stretching of neck region muscle wise

1. MUSKAN RASTOGI
B.P.T.
STRETCHING -Neck region

2. Platysma
Stretching technique
• Patient is lying on back, head
and cervical spine rotated and
bent away from the muscle to
be treated.
• Therapist presses downwards
with one hand to broad area
of the chest, below the
collarbone and stretches with
the other hand upwards
against the chin increasing
rotation and side bending.

3. Sternocleidomastoid
Stretching technique
• Patient is lying on back,
head and cervical spine
rotated to the contralateral
side and lifted slightly
upward to expose muscle.
• Therapist supports head
with free hand while pulling
muscle to side using broad
contact with the tips of the
thumb and fingers of the
other hand.

4. Scalenus anterior
Stretching technique
• Patient is lying on their back; therapist
supports head with body contact and hand
at the base of skull.
• Therapist applies the thumb or the first
metacarpal bone of the other hand on the
insertion of the muscle on the rib.
• Therapist lifts head and cervical spine
forward, rotates and bends away from
muscle to be treated. The angle of stretch
and level of contact in the neck will vary
slightly depending on which section is to
be stretched. In changing position, the
cervical spine is allowed to partially
straighten before the next stretch is
performed.

5. Scalenus medius
Stretching technique
• The insertion of scalenus
anterior may lie beneath the
sternocleidomastoid muscle
making direct contact
impossible.
• The therapist presses with the
thenar down on the second
rib, just below the collarbone.
The other hand completes the
stretch by bending the head
and cervical spine forward
combined with rotation and
side bending to the
contralateral side.

6. Scalenus minimus
Stretching technique
• Patient is lying on stomach, head and
cervical spine in forward flexion,
rotated and bent to contralateral side
to expose muscle.
• Therapist stretches with pressure of
hypothenar to the body of the muscle,
down towards the first and second rib,
while pulling with the other hand
placed over the facet joints at the level
of C4-7 to increase rotation and later
flexion of the cervical spine.
• Stretch is performed at the end of
exhalation.

7. Scalenus posterior
Stretching technique
• Patient is lying on back, head and
cervical spine in forward flexion,
slightly rotated and bent to
contralateral side to expose
muscle.
• Therapist pulls at level of C4-7
while increasing rotation and
lateral flexion. The other hand
presses down diagonally and to
the side on the second rib.
• Stretch is performed at the end of
exhalation.

8. Stretching technique
• Patient is lying on back,
neck slightly bent back.
• Therapist presses with
fingers against the base of
chin while drawing hyoid
bone downwards using the
thumb and forefinger of the
other hand.
Geniohyoid and Digastric (anterior
belly)

9. Mylohyoid
Stretching technique
• Patient is lying on back,
head and cervical spine
slightly bent back.
• Therapist applies pressure
at insertion of muscle on
mandible and stretches
backwards.

10. Digastric (posterior belly) and
Stylohyoid
Stretching Technique
• Patient is lying on side, head
and cervical spine rotated to
same side as muscle treated.
• Therapist takes contact with
thumb on the mastoid
processes, while using the
thumb and forefinger of the
other hand to grasp the hyoid
bone.
• Stretching is achieved by
pulling hands away from each
other.

11. Omohyoid
Stretching technique
• Patient is lying on back, head
and cervical spine bent
forwards, side bent and
rotated as far as possible away
from the muscle.
• Therapist presses with the
thenar down on the origin of
the muscle, located on the
scapula.
• Stretching is achieved by
pulling up on the hyoid bone,
with fingertips of the other
hand, at the point of insertion.

12. Sternohyoid
Stretching technique
• Patient is lying on back, head
and cervical spine slightly bent
back.
• Therapist presses with the
hypothenar down on sternum
near the origin of muscle.
• Therapist uses fingertips of the
other hand to push hyoid bone
upwards. Forearms will cross
over each other as they press
in opposite directions.

13. Thyrohyoid
Stretching technique
• Patient is lying on back,
head and cervical slightly
bent back.
• Using fingertips of both
hands, therapist pulls hyoid
bone and thyroid cartilage
away from each other.

14. Sternothyroid
Stretching technique
Patient is lying on back. Press
sternum downward with the
thenar.
Grasp thyroid cartilage at
muscle
insertion with fingertips of the
other
hand, and stretch upwards.

15. Longus capitis, Longus colli & Rectus
capitis anterior
Stretching technique
Patient is lying on back, therapist
bends cervical spine back.
This technique is not
recommended.
Fixation and/or direct contact are
not possible with these muscles
and effective stretching cannot be
applied, because of the limitation
in
the movement of the cervical
spine.

16. Trapezius (superior
descending part)
Stretching technique
Patient is lying on back, head
supported against therapist in
slight
flexion. Therapist stretches with
the
thenar of the hand down towards
muscle insertion while using the
other hand and the body to bend
the head and cervical spine to the
opposite side.

17. Levator scapulae
Stretching technique
• Patient is lying on side with the upper arm
over therapist's forearm.
• Therapist grasps around the superior,
medial angle of the scapula and pulls the
scapula downwards while using the thenar
of other hand to rotate and lateral flex
cervical facet joints away in the
contralateral direction.

18. Splenius capitis & Longissimus capitis
Stretching Technique
• Patient is lying on back, head slightly
bent forwards and to the side away from
muscle to be treated.
• Therapist applies pressure with the
thenar of the hand next to transverse
processes on the facet joints at the level
of C5-C7 and presses diagonally down
and away from the spine and moves
then at the level of Thl-3.
• The other hand, wrapped around the
mastoid process and occiput, is used to
increase lateral flexion and rotation by
pulling from the base of the skull.

