Presentation:
22 y/o female had been troubled with a 2 days history of semi-acute right sided neck pain and stiffness following a recent long haul flight. She denies any history of headache or neurological symptoms.
Examination:
Cervical range of motion; Right rotation = 60 deg. Left rotation = 80 deg. Right lateral flexion = 15 deg. Left lateral flexion = 30deg.
Cervical facet compression (Kemps); Right positive. Left negative.
Cough/Valsalva; Negative
Neurological examination; unremarkable. No radicular signs. Reflexes intact bilaterally. Muscle strength good bilaterally.
Palpation; sensitivity and restriction at T6/7, T2/3, C1/2 right sided.
Vascular Testing; Hautant’s/Maigne’s (Seated) & VBI (Supine); No abnormalities detected.
Treatment:
Education & Advice.
Myofascial therapy.
Active releases of upper trapezius, levator scapulae, and posterior scalenes.
T6/7 extension tractional adjustment – released well
T2/3 ectension tractional adjsutment – released well
C1/2 bilateral Natural Apophyseal Glides (NAGS), Sustained Natural Apophyseal Glides (SNAGS)
Home Exercise:
Ice immediately post treatment
Cervical SNAG technique 3x/day
Seated scapular retraction 5 reps of 2 second holds – 3x/day
Outcome:
After 6 consultations over a 4 week period, the patient’s range of motion was unrestricted and pain free.
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