Recall: Diagnosing the OA

Steps for Treatment:

NEUTRAL, COMPRESSION, EASE

1. The patient is supine with the physician standing or seated at the head of the table.
2. The physician places a hand under the occiput of the patient using the index finger and thumb to monitor.  The finger and thumb should be placed just posterior to the mastoid processes and the patient’s head should be supported by the palm of the physician’s hand.
3. Neutral
   • The head is flexed (Ex: OA E RlSr) slightly to bring the OA into neutral position on the atlas
4. Compression
   • The physician adds a gentle caudad compression down to the OA (basiocciput), until softening of the tissues occurs– do NOT compress to the point where you see movement in the toes
5. Ease
   • While maintain compression, move the OA joint into its ease – all 3 planes. (Ex: OA E RlSr: Extension, rotate left, sidebend right)
     • Side bending and Rotation: create a translative force with your index finger (monitoring hand; in this example, the left hand):
       • Sidebend right (left rotation): Apply translative force right to left w/ left index finger
       • Sidebend left (right rotation): Apply translative force left to right w/ right index finger
6. Hold Compression for 3-5 seconds
7. Release compression and return to neutral
8. Reassess

Video Tutorial: