Sternocleidomastoid Special Tests

Anterior Neck Flexors Strength Test

To do:

With the client supine, the therapist gets them to abduct their arm 90 degrees, flex their elbow to 90 degrees and rest the back of their hands on the table.

The client then does chin tucks and lifts their head off the table.

The therapist applies pressure downward if the client is able to keep their head off the table by themselves.

Positive sign:

The client is unable to keep neck flexion against gravity or therapist’s pressure

Antero-Lateral Neck Flexors Strength Test

To do:

With the client supine, the client abducts their arm to 90 degrees, flexes their elbows to 90 degrees and rests the back of their hands on the table.

The client then rotates their head away from the side being tested, while the therapist stabilizes the side being tested.

The client then lifts their head into slight flexion and holds it agains gravity.

If the client is able to do that, the therapist applies pressure in the oblique postero-lateral direction, away from the tested side.

Positive sign:

Weakness  of the anterolateral neck flexors if the client is unable to keep the neck flexion against gravity. Therapist pressure 

Swallowing Test

To do:

With the client seated, the therapist palpates and pincer grasps the SCM.

The therapist locates the most tender point and places firm pressure on the most tender points along the SCM and directs the client to swallow.

Positive sign:

Pain diminished when the client swallows 

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