Arthrokinetics for the Neck

This video was updated on May 26, 2020.
A section was added starting at 6 minutes 51 seconds that shows working with your client’s breath while doing the arthrokinetic work.

Cautions:

Do not use this technique with clients with a recent neck injury.

Do not use compression if a positive Spurling test is present.

Do not use traction if your client has a disc replacement in the cervical area.

This work should be done slowly and without pain.

 

This is a great technique to work with all the joints in the neck gently. Before doing this, I like to warm up the muscles by massaging the neck to relax them, then work on the joints.

Begin with the Spurling test to check for nerve root compression. I do the Spurling test with any client with neck pain, especially if they have had recent trauma to the neck, such as a whiplash accident.

Spurling Test

Ask your client to keep their eyes open, then press inferiorly on the top of their head and ask if they have any symptoms of pain, tingling, or numbness in their arms, or any dizziness, nausea, or changes in vision. Hold for up to 30 seconds.

Repeat this test with your client’s head turned to the right and extended, then to the left and extended.

If the Spurling test is positive, it can indicate cervical disc compression or compression of the vertebral arteries. If the test is positive, do not continue treatment of the neck and refer your client to a doctor for further evaluation.

If the Spurling test is negative, you can proceed with the treatment.

Arthrokinetics for the Neck

While cradling your client’s head, offer gentle compression by pressing their head toward their feet, then apply traction by pulling their head back toward you. Slowly alternate the compression and traction, pumping the discs and facet joints. Ask your client which method they prefer, compression or traction, and emphasize the movement that feels best for them.

I like to explain to clients that compression squeezes the cartilage in the joints, and traction draws fluids back in. Cartilage is avascular, so it remains healthy through movement, which promotes fluid flow.

Continue the alternating compression and traction with your client’s head turned to either side. Check in with your client to be sure the work is pain-free.

Cervical Snake

Cradle your client’s head and have your fingers on either side of their neck. Using the middle finger of your left hand, press in toward the spinous process of C1 on the right and laterally flex their neck to the right using your finger as a fulcrum for a stretch.

Using the middle finger of your right hand, press in toward the spinous process of C2 on the left and laterally flex their neck to the left using your finger as a fulcrum for a stretch.

Continue down and back up the neck, alternating sides and stretching at each vertebral level.

Egyptian Movement

Place both middle fingers on either side of C1 spinous process, then do lateral displacement, moving their head side to side, but keeping their chin parallel to the shoulders. Then, place both middle fingers on either side of C2 and repeat. Next, put them on C3 and continue down to C7. You can also do circular motions with the head, keeping the chin parallel with the shoulders. This gives a shear force to the joints in their neck.

 

Arthrokinetic work can be done on any joint in the body. Arthrokinetic work for other joints is shown in the section on Joint Mobilization.

Related Techniques:

Spurling Test
Cervical Snake
Cervical Snake – Egyptian Movement
Joint Mobilization