Abstract :

Stretching seeks to increase performance by promoting flexibility. In addition to muscle strength and endurance training, flexibility training is a crucial part of physical conditioning programs. A joints or group of joints’ potential range of motion can be used to describe flexibility. Post-facilitation stretching techniques are important to increase muscle flexibility and may be the technique of choice in therapeutic practice. It uses a mechanical stimulus in order to trigger several neurophysiological responses, which may include hypoalgesia sympathetic responses, neuromuscular adaptations, kinesthetic sensibility improvements and changes in biomarkers levels. A 28-year male patient came to OPD with pain in suboccipital region and right-side upper neck since last 6 days. He was having history of heavy weight lifting in gym and due to repeated weight lifting patient is having severe pain. On observation patient right shoulder is elevated due to hyperactive right upper trapezius muscle. Tenderness is present over suboccipital region and over right upper trapezius. On examination left cervical side flexion Range of motion is restricted and having spasm of upper trapezius and suboccipital muscles. Physiotherapy treatment was given for 6 days. This case report shows the application of post facilitation stretching over upper right-side trapezius and suboccipital muscle along with cervical spine mobilization to have a greater improvement.

---

Keywords :

cervical spine mobilization, chronic neck pain, post facilitation stretch, suboccipital region, trapezius

---

References :

1. Rampazo, P.; da Silva, V.R.; de Andrade, A.L.M.: Sensory, motor, and psychosocial characteristics of individuals with chronic neck pain: A case-control study. Phys. Ther. 2021, 101:104.
2. Rojas, E.A.; Pluma, A.F.; Pecos-Martín, D.: Relationship between neuromuscular mechanosensitivity and chronic neck pain in guitarists: A cross-sectional study. Int. J. Environ. Res. Public Health. 2021, 18:2673.
3. Nunes, ; Petersen, K.; Espanha, M.; Arendt-Nielsen, L: Sensitization in office workers with chronic neck pain in different pain conditions and intensities. Scand. J. Pain. 2021, 21:457-473.
4. Strom, ; Roe, C.; Matre, D.; Knardahl, S: Deep tissue hyperalgesia after computer work . Scand. J. Pain. 2012, 3:53-60.
5. Roldán-Jiménez, C.; Pérez-Cruzado, D.; Nebblett, R.; Gatchel, R.; Cuesta-Vargas, A: Central sensitization in chronic musculoskeletal pain disorders in different populations: A cross-sectional study. Pain Med. 2020, 21:2958-2963.
6. Kim, H.; Kim, C.J.; Son, S.M: Neck pain in adults with forward head posture: Effects of craniovertebral angle and cervical range of motion. Osong Public Health Res. Perspect. 2018, 9:309-313.
7. Mahmoud, N.F.; Hassan, K.A.; Abdelmajeed, S.F.; Moustafa, I.M.; Silva, A.G: The relationship between forward head posture and neck pain: A systematic review and meta-analysis. Curr. Rev. Musculosket. M 2019, 12:562-577.
8. Morishita Y, Falakassa J, Naito M, Hymanson HJ, Taghavi C, Wang JC: The kinematic relationships of the upper cervical spine. Spine. 2009, 15:2642-5. 1097/BRS.0b013e3181b435e4
9. Kang J, Chen G, Zhai X, He X: In vivo three-dimensional kinematics of the cervical spine during maximal active head PLoS One. 2019, 16:0215357.
10. Physical Therapy. 1988, 68:314-20.
11. Jadav M, Patel D: Comparison of effectiveness of post facilitation stretching and agonist contract-relax technique on tight Indian Journal of Physical Therapy. 2015, 11:70-5.
12. Ahmad N, Akram MJ, Hussain H, Imtiaz I, Khan N, Qi L: Effectiveness of post facilitation stretch technique versus myofascial release in piriformis syndrome: A Randomized controlled trial. Rawal Medical Journal. 2022, 11:936. 3233/BMR-181290
13. Grant KE, Riggs A: Myofascial releas
14. Barnes MF: The basic science of myofascial release: morphologic change in connective tissue . Journal of bodywork and movement therapies. 19971, 1:231-8. 1016/S1360-8592(97)80051-4
15. Palomeque-del-Cerro, L.; Arráez-Aybar, L.A.; Rodríguez-Blanco, C.; Guzmán-García: R.; Menéndez– Aparicio, M.; Oliva-PascualVaca, A. A systematic review of the soft-tissue connections between neck muscles and dura mater: The myodural Spine. 2017, 42:49-54. 10.1097/BRS.0000000000001655
16. La Touche, R.; Fernandez-de-las-Penas, C.; Fernandez-Carnero, J.; Díaz-Parreño, S.; Paris-Alemany, A.; Arendt-Nielsen, L: Bilateral mechanical-pain sensitivity over the trigeminal region in patients with chronic mechanical neck J. Pain. 2010, 11:256-263.
17. Grice AS: Muscle tonus changes following manipulation . J Can Chiro 19741, 8:29-3.
18. Herzog W: Mechanical and physiological responses to spinal manipulative treatments . J Neuromusculoskel Sys. 1, 1:1-9. 1016/S1529-9430(02)00400-X
19. Lewit K: Post isometric relaxation in combination with other methods of muscular facilitation and Man Med. 1986, 2:101-104. 10.5772/intechopen.111590