Restricted Cervical Rotation?Then try looking where you?re going!

Reference:Interesting reference on the Occulo-motor system: Tjell C, Rosenhall U. 1998. Smooth pursuit neck torsion test: A specific test for cervical dizziness. The American Journal of Otology 19, 76-81

Loss of ?normal? cervical rotation is a common clinical challenge and can be frustrating to treat when patients don?t respond to passive mobilizations, self-stretches and various modalities.

I have had patients referred to me by other Physical Therapists, to perform cervical manipulations on them with the hopes of regaining ROM.

I have rarely ?needed? to apply cervical manipulations as I rely on other treatment options. One valuable tool I will share with you

Clinicians need to appreciate the power of occulo-motor function and its influence on cervical ROM.

Personal Comment:Translation: Prior to asking a patient to turn their head/neck, ask them to look in the same direction they are heading and continue to look in the same direction they are turning (e.g. say, ?face straight ahead? now look all the way to the left with your eyeballs? now turn your head to the left? ?repeat the process 5-10 times.

The PT may use his or her index finger to guide the eye movements (i.e. say, ?follow my finger?. You can be amazed by the immediate improvement in the ROM in some patients.

Try this experiment on yourself: (Not on real patients!)

1) Face straight ahead and look with your eyeballs only, to your left.

2) Now keep looking to your left and turn your head slowly to the right?go as far as possible/comfortable.

3) Once you have reached your ?end of range?, now look with your eyeballs to the right?and notice a significant and sometimes dramatic gain in ROM.

Note #1: This experiment works on most individuals, but not all!

Note #2: Do not attempt this experiment if it induces dizziness or nausea?it may actually cause vomiting in some individuals; especially those with whiplash associated dizziness.

Posted on: April 04, 2002

Categories: Cervical Spine

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