8.9 Cervical spine C2–7
Up-slope gliding
Assume somatic dysfunction (S-T-A-R-T) is identified and you wish to use an upward and forward thrust, parallel to the apophysial joint plane, to produce joint cavitation at C4–5 on the left (Figs 8.42, 8.43).
4 Operator stance
Stand in front and to the right of the patient, feet spread slightly. Adjust couch height so that you can stand as erect as possible and avoid crouching over the patient as this will limit the technique and restrict delivery of the thrust (Fig. 8.44).
5 Palpation of contact point
Place the fingers and palm of your left hand against the patient’s right occiput and neck, gently covering the patient’s right ear. Use the index or middle finger of your right hand to palpate the patient’s left articular pillar of C4. Slowly but firmly slide your applicator along the articular pillar of C4 until it approximates the proximal or middle phalanx (Fig. 8.45). Several sliding pressures may be necessary to establish close approximation to the contact point.
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