CERVICAL REGION - SUPINE TRACTION
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1. The patient lies supine on the treatment table.
2. The physician sits or stands at the head of the table.
3. The physician's one hand gently cradles the occiput between the thumb and index finger. The physician's other hand lies across the patient's forehead or grasps under the chin (Figs. 1 and 2). (Use caution in patients with temporomandibular joint [TM] dysfunctions.)
4. The physician exerts cephalad traction with both hands with the head and neck in a neutral to slightly flexed position to avoid extension. The cradling hand must not squeeze the occiput, or the occipitomastoid suture will be compressed (Fig. 3).
5. This tractional force is applied and released slowly. It may be increased in amplitude as per patient tolerance.
6. This technique may also be performed using sustained traction.
7. This technique may be performed for 2 to 5 minutes to achieve the desired effects. It may be especially helpful in patients with degenerative disk disease.
8. In patients with TMJ dysfunction, it may be modified by placing one hand on the forehead instead of the mandible (Fig. 4).
9. Tissue tension is reevaluated to assess the effectiveness of the technique.