Upper Cervical Therapy
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Palpatory Examination in Upper Cervical Therapy

Two men. Before therapy (gray), the left upper cervicals (medium finger, lower one) lie forwardly as compared to the tip of the mastoid process (index, upper finger). As a result of therapy (sepia), the upper cervicals move backwards. This symmetrization appears regularly as soon as the digastric muscle has been relocated.

In people not yet treated with respect to upper cervical asymmetry, the left upper cervicals (C1, C2) lie forwardly as compared with the tip of the mastoid process before therapy . The mobility of the atlas and axis is severely limited. A high pressure and pain sensitivity is noticeable when reviewing the position of the left axis extension. 

That state is exchanged with a new state whereby the atlas and axis oscillate elastically and symmetrically between the mastoid processes. On the left side, they have gone back with respect to the previous state and are no longer pressure-sensitive. The axis takes its position just below the mastoid tip, the atlas is  easy to palpate just behind the mastoid tip.

From left to right: before treatment (gray), after treatment (sepia), after vibratory retuning (blue). From top to bottom: father, mother, adult son.

Following the digastricus muscle relocation, a gentle vibratory therapeutic measure onto the muscles of the upper cervical region and of the shoulder girdle ensues, so that the upper cervicals (C1, C2) find their position even better according to the symmetrically established muscles. The vibratory stimulation of the muscles leads to the phenomenon that the axis, as it were, is swinging back and forth like a shuttle. The palpatory access to the atlas is also facilitated, because the tone of the upper cervical muscles has softened in particular on the right hand side. According to later palpations, symmetry is usually maintained and easily detected. A qualitative change has taken place that now guarantees optimal physiological conditions concerning the head-neck junction. 

Two boys aged approximately 8 years before (gray) and after (sepia) therapy. In children, palpatory findings and treatment outcome are clear-cut.

Concerning palpation, there are two distinct states: Either the left posterior digastric muscle exerts pressure on the upper cervicals or not. In between, there are no transitory states:

  • In the first case, due to the head protrusion, one palpates the wedged-formed neck, whereby the scalene muscles (Musculi scaleni) are positioned in front and laterally of the cervical vertebrae, the hard, sunken in upper cervical muscles, and the left axis transverse process tending to the left border of the mandible.
  • In the second case, one palpates the rounded neck, whereby the scalene muscles surround the spine in a balanced way, the protruding, much softer upper cervical muscles and the displaceable axis transverse process just below the tips of the mastoid processes.

In very rare cases, the left axis transverse process is hidden behind the left border of the mandible. This was, for example, the case in a woman who suffered simultaneously of strong weekly migraine without aura, chronic tension headache and long-term whiplash effects. Diagnostically, the question is how close the transverse process is being positioned at the border of the mandible, and whether it has gone behind it.

One should not be looking for the left atlas transverse process; it is positionned in the retromandibular space, which is very sensitive to pain. However, it makes sense to palpate the right axis transverse process which is positioned medially and parietally of the right mastoid tip.