Issue link: https://www.massageandbodyworkdigital.com/i/68012
WORKING WITH THE CERVICAL CORE In the previous article (Myofascial Techniques: "Preparing the Neck and Shoulders for Deep Work," Massage & Bodywork, January/ February 2009, page 120), I talked about how taking time to release superficial restrictions, before working deeper structures, can increase your effectiveness and give longer-lasting results. In this article, we'll look at ways to assess and release deeper neck restrictions. Since it is part two of the earlier article, I'll assume you've done some work to release and prepare the superficial fascial layers before attempting the techniques here. As in the first article, I'll draw on the myofascial work as taught in my workshop series. You can see video related to these techniques and tests by visiting Massage & Bodywork's digital edition, which features a video clip from the 2009 DVD Advanced Myofascial Techniques for the Neck, Jaw, and Head from Advanced- Trainings.com. The link is available on ABMP.com and Massageandbodywork.com. NOD TEST The Nod Test allows us to assess three important things: • Freedom at the atlantooccipital (AO) joint. • The ability of the posterior compartment of the neck (Image 1) to lengthen. • The degree of participation of the "prevertebral" muscles along the front of the cervical spine. These each contribute to the alignment, flexibility, and stability of the neck, particularly in head- forward positions (cervical lordosis).1 Begin with your client sitting or standing. While looking at his or her profile, ask for small nodding motions. We want just a little bit of movement—too much will make the initiation of movement hard to see. Ask yourself: Which neck joint moves first? Which joint or joints are flexing and extending in these small nodding motions? If it is hard to see these things, ask your client to make even smaller motions, while you look for the very first joints that move. You can also use your hands to feel for this initiation, if it still isn't clear to your eyes. This simple small-nodding test helps you find where most of your client's cervical flexion and extension typically occurs. By implication, you can determine if there is freedom at the topmost joint of the neck, the AO joint. When the soft-tissue structures around the AO are free, small nodding motions will happen primarily here, allowing the head to balance and rock on the atlas like a seesaw (Image 2). When it is present, this top-of- the-neck freedom gives a sense of lightness and poise. If the motion looks like it is happening lower in the neck instead of at the AO, it could indicate restrictions in the suboccipital or transversospinalis muscles. When the soft-tissue structures around the atlantooccipital joint are free, small nodding motions will happen primarily at the top of the neck, allowing the occiput to balance and move on the atlas like a seesaw.2 visit massageandbodywork.com to access your digital magazine 123