The document discusses manual therapy techniques for the cervical spine. It describes the range of motion and coupled movements of the upper cervical spine segments C0-C1 and C1-C2. It also discusses mobilization techniques like traction, glides, and flexibility tests for the upper cervical spine, lower cervical spine, and cervicothoracic junction. Soft tissue mobilization techniques are also described for the superficial and deep cervical muscles and connective tissues.

1. MANUAL THERAPY
DPT 9
THE CERVICAL SPINE
Part B
Dr Abdul Ghafoor Sajjad
Assistant Professor
RCRS, RIU

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3. • Follows the Convex-concave Rule
• During Flexion The Condyle of the occiput
move ……….
• Couple movement is side bending with
opposite side rotation
• Right Side bending couple with ……….
• End Feel ……..
Dr Abdul Ghafoor Sajjad
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4. Atlas Axis C1-C2

5. Atlas Axis C1-C2
• The Axis of movement is Dens
• Movement of the Posterior Arch of Atlas
During Flexion …………
• No Side bending
• 45 Rotation (Contribute half of the rotation
of Cervical Spine)
• Follows the Concave-Convex Rule
• Couple movement same as C0-C1
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6. Upper Cervical Spine Flexion &
Extension
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7. Upper Cervical Spine couple movement
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8. Upper Cervical Spine C0-C1 Traction
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9. Upper Cervical Spine Mobilization
C0-C1 Flexion & Extension Test
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10. Upper Cervical Spine Mobilization
C0-C1 Flexion & Extension Stretch Mobilization
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11. Upper Cervical Spine Mobilization
Couple Side Bending and Rotation Test
& Stretch Mobilization
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12. Upper Cervical Spine Mobilization
Atlas-axis Rotation
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13. Upper Cervical Spine Mobilization
Lateral Glide with Caudal Fixation
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14. LOWER
CERVIAL SPINE
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17. Lower Cervical Spine
• The cervical spine has the greatest mobility
of the entire spine, mostly in the sagittal
plane and especially in extension.
• Resting position there is a lordosis in the
cervical spine
• During flexion the lordosis is ……
• During extension the lordosis is …….
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18. Lower Cervical Spine
• Follow Concave Rule
• Concave Surface Move ……. During
Flexion & Vice Versa
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19. Lower Cervical Spine
• Coupled movement
• Cervical rotation and side bending to the
same side
• Non coupled movement ???
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20. LOWER CERVICAL SPINE
MOVEMENTS
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21. Active cervical flexion and
extension
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22. ACTIVE CERVICAL FLEXION
WITH COMBINED SIDEBENDING AND ROTATION
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23. LOWER CERVICAL SPINE MOBILIZATION
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LOWER CERVICAL SPINE MOBILIZATION

24. Cervical traction
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25. Cervical traction
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26. Cervical traction ê Belt
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27. Cervical segment: lateral glide
Cranial Fixation
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Cervical segment: lateral glide
Caudal Fixation

29. Cervical segment C2 to C5
translatoric joint play
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30. Cervical segment C2 to C5
translatoric joint play (Side Laying)
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31. Cervical segment Flexion
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32. Cervical segment: Flexion With
Couple Movement
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33. Cervical segment Extension
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34. Cervical segment: Extension With
Couple Movement
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35. CERVICOTHORACIC SPINE MOBILIZATION
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CERVICOTHORACIC SPINE
MOBILIZATION

36. CERVICOTHORACIC SPINE MOBILIZATION
Traction
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37. CERVICOTHORACIC SEGMENT (C5- T3)
TRANSLATORIC JOINT PLAY
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38. CERVICOTHORACIC SPINE MOBILIZATION
Flexion & Extension
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39. CERVICOTHORACIC SPINE MOBILIZATION
Flexion With Side bending & Rotation
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40. CERVICAL SOFT
TISSUE
MOBILIZATION
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Cervical Soft tissue mobilization

41. Cervical Soft tissue
mobilization
Superficial Fibers
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42. Cervical Soft tissue
mobilization
Upper Deep Fibers
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43. Cervical Soft tissue
mobilization
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44. Cervical Soft tissue
mobilization
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45. Cervical Soft tissue mobilization
Dorsal Fibers
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46. Cervical Soft tissue Ventral
mobilization (Caudal
Stabalization)
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