C2 Anterior Glide (SNAG) for Cervicogenic Dizziness / Vertigo

Reference:Mulligan BR. Manual therapy ??NAGS,?? ??SNAGS,?? ??MWMS?? etc. Wellington, New Zealand: Hutcheson Bowman & Stewart Ltd; 2010.

Indication: Dizziness / vertigo with cervical extension / looking up


  • Place thumbs on C2 SP and apply a GENTLE anterior glide straightforward and ask the patient to look up very slowly as long as symptom free. If the dizziness is still reproduced with extension, STOP!
  • Simultaneously adjust the direction of the glide and angle the thumb cranially as the patient extends the neck.
  • Maintain the anterior glide until the patient returns to neutral.
  • If the patient reports some dizziness or cervical pain, then either the range of active movement is decreased, the angle of the glide is slightly altered or the point of application is changed to ensure the mobilization is symptom-free.
  • Perform up to 5 times. In future sessions you may increase to 10 reps and may hold end range for a few seconds.
  • If technique works, their dizziness / vertigo with extension will be resolved or dramatically reduced.
    Posted on: October 10, 2010

Categories: Headache/Vertigo , Cervical Spine

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