Cervical Extension-Rotation Syndrome

Cervical Extension-Rotation Syndrome


Cervical rotation is not precise, with extension or lateral flexion occurring during the motion.  This causes neck pain that is usually worse on one side of the neck in back.  Sometimes there may be arm pain as well.  This pattern coincides with vision or hearing loss because an individual may turn their head to improve their vision or hearing.


  • Forward head posture
  • Asymmetry in muscles of the neck with one side being more pronounced than the other.
  • History of repeated 1 arm overhead activities
  • Extension or lateral flexion with cervical rotation
  • asymmetrical cervical rotation

Kinetic Control / Uncontrolled Movement Tests:

  • Cervical Side-Bend Control – Head Turn Test
  • Cervical Rotation Control – Head Tilt Test
  • Low Cervical Side-Bend Control – Upper Neck Tilt Test
  • Upper Cervical Side-Bend Control – Lower Neck Lean Test


  • Improve control of cervical intrinsic muscles in rotation.
  • Improve control of cervical intrinsic flexor and extensor muscles.
  • Correct scapular and thoracic posture.
  • Identify pain provoking every day patterns and change or eliminate them.

These are primarily sourced from work by the great Shirley Sahrmann PhD. I use these pages as a personal reference for this type of information.


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