Suboccipital Stretch

Suboccipital Stretch Purpose: To increase muscle length of the suboccipitals. Origin: Occiput Insertion: C1 and C2 Action: Upper cervical extension Step 1: 0:40 With the patient lying supine, assist them to angle themselves on the table so that their head rests on the corner of the table away from the face cutout. Step 2: 1:00 Lift the patients head and palpate to find the spinous process of C2. Step 3: 1:10 You will stabilize C2 by utilizing the “Karate Hand”. Contact just above the C2 spinous process with the radial border of your index finger. The rest of your fingers will be stacked beneath it in a karate chop fashion and stabilized against the table. Be sure to keep your fingers rigid so that your karate hand does not collapse during the stretch, compromising your stabilization. Your stabilizing arm will be fixed against the table to increase stability. Step 4: 1:45 Cradle under the patients head with your stretching hand, put your shoulder against the patient’s forehead; be sure to stand in a lunge position to protect your own back. Step 5: 2:04 First apply a posterior glide to the occiput with your shoulder to ensure that C2 is being blocked by your karate hand. Then, scoop with your stretching hand to produce cranial flexion (nod), bringing the patient’s occiput away from C2. If you have stabilized effectively, it will only take a small amount of flexion to achieve a stretch. Ask your patient to identify the location and intensity of the stretch to ensure that your technique is effective. Hold the stretch for a cumulative 90-150 seconds. Evidence: Leal & Dennison, 2011. ISC 21.1.3 pp.19