Professional Documents
Culture Documents
By Til Luchau
In the previous article As in the first article, I’ll draw on the This simple small-nodding test
myofascial work as taught in my workshop helps you find where most of your
(Myofascial Techniques: series. You can see video related to these client’s cervical flexion and extension
techniques and tests by visiting Massage typically occurs. By implication, you
“Preparing the Neck and & Bodywork’s digital edition, which can determine if there is freedom at
features a video clip from the 2009 DVD the topmost joint of the neck, the AO
Shoulders for Deep Work,” Advanced Myofascial Techniques for joint. When the soft-tissue structures
the Neck, Jaw, and Head from Advanced- around the AO are free, small nodding
Massage & Bodywork, January/ Trainings.com. The link is available on motions will happen primarily here,
ABMP.com and Massageandbodywork.com. allowing the head to balance and
February 2009, page 120), rock on the atlas like a seesaw (Image
Nod Test 2). When it is present, this top-of-
I talked about how taking The Nod Test allows us to assess the-neck freedom gives a sense of
three important things: lightness and poise. If the motion
time to release superficial • Freedom at the atlantooccipital looks like it is happening lower in the
(AO) joint. neck instead of at the AO, it could
restrictions, before working • The ability of the posterior indicate restrictions in the suboccipital
compartment of the neck or transversospinalis muscles.
deeper structures, can increase (Image 1) to lengthen.
• The degree of participation of
your effectiveness and give the “prevertebral” muscles along
the front of the cervical spine.
longer-lasting results. In this These each contribute to the
alignment, flexibility, and stability
article, we’ll look at ways to of the neck, particularly in head-
forward positions (cervical lordosis).1
assess and release deeper neck Begin with your client sitting or
standing. While looking at his or
restrictions. Since it is part her profile, ask for small nodding
motions. We want just a little bit of
two of the earlier article, I’ll movement—too much will make the
initiation of movement hard to see.
assume you’ve done some work Ask yourself: Which neck joint moves
When the soft-tissue structures around the
first? Which joint or joints are flexing
atlantooccipital joint are free, small nodding
to release and prepare the and extending in these small nodding
motions will happen primarily at the top of
motions? If it is hard to see these
the neck, allowing the occiput to balance
superficial fascial layers before things, ask your client to make even
and move on the atlas like a seesaw. 2
smaller motions, while you look for the
attempting the techniques here. very first joints that move. You can also
use your hands to feel for this initiation,
if it still isn’t clear to your eyes.
Cervical
Transversospinalis
Technique
In a client who has limited neck
flexion, as in the person on the
right in Image 3, your next step
The Nod Test. When the deep structures of the posterior neck are able to lengthen in the
will be to lengthen and release the larger motions of cervical flexion, nodding happens primarily at the top of the neck (as on
strong, middle-level longitudinal the left). When the posterior compartment cannot lengthen, cervical flexion is limited,
structures (shown in Image 1). and the motion of nodding gets driven into the base of the neck (as on the right).
We’ll use the knuckles of our
proximal interphalangeal (PIP) joints
to anchor and lengthen these mid-level
layers (Image 4). Seated comfortably
the head has the effect of dragging the Posterior Cervical
at the client’s head, place your right
tissues out from under your knuckles. Wedges Technique
forearm and wrist on the table for
Keep your pace slow and steady, It is one thing to release restricted
stability. With the PIP knuckles of
feeling for restrictions in the posterior tissues; it is another to help our clients
your first two fingers, gently feel
compartment of the neck, and waiting, find new ways of moving that will
for longitudinal shortness in the
rather than pushing, for release. keep the restrictions from returning.
various layers of the deeper neck
Once you’ve made an initial pass This technique can do both. It is an
structures, first on the right side of
or two, you can focus on detailed effective way to release deep, soft-tissue
the neck. Anchor these short tissues
work into particularly tight or short restrictions, right down to the deepest
in a caudad or foot-ward direction.
structures by incrementally lifting, articulations of the cervical spinal
Once you’ve comfortably placed
rotating, flexing, and extending the column. In the active-motion version, it
your right hand, you can slowly bring
neck around the point of contact, all will help your client find new movement
your client’s neck into a bit of flexion.
the while encouraging length up the possibilities that will support the
With the left forearm braced against
back of the neck. Be thorough, working structural work once the session is over.
the edge of the table for stability, lift
deeper through the various layers Use the fingertips of both hands
the head to slightly flex the neck. When
you encounter, all the way from the to feel the space and tissue texture
you get your position and angles right,
occipital ridge into the shoulders and beside and between the spinous
lifting the head is relatively easy, even if
base of the neck. By switching your processes of two vertebrae, beginning
your client is bigger than you. If lifting
hand position, you can work the left at the base of the neck with C6 and
the head feels like a strain for you or the
and right, as well as the central nuchal C7. Work head-ward, checking each
client, reposition yourself until you find
ligament (taking care not to apply articulation that you can palpate.
an easier way. Even though your right
an uncomfortable level of pressure Gently lift with your fingertips into
hand is stationary on the table, lifting
directly to the spinous processes). any restricted spaces between the
spinous processes (Image 5). Keep your