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.
This is a great technique to gently work with all the joints in the neck. Before doing this I like to work with the muscles, massaging the neck to get the muscles more relaxed before working with 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.
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 into their arms, or any dizziness, nausea, or changes in vision. Hold for up to 30 seconds.
Repeat this test with your clients 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 traction, pulling their head back toward you. Slowly alternate the compression and traction, pumping the discs and facet joints. Ask your client which feels better, compression or traction, and emphasize the movement that feels best for them.
I like to explain to clients that the compression squeezes the cartilage in the joints and the traction draws fluids back in. Cartilage is avascular, so it is kept healthy by 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.
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 on down and back up the neck alternating sides and stretching at each vertebral level.
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, then with C3 on down to C7. You can also do circular motions with the head, keeping their 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.