Today’s episode of “old man shouting at clouds” is putting the head joints and neck joint episode and the Coupling myths episodes to practical clinical use and treatment suggestions.

Apparently I can now embed photos and pics so we will see how it goes.

Last week I posted on a proposal that we should look at the head joints and neck joints as two different entities due to their differing anatomy and function. I discusse dhow the head can move independently of a fixed neck, or paradoxically. Yesterday I reviewed the sagittal

Plane, today I will discuss how oe May utilize and apply the principles to functional rotation and side bending to treat headaches and head joint stiffness and differentiate between head v neck joint issues.

Below is an illustration of normal range of motion for functional head and neck rotation and side bending.

There are two patterns of movement loss that commonly occur in patients, one which seems obvious and one not so obvious. Lets discuss the less obvious and sometimes confusing pattern of loss. Below is loss of left rotation and right side bending.

This can often be confusing clinically to have losses of motion in opposing directions. If we go back and think about my proposals, in the neck functional rotation and side bending are the same in the neck. When one side bends right the AA joint (head joints) rotate paradoxically

Remember the video I posted see below. It wil demonstrate this
Thus right side bending requires AA head rotation to the left to keep the face looking forward.

If the patient presents with loss of side bending to the right and loss of functional rotation to the left, I will propose this is a restriction of the head joints, not the neck complex below C2.
Remember the mouth is the plane and nose is the axis of motion

The exercise demonstrated below can be a useful exercise for such movement restriction and concomitant headaches. This motion is often stiff and very sensitive, so cautious application and gentle exercises is recommended.

The second common motion loss is loss of functional rotation and side bending to the same side (see below) using the same principles one can propose that this is due to restriction in the joints of the neck not the head as having full right rotation means the AA joint moves...

To the right fine and is thus not restricting left sid bending (a bit of mental gymnastics is definitely needed to remember and visualize this) equally if right side bending is full it means the AA joints can rotate fully to the left and can thus not be the restrictor of left

Functional left rotation. This may take a bit of time to absorb and work with to get the implications and use of head v neck joint motion.
Remember side bending & rotation are the same for the neck joints biomechanically hence the restriction is in the neck joints
As seen below

The treatment self movement for this issue is actually to utilize sagittal neck motion, that was described yesterday. The neck responds best by doing sagittal motion even when restrictions are unilateral. So Rabbit ears, retraction and or retraction extension are the choice.

Of self treatment exercises.
I know this requires some thought and a bit of playing about with the concepts and principles. Understanding the head joints v neck joints can have good clinical parasitical applications.

As always thanks for reading.

@threadreaderapp unroll please