Therapist Notes – Semispinalis cervicis

This is almost always relieved when atlas is mobilized. That can be done with a number of techniques including cranial, intra-oral and anterior cervical NMT.

This protocol loosens the suboccipital region, which, as a rule of thumb, is the first step in treating around the cervical spine.


This pain pattern is often used as an indicator that the atlas is anterior. The pain pattern usually dissipates when the atlas is properly mobilized.

Now that the suboccipital region is loosened, the next step is to evaluate and mobilize the atlas. I like the intraoral mobilization but some therapists and clients are not comfortable with that and prefer using the transverse processes. This post has pages from the manual for evaluation and mobilization of the atlantooccipital joint.


This pattern may linger when trigger points around the 5th cervical are still active. This cervical lamina routine is a solid approach to releasing those muscles.

Stretching and other techniques can be used to stabilize the musculature around the upper cervicals and prevent the atlas from being wedged forward again. Lengthening the scalenes and other musculature in the lower anterior cervicals allows the base of the neck to support the correction of Forward-Head posture.


This site is undergoing changes. Starting in early 2020, we began changing the format of the posts to include more extensive self-care, illustrations, therapist notes, anatomy, and protocols. We’d love your feedback. We are adding posts and converting the old posts as quickly as time permits.


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Can’t Reach the Pain
Under the Shoulder Blade

This pain and tension under the shoulder blade may be the most common pain pattern that I see. It isn’t always the primary complaint as people have gotten used to the constant ache.

It is usually combined with this pattern in the upper neck, which creates upper neck tension to go with the shoulder blade pain.

Tony Preston has a practice in Atlanta, Georgia where he sees clients. He has written and taught about anatomy, trigger points and cranial therapies since the mid-90s.

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