Improve movement, restricting pain with movement, and functional restriction. If mulligan technique is indicated it will show immediate improvement in pain and movement.
NAGS (Natural Apophyseal Glides)--restore movement without pain—used for cervical spine and upper thoracic spine.
-useful in elderly, acute neck presenting with gross loss of movement
-mid-range to end-range facet jt mobs that are applied anterio-superiorly along the treatment planes of the jts. ( the glide is in the true direction of treatment planes—if glide in ventral before gliding up you will produce pain)
-performed in sitting
-can do traction with glides and can do varying degree of flex/ext(make sure the head is not SB or rotated)
-can be done for rotation by placing the little finger on the articular pillar on the restricted side.
Reverse NAGS – mobilizing the inferior facet on the one above.
SNAGS ( sustained Natural Apophyseal Glides)
-follow the treatment plane rule
mobilization are combined with active or passive mvts and end range overpressure
applied to most spinal jts
they are painless, if they are indicated
the glide is sustained throughout the motion even when returning to starting position
can be done with thumb on spinous process or can be done unilaterally on the articular pillar
Fist traction—for increasing cervical flexion
--if fist to small to limit painful flex can use other hand on sternum or a book under the chin as a wedge.
--hold for 10 sec and repeat 3x. It can be done for HEP.
SMWAM—spinal mobilization with arm movement
--use when pt has pain with UE mvt that could be