Cervical Muscular Retraining

Reference:Jull et al 1999, Further clinical clarification of the muscle dysfunction in cervical headache. Cephalgia 19 (3):179-185

(This is a brief summary taken from the DNF protocol of The Whiplash Physical Diagnostic Clinic, Department of Physiotherapy, University of Queensland)

Details on muscular retraining are in the “Cevical Headache” Video/Book program. For a 30 day free trial option visit the “APTEI Videos” section of this web site.


  • It is a highly skilled technique that requires the Physiotherapist to be extremely precise for it o be effective
  • Test position in supine with the cervical spine (Cx) in neutral position
  • Position the Pressure biofeedback in the sub-occipital region (not mid cervical) and inflate to 20mmHg
  • Instruct the patient to nod ?yes? to target 22mmHg and hold the position steadily. If successful, progressively target 24, 26, 28 and to a maximum of 30mmHgCorrect performance:

    1) Satisfactory performance is at least 26mmHg holding a steady contraction for 10 by 10 seconds 2) NO superficial muscle activity is present

    Poor Performance:

    1) Too quick (most common) 2) Overshooting target 3) Phasic contraction of the superficial muscles 4) Patient retracts neck instead of pure UCx flexion

    Note: Evaluating and training with a PBU is deemed necessary. Although training without the PBU is possible, it has been clinically shown to not be as effective!

    Clinical Relevance: The greater over-activity present in the SCM, UFT, Scaleni and Sub-occipital muscles, the more it indicates poor segmental stability control.

    If you are interested in purchasing a pressure biofeedback unit ($175), please contact: 1-866-APTEI-44 or 905-707-0819

    Posted on: May 16, 2002

    Categories: Cervical Spine

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