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The cervico-thoracic junction (C-T junction) is a key area for the function of the neck, shoulder and thoracic spine. The most common problem that is encountered in this region is that the upper thoracic spine and lower cervical spine becomes “stuck” in flexion (flexion DSM).

This is common with a forward head posture and also in workers that need to look down for long durations. This is particularly a problem for massage therapists, physiotherapists, osteopaths and chiropractors who are often standing while treating patients in a lying position.

As with any area of restriction, if movement can’t occur in one area (hypomobile segment) another area will compensate by moving more (hypermobile segment). This compensation can cause pain and dysfunction if it is not controlled. Common dysfunctions with restrictions at the C-T junction can cause painful symptoms in middle cervical extension, head rotation, shoulder extension and thoracic rotation.

While hands on techniques are very effective to mobilise the C-T junction, I would also recommend teaching your clients/patients how to self-mobilise. This is particularly important if they are intending on maintaining a sport or exercise training regime. If the client can be taught 1-2 simple techniques to mobilise the hypomobile areas they will at least be able to start the activity in reasonable condition.

Here are two of my “go to” mobilisation exercises that I use on a regular basis with clients:

1. Neck mobiliser

This is a safe, non-aggressive technique that can be performed anywhere. This mechanism of this technique is the use of the scapula-spinal muscles creating a “toggling” effect on upper thoracic spine as the head turns from side to side. Paul Chek introduced me to this exercise many years ago and I’ve had many clients enjoy it since.

• Hold arms straight out to the side and stay relaxed.
• Inhale, turn your right arm up and left arm down and look down the left arm.
• When you naturally want to exhale, turn your head to the other side and reverse arm positions
• Repeat 10 times each side.

 

2. Foam roller neck mobiliser

I was shown this exercise by Suzi Nevell – physiotherapist and CHEK practitioner. This technique uses a posterior glide of the cranium and neck while the roller is placed on the hypomobile segment to “encourage” movement into extension.

 

• Place hypomobile segment on the edge of the roller with elbows point to ceiling
• Inhale, when you naturally want to exhale, glide your head towards the floor positions
• Return to start position on inhale
• Repeat 10-15 times

 

Please trial these techniques on yourself and your fellow workers before use on your patients/clients. Many of you will personally benefit from performing these exercises. There are several hands on techniques and accompanying strengthening techniques that I also commonly use for the C-T junction. These exercises are from the Musculoskeletal Corrective Exercise Workshop 16-18 April throughout New Zealand.