![]() The upper cervical spine will rotate more than the lower. (That does not mean each segment should rotate to the same degree. And each segment should contribute to this motion. Second, what is the quality of the motion? Ideally the neck should rotate around a vertical axis. This motion should be pain free and symmetrical to each side. As you observe the patient actively rotate their neck you need to look for two things.įirst, what is the range? How far can the patient comfortably turn their neck to each side? Under normal circumstances the patient should be able to turn 90 degrees (or very close to it). This is best done from a seated or standing position (although it can be done in quadruped as well). Muscle balance of the cervical rotators can be assessed with active cervical rotation range of motion (ROM). Assessment of Cervical Rotator Muscle Imbalance And we must know what to do when we find them. As clinicians we must be able to decipher these imbalances. But with many neck, thoracic, and shoulder conditions it is common for the extrinsic muscles to become dominant over the intrinsic extensors. Under normal circumstances these intrinsic and extrinsic muscles work synergistically. These accessory motions will compromise cervical stability and control. Instead, rotation will occur in conjunction with lateral flexion or extension. Due to their orientation these muscles are unable to produce pure rotation about the vertical axis. The extrinsic cervical rotators include the sternocleidomastoids (SCM), scalenes, Levator Scapulae, and Upper Trapezius. These muscles are well suited to produce pure cervical rotation about a vertical axis. ![]() ![]() The intrinsic rotators include the rectus capitus posterior major, the oblique capitus superior and inferior, and the splenius group. Basic Anatomy of the Cervical RotatorsĪs discussed in parts one and two of this series, the cervical musculature can be divided into intrinsic and extrinsic muscles. In this final article we will discuss assessment and corrective exercise recommendations for the cervical rotators. Neck flexion and neck extension were the topics of the first two articles. That has been the topic of this three part article series. And they need to know what to do when dysfunction in uncovered. As such, clinicians need simple and effective tests to assess movement and muscle balance in the cervical spine. Muscle imbalances are a common cause of neck pain. ![]()
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