Diagnosis

• Position:  ES_rightR_left
• Motion Restriction:  Forward-bending, left side-bending, right rotation.

Treatment

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

Operator’s left hand controls the patient’s occiput with the web of the thumb and the index finger along the soft tissues of the suboccipital area.

The operator’s right hand cups the chin with the index finger in front and the middle finger below the tip of the ramus.  The operator’s right forearm is placed along the right side of the patient’s head.

Forward-bending is introduced by rotating the head forward by the operator’s hands around a transverse axis through the external auditory meatus.

Left side-bending and right rotation are introduced by the operator’s right forearm with slight left-to-right translation of the patient’s head to engage the restrictive barrier. (Right rotation is not actively introduced)

Patient instruction is to push the head directly posterior toward the table and into the hand offering resistance for 3-5 seconds of a mild isometric contraction. (An eye motion activating force is to look up toward the operator or toward the eyebrows.)

After relaxation, the operator engages the new forward-bending, left side-bending, and right rotational barriers.

Patient repeats the isometric contractions 3-5 times.

Retest.