Comprehensive Cervical Mobility & Self-Release Techniques

1. Press the ball into the wall with the head using moderate force. Use just neck muscles to create head movement. Move the head around the ball slowly. Perform 10 slow repetitions on each side. Slow down in zone of tension to maximize release of muscle/joint tension. Always perform in a pain free range of motion [No Guarding or Stretch Reflex] Cervical Mobility Training Ball to Wall - Lateral 1) Move ear away from shoulder 2) Move ear to shoulder

2. Cervical Mobility Training Ball to Wall - Extension 1) Tuck chin to chest 2) Raise chin to sky • Press the ball into the wall with the head using moderate force. • Use just neck muscles to create head movement. • Move the head around the ball slowly. • Perform 10 slow repetitions on each side. • Slow down in zone of tension to maximize release of muscle/joint tension. • Always perform in a pain free range of motion [No Guarding or Stretch Reflex]

3. Neck Flexion/Extension Stretch Active: Slowly flex and extend head fully 5x Passive: 1) Push chin to sky with hand, gently rotate head side to side. Observe: Feel the neck flexors stretch open. Discomfort may occur at occiput-C1 junction. Passive: 2) Gently curl neck forward with hands, rotate head side to side with elbows hanging down. [pulley] Observe: Do Not pull head or tense up. Feel the occiput-C1 junction stretch open.

4. Neck Rotation Stretch Active: Slowly rotate head fully side to side 5x. Passive: Push on cheekbone with hand to move head into full rotation, gently flex and extend head fully. Observe: While passively rotated fully, find the zone of tension by adding flexion and extension. Do Not push on the chin.

5. Neck Lateral Flexion (1) Active: Laterally flex head fully side to side 5x [do not rotate head while performing] Passive: Cautiously traction neck muscles using the opposite hand. Next, add gentle flexion and extension of the head. Return to neutral alignment and then perform slow rotation of the head. Observe: During passive motions, find and release the zone of tension.

6. Neck Lateral Flexion (2) Passive: Neck lateral flexion Active: Circumduct shoulder both directions 5x. [maintain hand contact with hip] Observe: Find the zone of tension and release using cross-plane motions.

7. Shoulder Rolls Active: Circumduct shoulder girdles both directions 5x. [maintain hand contact with hip] Observe:Crepitus at the scapulo-thoracic junction. Use micro-movements to reduce hypertonicity of associated muscles.

8. Body Weight Isometrics Cervical Exercises Flexion Starting Position - head flexed forward Hand Position - both hands press into the forehead Line of Drive - push head toward neutral alignment ___% effort ___seconds held ___sets

9. Body Weight Isometrics Cervical Exercises Extension Starting Position - head extended backward Hand Position - both hands press into the back of the skull Line of Drive - resist push of head toward neutral alignment ___% effort ___seconds held ___sets

10. Body Weight Isometrics Cervical Exercises Lateral Flexion Starting Position - head flexed laterally Hand Position - press hand into the side of the skull Line of Drive - push head toward neutral alignment ___% effort ___seconds held ___sets

11. Body Weight Isometrics Cervical Exercises Rotation Starting Position - head rotated to one side Hand Position - press hands into the corners of the skull Line of Drive - push head toward neutral alignment Observe - neurological control/coordination may be challenging ___% effort ___seconds held ___sets

12. Jaw Injuries associated with TBI Movements of the TMJ: [the joints rotate and/or translate] 1) Depression - lateral pterygoid and anterior digastric 2) Elevation - masseter, temporalis and medial pterygoid 3) Protrusion - medial pterygoid, masseter and inferior lateral pterygoid 4) Retraction - temporalis, digastric and superior lateral pterygoid 5) Lateral movement - lateral pterygoid and temporalis

14. Self Release Techniques [Perform to patient tolerance] - Squeeze a spasm (muscle belly) - Press & hold (acute, painful areas) - Find & grind (chronic tension) - Pin & stretch (short, tight muscles) - locate zone of tension - release muscle fiber tension Repetitive correction builds healthy muscle memory patterns.

15. Scarf Stretches (traps) Pin: Trapezius tendon insert into posterior lateral aspect of clavicle. Active: Laterally flex head fully, painfree Passive: Gently flex and extend head 2x, then rotate head 2x.

16. Scarf Stretches (SCM) Pin: SCM tendon insert into sternum. Use downward pressure into sternum. Active: Extend head fully. Passive: Gently flex head laterally 2x, then rotate head 2x.

17. Scarf Stretches (Anterior Scalene) Pin: Locate the anterior scalene tendon insert on the lateral part of the rib under the clavicle. Press inferiorly into superior aspect of the rib. Active: Extend and laterally flex head away. Passive: Gently rotate head 2x.

18. Scarf Stretches (Middle Scalene) Pin: Locate the middle scalene tendon insert on the superior part of the 1st rib. Press inferiorly into superior aspect of the rib. Active: Laterally flex head away. Passive: Gently rotate head 2x, then flex and extend head 2x.

19. Scarf Stretches (Posterior Scalene) Pin: Locate the posterior scalene tendon insert on the medial part of the 2nd rib. Press inferiorly and posteriorly into superior aspect of the rib. Observe: Do Not pull anteriorly. Push down and back. Active: Laterally flex head away. Passive: Gently rotate head 2x.

20. Scarf Stretches (Levator Scapula) Pin: Locate the levator scapula tendon insert on the superior angle of the scapula. Press inferiorly into scapula. Observe: Do Not pull superiorly. Active: Laterally flex head away. Passive: Gently rotate head 2x.