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Clinical Pearl Details
June 2012
Brian Macks, PT, OCS, COMT, FAAOMPT -
| Overview: |
Adapted from the North American Institute of
Orthopedic Manual Therapy OMPT curriculum Level II Upper as instructed
by Kathy Berglund and as originated by Erl Pettman. |
| Technique: |
Assess the passive accessory motion of the AA joint in the Cranio-Vertebral detailed biomechanical exam. |
| Indication: |
A determination has been made that the AA joint is
restricted for left rotation. The ipsilateral inferior surface C1
inferior/posterior glide and the contralateral inferior surface C1
inferior/anterior glide of the AA joint need joint glides assessment. |
| Procedure: |
The following assumes a loss of left rotation. It has been previously determined that the AA joint is at fault.
To check AA contralateral joint glide, have the patient sit in a chair.
The physical therapist should stand on the left side of the patient.
Hold the head with your left hand and place the 5th finger over the
right transverse process C1. The right hand should stabilize C2 with a
wide pinch grip along both sides. The left hand slightly side bends the
head to the right, left rotates the head to the motion barrier, and
then pulls C1 anterior/inferior.(Figure 1)
To check AA ipsilateral joint glide, have the patient sit in a chair.
The physical therapist should stand on the left side of the patient.
Hold the head with your left hand and place the 5th finger over the
right transverse process C1. The right hand should stabilize C2 with a
wide pinch grip along both sides. The left hand left rotates the head
to the motion barrier. The right hand pushes C2 with the right thumb
anterior/superior.(Figure 2) |
| Instruction: |
Possible questions to be answered are:
1. Is motion available?
2. What is the endfeel?
3. Is pain produced? |
Figure 1 |
Figure 2 |
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