C1-C2 Traction Manipulation (sitting)

Position of the therapist:

• Standing behind the patient in a split stance

Position of the patient:

• Patient is in sitting position with the feet on the ground
• Patient leans backwards comfortably against the lateral side of the therapist’s thigh
• Patient’s head at the height of the therapist’s abdomen

Hand placement:

• Cervical spine in flexion
• Upper cervical spine sub-maximally rotated to contralateral side
• Hypothenar eminence against the patient’s arch of C1 from caudally with other hand on top for stability

Direction of the manipulation:

• Cranially by supinating the forearms and adding slight knee extension