C&T muscle strength

• Muscle Strength:

  • cervical spine
  • craniocervical flexors
  • cervicothoracic extensors
  • thoracic spine
  • serratus anterior
  • lower trapezius
  • advanced strength
  • thoracic rotation and scapula-thoracic strength
• Craniocervical flexors (deep neck flexors):

  • pts position: supine, cervical spine in neutral and forehead level using towel under occiput
  • cue pts to slide back of head up towel and eye to follow imaginary line along ceiling
  • axis of movement is occurring through the pts ear
  • looking for a small nodding movement, not cervical retraction
  • check for over-activity in superficial muscles as they should be relaxed throughout
  • put tongue on roof of mouth the help
  • can progress with holds and headlifts
• Cervicothoracic extensors:

  • pts positions: 4 point kneeling
  • cue pts to look between hands then lower head to look at thighs
  • return to starts position
  • movement to be initiated from the lower cervical spine whilst maintaining good cervical spine throughout
  • look out for compensatory movement through the upper cervical spine
• Serratus anterior:

  • has a role in stabilising the scapula
  • pts position: 4 point kneeling
  • tell pts to round their chest and push shoulder blades apart
  • maintain this whilst increasing weight through limb by lifting off other arm, then can lift leg off
  • look out for winging of scapula of weightbearing limb to indicate weakness
  • can also do a modified version in a wall push-up position
• Lower trapezius:

  • has role in stabilising the scapula on the thoracic wall
  • cue pts to pull scapula towards the opposite back pocket
  • assess ability to perform movement without overactivity in latissimus dorsi and upper traps