Adendum-the lower cervical spine

A pattern I see on occasion in the lower cervical spine is perhaps best visualized as occuring on the convex side of the injury in which the first ribe is compressed medially and 1st thoracic is stuck as well. Clasping the 1st rib posteriorly and pulling the medial portion of the clavicle laterally will reveal the restriction. The clavicle is restricted and by inference so is the 1st rib anteriorlay and posteriorly. The lateral traction is performed gently after taking the sllack out and is maintained for up to 5 minutes. Side-glide cervical mobility is tested in sidelying with the head and shoulders off the table. The eyes are perpendicular to the floor and the head and neck are allowed to gently achieve end-range of side glide towards the floor. If a restriction is perceived by the client thay can then "open up" the restriction by abducting the arm (that is on the top) and at approximately 90 degrees there will be an almost immediate and easily discernible release, though the position is maintained for up to 2 minutes.
Give consideration to the possibility that the opposite of the above is occuring on the opposite side and proceed according. When rib joint or thoracic joints are involved (just like the si/pelvis) I always treat both sides and treat as a hoop, coming full circle with respect to mobility testing and treatment. I try to think outside the body of traditional manual therapy and especially think in terms what else is possible and ultimately let the client's body reveal itself. "The 1st step towards mastery is the actual envy of the unknown." Thomas Mann The Magic Mountain. I hope I have been helpful.
Thank you.
Jerry Hesch, MHS, PT
[email protected]