DO NOT Stretch the neck...if neural!
Reference:Hall T, Elvey R. 1998 Adverse mechanical tension in the nervous system? Analysis of straight leg raise. Manual Therapy 1998; 3(3):140-146
Pain and “stiffness” over the supra-scapular region is common, however it is imperative to determine if the source of the symptoms is muscular, articular or neural tissue.
If the appropriate neurodynamic testing (formerly known as upper limb tension testing) is positive, the symptoms may be neurogenic.
Clinical Relevance: Do NOT stretch the protective muscles such as upper fibers of the trapezius (UFT), scalenes or pectoralis minor if symptoms are related to neural irritation, just as one would not stretch the hamstrings in a patient with “sciatica”.
Clinical Relevance #2: Too often primarily neural patients who have persisting supra-scapular region pain are performing self-UFT stretches, which in fact is maintaining the sensitivity of the neural tissue. (Even though the stretching “feels good” at the time!)
Personal Comment: Also give these patients advice on avoiding talking on the phone with head tilted away, sleeping on stomach, carrying a heavy purse on the shoulder and “heavy” bra straps as they are sometimes a significant contributing factor.
Posted on: February 12, 2002
Categories: Cervical Spine
