to glide MIA) and/or the same or worse in flexion (when both need to glide LPS), it can be assumed the L OA joint is at fault (unable to glide LPS). If one side is clearly at fault more than the other, the patient may be treated using the unilateral OA distraction mobilization shown (affected side up). If one side is not clearly at fault, both sides may require treatment with either the OA flexion or OA extension mobilizations shown. FOR THE TYPICAL CERVICAL SPINE: If R side-gliding (akin to L side-bending) is limited at a segment, at least two possibilities exist: 1. The R side is unable to move up and forward, or 2. The L side is unable to move down and back. To determine which side is most at fault, the side-glide assessment is performed again in flexion (where facets need to glide up and forward). If the restriction is the same or worse, it can be assumed the R side is at fault (unable to glide up and forward). On the other hand, if the restriction was the same or worse when the spine is placed in extension (where facets need to glide down and back), it can be assumed the L side is at fault (unable to glide down and back). If one side is clearly at fault more than the other, the patient may be treated using the "down and back" or "up and forward" mobilizations shown. If one side is not clearly at fault more than the other, both sides may require treatment with the cervical flexion or extension mobilizations shown.