Extended, Rotated, and Side-bent Dysfunction

Patient is supine on the table with the operator sitting at the head of the table.

Operator’s index and middle fingers of each hand contact the pillar of the superior vertebra of the motion segment being tested.

Operator’s palms and thenar eminences control the patient’s head and upper cervical spine.

Operator flexes the head and neck down to the segment under examination.  

With the palm and thenar eminence controlling the patient’s head and upper cervical, the operator introduces translation from right to left, sensing for resistance to movement at his index fingers.  If resistance is felt, the motion restriction is to forward-bending, right side-bending, and right rotation (indicating that the segment is extended, rotated and side-bent left [ERS_left]).  Something has interfered with the capacity of the left facet to open.

With the palm and thenar eminence controlling the patient’s head and upper cervical, the operator introduces translation from left to right, sensing for resistance to movement at his index fingers.  If resistance is felt, the motion restriction is to forward-bending, left side-bending, and left rotation (indicating that the segment is extended, rotated, and side-bent right [ERS_right]).  Something has interfered with the capacity of the right facet to open.