Cervical Rotation

By: Eric Blackstone

Description

Cervical rotation is the motion of the neck that moves through the transverse plane and allows us to look from side to side without turning our entire body. Functionally, this movement is produced from C0/C1 caudally to T3/T4. Most of the movement is produced from the upper cervical spine, 60% of total rotation comes from the C1-C2 vertebrae. The following muscles involved with cervical rotation include:¹

• Upper Trapezius via spinal segment C3-C4
• Sternocleidomastoid via spinal segment C2 and cranial nerve XI
• Splenius Cervicis via spinal segment C1-C8
• Splenius Capitis via spinal segment C1-C8
• Semispinalis Cervicis via spinal segment C1-C8
• Semispinalis Capitis via spinal segment C1-C8
• Scalenes via spinal segment C4-C8
• Upper Erector Spinae via spinal segment C1-T1

Mobilizing

Supine Pillow Support Stretch²

This may be used for the more irritable or severe patient.

1. Lay down in a supine position with a pillow underneath your head.
2. Slowly rotate head to affected side to provide gentle stretch.

Do this 5 times for 30 seconds.
Progress to 5 times for 60 seconds as pain or stiffness decreases.

Cerivical Rotation with Over-Pressure³

1. Position yourself in a seated or supine position.
2. Start in a neutral position.
3. Rotate head to affected side.
4. Apply overpressure with your ipsilateral hand in your upper cheek area.

Do this 3 times for 30 seconds.
Progress to 3 times for 60 seconds as pain decreases.

Levator Scapulae Stretch⁴

1. Perform this in a standing position.
2. Grab the arm of the affected side.
3. Pull this arm to the contralateral side.
4. Tilt your head downwards and to the side looking away from your affected side until you feel a stretch.

Complete this 3 sets for 30 seconds.
Progress to 3 sets for 60 seconds.

Indications for Stretching

Forward head posture is common among the poor ergonomics working community. When an individual has this it decreases the mobility of cervical rotation in the neck.⁵ In order to avoid this decline in motion, one should apply these stretches to their exercise program. This will decrease the onset of many pathologies, such as cervicogenic headaches, degenerative discs, etc.

Strengthening Exercises

Supine Cervical Rotation Strengthening⁶

Can be used for the more irritable or severe patient.

1. Perform in a supine position, pillow is optional.
2. Rotate head from side to side to a comfortable position.
3. Make sure there is no side flexion.

This can be 30 times for 3 sets. This should be done 2-3 times a day.
Progress to 30 times for 6 sets. Still complete 2-3 times a day.

Seal Cervical Rotation⁷

1. Perform this in a prone position.
2. Start on your elbows.
3. Then tuck in your chin.
4. Rotate head from side to side.
5. Stay in a comfortable range.

Do this 30 times for 3 sets.
Progress to 30 times for 6 sets.

Cervical Rotation Strengthening with Resistance Band⁸

This is for the stronger patient.

1. Perform in a supine position.
2. Place theraband across the bed.
3. Lie down and wrap the theraband around your forehead.
4. Apply resistance by pulling with your upper extremity.
5. Tuck chin to correct posture.
6. Rotate head away from stabilized theraband.
7. Make sure to control eccentrically when coming back to neutral.

Perform 20 times for 3 sets.
Progress to 30 times for 3 sets.

Potential Clinical Syndromes or Etiologies

Here is a list of the different pathologies that may benefit from cervical rotation:
http://morphopedics.wikidot.com/clinical-syndromes

Additional Web Based Resources

• Here's more information on a cervical examination: http://www.physio-pedia.com/Cervical_Examination
• Here's more information on the normal range of motion of the cervical spine http://www.dshs.wa.gov/pdf/ms/forms/13_585a.pdf

Footnotes

1. Schafer, R. Clinical Biomechanics: Musculoskeletal Actions and Reactions. Chiro. http://www.chiro.org/ACAPress/Biomechanics_of_Cervical_Spine.html. Accessed December 15, 2014.

2. Schroeder, G. Cervical - Ball supported neck rotations. HEP 2 GO. http://www.hep2go.com/exercise_editor.php?exId=12523&userRef=90668. Created April 26, 2013. Accessed December 5, 2014.

3. Mitchell, J. Cervical Rotation with Over-pressure. HEP 2 GO. http://www.hep2go.com/exercise_editor.php?exId=4279&userRef=90668. Created March 30, 2011. Accessed December 5, 2014.

4. Levator Scapulae Stretch - Modified. HEP 2 GO. http://www.hep2go.com/exercise_editor.php?exId=366&userRef=90668. Created September 1, 2009. Accessed December 5, 2014.

5. Neck Related Headaches. Core Concepts Muscuoskeletal Health Group. http://www.coreconcepts.com.sg/mcr/neck-related-headaches/. Accessed December 5, 2014.

6. Schroeder, G. Cervical- Ball supported neck rotation. HEP 2 GO. http://www.hep2go.com/exercise_editor.php?exId=12523&userRef=90668. Created April 26, 2013. Accessed December 5, 2014.

7. Houghton, T. POE Lower Cervical Extension. HEP 2 GO. http://www.hep2go.com/exercise_editor.php?exId=14384&userRef=90668. Created September 24, 2013. Accessed December 5, 2014.

8. Phifer, C. Cervical Spine Rotation on Book With / Without Resistance. HEP 2 GO. http://www.hep2go.com/exercise_editor.php?exId=7445&userRef=90668. Created June 8, 2012. Accessed December 5, 2014.