Full Programme

Neck

Assessment & Retraining of Uncontrolled Movement

Clinical Analysis and Management Planning

Review of Cervico-Thoracic Musculature:
• Functional anatomy
• Myofascial influences on postural alignment and postural adaptation

[practical] Alignment Assessment:
• Assessment of cervico-thoracic posture
• Clinical guidelines for ideal
• Cervical posture classification groups

Kinaesthetic Repositioning
• Proprioception and Pain
• Proprioception and recruitmentPrinciples and Practice of Dynamic Stability Assessment and Correction

Control of Direction

[practical] Assess the Direction and the loss of Dynamic Control in the Cervico-Thoracic Region and Retrain Stability Mechanisms at an Appropriate Level

• Assess for Uncontrolled Movement and restriction during functional movements of the cervical spine and the ability to dissociate and control the dysfunction relative to the restriction.
• Observe and rate.
• Cervical Movements: Flexion, Extension, Rotation & Lateral Flexion
• Diagnose the type of cervical stability dysfunction based on the direction of Uncontrolled Movement 'give' and its relationship to pathology
• Upper cervical extension stability dysfunction
• Mid cervical extension shear stability dysfunction
• Low cervical flexion stability dysfunction
• Upper cervical flexion stability dysfunction
• Cervical rotation stability dysfunction
• Unilateral bias - 'give ' into rotation / lateral flexion (coupling dysfunction)

- Activation with appropriate facilitation techniques

Control of Translation

[practical] Assessment and rehabilitation of Local and Global Stability Systems to Control Translation:
Observe, teach, test and rate

• Positioning cervical, temporo-mandibular and scapulo-thoracic neutral
• Assessment of the stability function of the cervical local and global stabiliser muscle systems:

- Rectus Capitus Anterior & Lateralis and Longus Colli: low load recruitment test
- Rectus Capitus Posterior & Obliquus: low load recruitment test
- Trapezius
- Anterior Stabilisers: functional load test
- Posterior Stabilisers: functional load test
- Identification of Substitution strategies and faulty recruitment patterns
- Elimination of these faulty strategies

Control of Imbalance - Through Range Control

Assessment of Motor Control of the Global Stability Muscle System to Control throughout Range:

• Assessment of the ability of the Global stabilisers to actively shorten and control limb load through the passive inner range of joint motion.
• Observe, test and rate:

- Anterior Stabilisers (Mid - Inner Range)
- Anterior Stabilisers (Mid - Outer Range)
- Posterior Cervico-Thoracic Stabilisers
- Posterior Sub-Occipital Stabilisers
- Assessment of the Global stabilisers with superimposed unilateral bias

[practical] Rehabilitation of the Stability Role of the Global Stability Muscles:

• Facilitate and retrain tonic, low threshold recruitment in the muscle's shortened position to control the inner range of movement
• Retrain eccentric control of functional load throughout outer range
• Progression of stability function for:
• Anterior (flexor) global stabilisers (Longus Colli)
• Posterior (extensor) global stabilisers (Superficial Multifidus, Spinalis and Semispinalis)
• Training with a superimposed unilateral bias (especially rotation)

Control of Imbalance - Extensibility

Assessment of the Global Mobiliser Muscle System:

• Assessment of the length and dominance of the global mobilisers and associated connective tissues.
• Observe, test and rate
• The technique of Active Inhibitory Re-stabilisation's (AIR) is developed
• Implications of using trigger point myofascial release or neural mobilisation as an adjunct to muscle lengthening

[practical] Lengthen and Inhibit Over activity in the Dominant Global Mobilisers:

• Scalenes, Sterno-cleido-mastoid, Hyoids, Levator Scapulae, Upper Trapezius, Ligamenttum Nuchae, Sub-occipital Extensors

Clinical Decision Making and Integration of Local and Global Muscle Recruitment into Function

Cervical Stability Dysfunctions Overview

Rehabilitation Strategies

• Integration of flow chart strategies to develop a framework for dynamic stability progression
• Strategies and priorities for rehabilitation progression
• Development of individual corrective programmes

Functional Integration

Maintenance Programme / Prevention