The OMT Cervical Somatic Dysfunction provides High Yield information that is needed for the COMLEX Level 1, 2, and 3, Medical School, Residency, and as practicing Physician.
Table Of Contents
Cervical Tender Points
Anterior Cervical Tender Points
| AC 1 | RA Can fine-tune with side bending away Transverse process or mandible (mandible: posterior surface f the ascending ramus of the mandible at the level of the earlobe) Anatomic Correlation: – Rectus capitis anterior muscle |
| AC 2-6 | F SARA anterolateral aspect of the anterior tubercle of the C2-C6 transverse process Anatomic Correlation: – Longus Colli muscle – Longus Capitis muscle – Anterior scalene muscle |
| AC 7 | F STRA superior to the medial end of the clavicle at the clavicular attachment of the SCM |
| AC 8 | F SARA on the medial end of the clavicle at the sternal attachment of the SCM |
Posterior Cervical Tender Points
| PC 1 inion | F S R On the inferior nuchal line lateral to the inion Anatomic Correlation: deep to the trapezius, near the medial border of the semispinalis capitis &/or rectus capitis posterior minor |
| PC 1-2 occ | E SARA PC1: on the posterior inferior border of the occiput, in the splenius capitis muscle, midway between the inion and mastoid process *Anatomic Correlation: – Obliquus capitis superior – Rectus capitis posterior major & minor muscles PC2: just below the occiput, on the inferior nuchal line, in the semispinalis muscle, just lateral to midline *Anatomic Correlation: – Rectus capitis posterior major & minor muscles – Obliquus capitis superior |
| PC 2; 3; 4-8 midline and lateral | E SARA Midline PC2: on the superior tip of sp of C2 PC4-8: on the inferior tip of sp of segment above *Anatomic Correlation: – Splenius capitis/cervicis – Semispinalis cervicis – Multifidus – Interspinales Lateral PC3-7: in the semispinalis &/or multifidus over the posterior articular pillar PC8: anterior to the trapezius muscle on the transverse process of C7 |
| PC 3 sp (maverick) | F SARA (on the inferior tip of sp of segment above) |
Cervical Long Axis Kneading
- TECHNIQUE: Soft tissue, passive, direct, regional; Traction is parallel to the affected tissue
- INDICATIONS: Hypertonicity of paravertebral mm.; TART changes in C-spine
- SET UP: Patient supine
- TREATMENT:
- Contact paravertebral mm. lateral to the spinous processes
- Move fingers inferolateral to displace skin then draw superiorly
- Repeat until there is observable softening of the tissues, increase in warmth and/or compliance
- RETEST
Cervical Transverse Push-Pull
- TECHNIQUE: Soft tissue, passive, direct, regional or segmental, bilateral; traction is perpendicular to affected tissue
- INDICATIONS: Hypertonicity of paravertebral mm.; TART changes in C-spine
- SET UP: Patient supine, opposite side of dysfunction
- TREATMENT:
- Place non-treatment hand on patient’s forehead and contact paravertebral mm.lateral to the spinous processes
- Apply anterolateral to the paraspinal mm. while gently rotating the head away from you to create a dynamic stretch
- Continue until desired tissue response is achieved
- RETEST
Cervical Flexion
- TECHNIQUE: Articulatory (LVHA), direct, passive, regional
- INDICATIONS: Cervical flexion restriction
- SET UP: Patient supine. Operator can either support head directly or cross arms to contact either shoulder
- TREATMENT:
- Bring the patient’s head into his/her flexion restrictive barrier
- Engage the barrier, move slightly through it and then back off
- Repeat 50-100 times in a rhythmic fashion until there is a improvement in range of motion
- RETEST
Cervical Extension
- TECHNIQUE: Articulatory (LVHA), direct, passive, segmental
- INDICATIONS: Cervical extension restriction
- SET UP: Patient supine. Place one hand under the patient’s chin and the forefinger and thumb of the other hand on the articular pillars of the affected vertebra
- TREATMENT:
- Bring the patient’s head into his/her extension restrictive barrier