19. Splenius cervicis
Stretching Technique
• Patient is lying on stomach, head
slightly in forward flexion and
rotated, and bent away from the
muscle to be treated.
• Therapist cups hand around atlas
(C1) and axis (C2).
• Stretching is achieved by gently
pulling on the muscle insertions to
increase rotation and lateral flexion
while using the thenar of the other
hand to apply pressure downwards
next to the spinous processes of
Th3-6 on the facet joints.

20. Iliocostalis cervicis
Stretching Technique
• Patient is lying on stomach, head bent
slightly forward, lateral flexed and rotated
away from the muscle to be treated.
• Therapist presses with the hypothenar
next to the spinous processes of C4-6 on
the facet joints to increase lateral flexion
and rotation.
• The hypothenar of the other hand presses
diagonally away from the cervical spine on
ribs 3-6.
• The forearms of the therapist are crossed.

21. Longissimus cervicis
Stretching technique
• Patient is lying on stomach, head
bent slightly forward, lateral flexed
and rotated away from muscle to be
treated.
• Therapist places thenar of the hand
next to spinous processes of C2-5, on
the facet joints and applies pressure
in a diagonal direction, to the side
with rotation. The other hand, placed
on the facet joints next to the
spinous processes of Thl-6, presses
diagonally away from the cervical
spine. The therapist's arms are
crossed.

22. Spinalis capitis & Semispinalis capitis
Stretching technique
• Patient is lying on stomach, head flexed
and supported against therapist
• Therapist wraps one hand around the
occiput to rotate and laterally flex cervical
spine away from the muscle. The hypo-
thenar of the other hand presses
downward and away from the head on the
facet joints next to spinous processes at
the level of C3-7.
• Then the hand is moved over the facet
joints at the level of Th1-4 and stretching
is repeated.

23. Semispinalis cervicis
Stretching Technique
• Patient is lying on stomach, neck bent
slightly away from muscle to be treated
without rotation.
• Therapist presses with the hypothenar
next to spinous processes C2-5 on facet
joints and applies pressure diagonally up
towards the skull.
• Placing the hypothenar of the other hand
next to the spinous processes on the facet
joints of Th1-6 of the same side, the
therapist presses down diagonally and
away from the neck.

24. Semispinalis thoracis
Stretching Technique
• Patient is lying on stomach, inferior
part of cervical spine rotated and
bent to side to expose muscle to be
treated.
• Therapist presses with the
hypothenar diagonally upward
towards head on the facet joints next
to the spinous processes of C2-5. The
hypothenar of the other hand
presses diagonally down and away
from the neck on the facet joints next
to the spinous processes of Th1-6 on
the same side.

25. Spinalis cervicis
Stretching Technique
• Patient is lying on stomach, cervical
spine bent noticeably forward.
• Therapist presses with the hypothenar
diagonally upward towards head on the
facet joints next to the spinous
processes of C2-4. The hypothenar of
the other hand presses diagonally down
and away from the neck on the facet
joints next to the spinous processes of
C6-Th2 on the same side.

26. Posterior superior
serratus
Stretching Technique
• Patient is lying on stomach, lower cervical
spine flexed forward, and head rotated
away from muscle to be treated.
• Therapist presses the hypothenar on the
facet joints next to the spinous processes
of C6-Th2 towards the head. The
hypothenar of the other hand applies
pressure diagonally down and to the side
on ribs 2-5. The forearms of the therapist
are crossed.

27. Interspinales cervicis & Interspinalis
thoracis
Stretching Technique
• Patient is lying on back,
head flexed forward.
• Therapist presses down on
shoulders with both hands
and with forearms crossed,
leans forward and presses
the head forward as far as
possible.

28. Rectus capitis posterior
major & Obliquus capitis inferior
Stretching Technique
• Patient is lying on back, cervical spine
straight, head bent slightly away from
muscle to be treated.
• Therapist cups hand under the cervical
spine so that the spinous process of axis
rests firmly at the base of the forefinger.
• Therapist applies pressure with the other
hand on the chin to rotate the head
towards the side of the muscles to be
stretched, while increasing lateral flexion
to the contralateral side, and pulls
diagonally back at about a 45° angle.

29. Rectus capitis posterior
minor & Obliquus capitis superior
Stretching Technique
• Patient is lying on back,
cervical spine straight.
• Therapist cups hand under
the cervical spine so that
the posterior arch of atlas
rests firmly at the base of
the forefinger.
• Therapist applies pressure
with the other hand on the
chin and pullsback at about
a 45° angle.

30. Rectus capitis lateralis
Stretching Technique
• Patient is lying on back,
cervical spine straight.
• Therapist cups hand under the
head so that the occiput rests
on the base of the forefinger.
• Therapist grasps under the
chin and applies pressure with
the forearm of the other hand
on the side of the head and
side bends only the upper
cervical joints

31. Intertransversarii muscles
Stretching Technique
• Patient is lying on back and therapist holds
the head with both hands with index
finger just under the occiput. The head is
bent to the side from just below the grip.
• The stretch effect is strongest between
the joints immediately inferior to the
position of the therapist's hands. By the
replacing hands and progressing down the
cervical spine from joint to joint,
stretching can be intensified with each
muscle the head and neck are
straightened each time as the place of grip
is moved.

32. Multifidus cervicis & Rotator cervicis
Stretching Technique
• Patient is lying on back and therapist holds the
head and neck with both hands so that fingers
overlay each other fully.
• Therapist supports the head and neck in slightly
flexed position and rotates and lateral flexes the
cervical spine to the same side. The stretch
effect is most intense on the deep muscles of
the vertebral joint immediately inferior to area
of contact.
• Muscles of each joint can be individually treated
by moving hands on the facet joints of the
adjacent vertebrae, working down the spine.