Contents

1. Introduction

1.1. The functional anatomy of the cervical spine (C-spine) 2

1.2. The arterial and venous circulation of the cervical region 31

1.3. Neurology of the C-spine 33

1.4. Cerebrospinal fluid (CSF) 41

1.5. Basic techniques for balancing and facilitating the CSF 51

1.6. Neuromuscular control in the C-spine 57

1.7. Special tests for the C-spine 61

1.8. Palpation of the muscles of the C-spine 78

2. Muscle Energy Techniques

2.1. General information about Muscle Energy Techniques (MET) 94

2.2. The results from the application of MET 94

2.3. The methodology of MET 95

2.4. Posture and muscle imbalances 96

2.5. The dysfunction of the C-spine 99

2.6. MET on the deep posterior neck muscles 99

2.7. MET on the prevertebral muscles of the C-spine 112

2.8. MET on the scalene muscles 119

2.9. MET on the anterior neck muscles, above and below the hyoid bone 124

2.10. MET in the middle layer of the posterior neck muscles 125

2.11. MET in the superficial layer of the posterior neck muscles 131

2.12. MET on the sternocleidomastoid muscles 136

2.13. MET on the temporomandibular joint (TMJ) muscles 142

2.14. Dynamic restriction and functional stability in the C-spine 147

3. Techniques for releasing the muscles and fascia of the neck

3.1. General information about fascia 156

3.2. The muscle fascia 156

3.3. The fascia of the neck 158

3.4. General guidelines for releasing fascia 161

3.5. The Muscle Release Technique (MRT) 161

3.6. Myofascial release maneuvers on the cervical muscles 164

3.7. Application of massage techniques for myofascial release 173

3.8. Massage maneuvers for lymphatic drainage in the C-spine 179

3.9. Application of positional release in the C-spine 183

3.10. Application of positional release and rhythmic oscillation in the C-spine 184

3.11. Application of the release method using special tools (IASTM) (IAS 1) 185

4. Applications of self-stretching techniques in the C-spine

4.1. General information 192

4.2. The neurophysiological basis of stretching 192

4.3. Application of stretching in the C-spine 194

5. Application of nerve structure gliding techniques originating from the cervical spine

5.1. General information about neural tissue gliding 218

5.2. The diagnostic effectiveness of neurodynamic tests 218

5.3. The primary mechanical functions of the nervous system 218

5.4. How do nerves move? 219

5.5. The physiological functions of nerves 219

5.6. Neurogenic inflammation 220

5.7. Neurodynamic sequential movements 220

5.8. Neurodynamic gliding 220

5.9. Neurodynamic tension test 220

5.10. The effect of vertebral movements on neural tissue 221

5.11. Parameters considered during tests 221

5.12. The neurodynamic tests of the cervical spine 222

5.13. Gliding and stretching techniques for nerves in the C-spine 228

6. Acupuncture techniques for releasing the C-spine

6.1. How does acupuncture reduce pain? 238

6.2. Muscle pain 238

6.3. The short muscle syndrome 238

6.4. Muscle shortening, "spasm," and contraction 239

6.5. The secondary pain caused by muscle shortening 239

6.6. The acupuncture response to chronic dysfunctions 240

6.7. The technique of acupuncture 240

6.8. The phenomenon "TEH CH’I" or "DEQI" 241

6.9. Acupuncture in the C-spine 241

6.10. Headaches: causes and treatment 247

6.11. The dysfunction of the temporomandibular joint 253

7. Trigger Points and zones of referred pain in the C-spine

7.1. How is a trigger point described? 258

7.2. What is the mechanism of forming a trigger point? 258

7.3. The hypothesis of energy muscle crisis 258

7.4. The hypothesis of dysfunctional kinetic plate 259

7.5. The causes of trigger point formation 259

7.6. The outcomes of trigger point formation 259

7.7. Central and satellite trigger points 259

7.8. How is the referred zone of each trigger point defined? 260

7.9. The correct palpation and treatment of trigger points 260

7.10. Trigger points and the referred zones of the cervical region muscles 261

8. The role of the diaphragm and breathing in chronic pain and rehabilitation

8.1. Diaphragmatic movement (Figure 8-1) 274

8.2. Stress and its effect on the breathing mechanism 275

8.3. The general consequences of stress on our body 275

8.4. Assessment of respiratory function 276

8.5. Methods to tone and retrain the diaphragm 279

8.6. Exercises for strengthening the diaphragm 280

8.7. The role of the ribs and the thoracic region in the function of breathing 284

9. Therapeutic exercises and advice

9.1. Dysfunction 294

9.2. Hypokinesia 294

9.3. Hyperkinesia 297

9.4. Hyperkinesia in the C-spine 298

9.5. Indicative stabilization exercises for hypermobile segments of the spine (C4-C5) and (L5-S1) 299

9.6. Basic principles of therapeutic exercise 302

9.7. Spine school 303

9.8. Mobilization-strengthening and stretching exercises in the cervical spine 307

Index 339

Description

The book "Application of Special Physiotherapy Techniques in the Cervical Spine," by Christos N. Koutsampelas and Bias D. Ioannou, is unique in its kind. In most physiotherapy texts, a type of technique is proposed for the entire set of the human body's motor structures. In contrast, this book proposes nearly all rehabilitation techniques for a single structure: the cervical spine.

The brain communicates with the rest of the body via the cervical spine. Throughout our lives, our choices and unpredictable situations create problems in the cervical region. Improper body positioning during work or rest, physical and psychological stress, poor technique during sports, direct traumatic injuries, and sudden changes in speed are factors of dysfunction and disorganization of the cervical spine.

Physical therapists represent the greatest hope for patients with cervical spine problems. This book analyzes the specific techniques that physical therapists can choose and apply to help restore issues so that patients can regain excellent communication with their brain. Proposed techniques include Muscle Energy Techniques (MET), stretching and mobilization techniques, relaxation techniques, techniques to improve cerebrospinal fluid flow, techniques for fascia release, acupuncture techniques, massage techniques, nerve tissue stretching techniques, techniques for the temporomandibular joints, diaphragmatic breathing techniques, stabilization techniques, and mobilization techniques for the cervicothoracic spine.

There are also ergonomic advice for improving body posture during work and rest. Finally, simple exercises are provided that everyone can easily apply in their space with the goal of mobilizing, strengthening, and stretching the cervical spine.