Upper cervical mobilization . The physical therapist uses the bottom hand to stabilize the segment while the top hand moves the segment gently . The therapist may hold this position as a stretch or perform gentle oscillatory ( to and fro ) movements .
Neck flexor strength and endurance exercise . A towel is place under the neck . The patient is instructed to gently nod his head by bringing his chin towards his throat . This position may be held for 10 to 20 seconds , and repeated based on the ability to perform correctly .
Another component of physical therapy treatment Another component of physical therapy treatment includes deep neck flexor muscle strength and endurance training . Strengthening the deep neck flexor muscles will assist in the maintenance of upright posture ; therefore , decreasing muscle tension and stress in the head and neck . Initially , training begins in the supine position ( Figure 5 ), and eventually is progressed to other positions such as sitting or standing .
The physical therapy interventions described above are commonly implemented with individuals who suffer from CTTH . This is not an exhaustive list , however . The physical therapist may elect to utilize additional interventions that are patient specific to ensure an individualized treatment plan is executed . Since physical therapy has proven to be effective for individuals who suffer from CTTH , it should be considered as a part of the comprehensive treatment plan . It is essential that the physical therapist works together with other members of the individual ’ s healthcare team to provide optimum care . HW
Recommended Reading
1 . Castien R et al . The working mechanism of manual therapy in participants with chronic tension type headache . JOSTP 2013 ; 43:693-699 .
2 . Fernandez de las Penas C . Clinical reasoning for manual therapy management of tension type and cervicogenic headache . JMMT 2014 ; 22 : 45-51 .
3 . Jull G et al . Clinical assessment of the deep cervical flexor muscles : The Craniocervical Flexion Test . J Manipul Physiol Ther 2008 : 31:525-533 .
4 . Winkel D . Differential diagnosis of the spine . Nonoperative Orthopeadic Medicine and Manual Therapy . Austin , TX : PRO-ED , Inc ; 1996 .
30 HeadWise ® | Volume 6 , Issue 1 • 2016