- Engage the barrier, move slightly through it and then back off
- Repeat 50-100 times in a rhythmic fashion until there is an improvement in range of motion
- RETEST
Cervical Rotation
- TECHNIQUE: Articulatory (LVHA), direct, passive, regional
- INDICATIONS: Cervical rotation restriction
- SET UP: Patient supine. Place one hand under the patient’s chin on the side of the restriction and the other on the patient’s occiput
- TREATMENT:
- Bring the patient’s head into his/her rotation restrictive barrier
- Engage the barrier, move slightly through it and then back off
- Repeat 50-100 times in a rhythmic fashion until there is an improvement in range of motion
- RETEST
Cervical Sidebending
- TECHNIQUE: Articulatory (LVHA), direct, passive, regional
- INDICATIONS: Cervical side-bending restriction
- SET UP: Patient supine. Flex the patient’s head slightly and move into the side-bending restriction while placing the other hand on the patient’s opposite shoulder
- TREATMENT:
- Bring the patient’s head into his/her side-bending restrictive barrier
- Engage the barrier, move slightly through it and then back off
- Repeat 50-100 times in a rhythmic fashion until there is an improvement in range of motion
- RETEST
OMT Cervical Somatic Dysfunction Techniques
Occipito-Atlanto Joint MET
- TECHNIQUE: Muscle energy, direct, active, segmental
- INDICATIONS: Somatic dysfunction of OA joint
- SET UP: Patient supine.
- TREATMENT:
- Engage all three planes of restriction with hands placed under the patient’s head
- Instruct patient to try and return to the midline using while resisting using unyielding counterforce for 3-5 seconds
- Wait for 1 second or have the patient take a deep breath
- Re-engage new restrictive barriers in all three planes
- Repeat 3-5 times followed by a final stretch
- RETEST
Atlanto-Axial Joint MET
- TECHNIQUE: Muscle energy, direct, active, segmental
- INDICATIONS: Somatic dysfunction of AA
- SET UP: Patient supine
- TREATMENT:
- Fully flex patient’s neck and engage the feather edge of the rotation restriction with hands under the head
- Instruct patient to try and return to the midline using while resiting using unyielding counterforce for 3-5 seconds
- Wait for 1 second or have the patient take a deep breath
- Re-engage new restrictive barrier
- Repeat 3-5 times followed by a final stretch
- RETEST
Typical Cervical MET
- TECHNIQUE: Muscle energy, direct, active, segmental
- INDICATIONS: Somatic dysfunction
- SET UP: Patient supine.
- TREATMENT:
- Using the finger pads contact the articular pillars and engage the feather edge of all three planes of restriction
- Instruct patient to try and return to the midline using while resiting using unyielding counterforce for 3-5 seconds
- Wait for 1 second or have the patient take a deep breath
- Re-engage new restrictive barriers in all three planes
- Repeat 3-5 times followed by a final stretch
- RETEST
Myofascial Release
- Indications:
- Contra-Indications:
Craniocervical MFR: indirect technique
- TECHNIQUE: Myofascial Release, indirect, passive
- INDICATIONS: Acute cervical sprains/strains, mild cervical degenerative diseases, URI’s, sinusitis
- PHYSIOLOGY: Parasympathetic influence increases while the sympathetic influence decreases
- GOAL: to inhibit the muscle tension
- SET UP: Patient supine.
- Treatment:
Ligamentum nuchae MFR
- TECHNIQUE: Myofascial Release, indirect, passive
- INDICATIONS: Somatic dysfunction
- PHYSIOLOGY: Parasympathetic influence increases while the sympathetic influence decreases
- GOAL: to inhibit the muscle tension
- SET UP: Patient supine.
- Treatment:
Suboccipital release/inhibition
- TECHNIQUE: Myofascial Release, indirect, passive
- INDICATIONS: Muscle tensions headaches, neck aches, neck tension
- PHYSIOLOGY: Parasympathetic influence increases while the sympathetic influence decreases
- GOAL: to inhibit the muscle tension
- SET UP: Patient supine.
- Treatment:
