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3.10.2B.

Therapy for the scalenus anterior and medius.

AIternative grip.

Starting Position: P: Supine; head and neck beyond couch end; shoulders positioned at couch edge.T: Standing at head of couch, facing left side of P's head.

Grip: T’s right hand grips P’s chin (without pressing on the larynx). T’s right forearm supports the right side of P’s head against T’s chest. Ts left thumb is placed just below P’s clavicle with the thenar and hypothenar over P’s lst and 2nd ribs.

Procedurę: Step one: Using this grip, T positions P's cervical spine in fuli rotation to the right while also laterally flexed to the left and slightly dorsally flexed.

Step two: T then asks P to exhale while he/she presses P’s lst and 2nd ribs caudally and dorsally. T simultaneously applies traction to P’s cervical spine, and moves his/her body together with P’s head. Step two is repeated until considerable improvement is attained.

Stimulation of Antagonists: T moves left hand to occiput. with the index finger hooked on P’s mastoid process. T then asks P to look to the right, rearwards and upwards, and press head and neck in dorsal flexion. T resists that movement to stimulate P’s antagonists.

Notes: It is important that P exhales as T stretches and inhales when resisting.

The finał position may move the vertebrae into a locked position.

Therefore, T must cautiously use successively smaller forces and movements in approaching the finał position.

If the movements at the costotransverse and/or costovertebral joints are restricted, T must begin treatment by mobilizing P’s first rib.

The sternocleidomastoideus will also be fully stretched if P's occiput is positioned in ventral flexion and laterally flexed to the left.

Fig. 66 a. Starting Position.

-ig. 66 b. Finał Position.

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