Screening the Neck with Repeated Movements and Planning the Next Steps

Using wrist extension and grip strength on a hand-held dynamometer as baselines, Richard explains to Lisa why the neck is worth screening, then tests cervical range of motion and finds stiffness in extension and left rotation. Repeated retraction does not change the elbow but eases the rotation stiffness, so he progresses to retraction with extension and then adds a small side-to-side movement at end range. Afterwards the elbow baselines improve and left rotation is free. To rule out simple pain modulation, repeated protrusion brings the pain back and further retraction with extension abolishes it again. With one indicator from the history and three from the exam, Lisa fits the 38% of patients in the research whose elbow pain had a spinal source. The plan is a trial of the neck exercise, six or seven repetitions five or six times a day, with a roll behind the back when sitting and reassessment if nothing changes. Richard and Georg close by noting that this test-retest reasoning fits any MSK approach.