Purpose: To facilitate improvements in cervical ROM and to diminish cervical pain. 

Start:  The patient is positioned in prone with towel under forehead to facilitate neutral spinal alignment. The therapist stands at the patients head and leans slightly forward, so that their shoulders are directly over the top of the desired segment. 

Procedure: The PT locates and places a dummy thumb over the spinous process of desired cervical segment with the other thumb on top, then provides a posterior to anterior glide in the direction of the patient’s eyes (grades I-IV) as appropriate. To facilitate unilateral motion, PT places dummy thumb on transverse process of segment to be mobilized, then places the mobilizing thumb atop the dummy thumb.  PT applies P-A force in direction of patient’s eyes as appropriate (grades I-IV).

Comments: If dummy thumb purchase is not well tolerated, PT can place thumbs on transverse processes of targeted spinal segment.