Cervical Extension Syndrome

Cervical Extension Syndrome


Pain is in the back of the neck with possible pain along the nerve paths.  This may go in between the shoulder blades or into an arm (rarely both arms).  Sometimes there may be headaches at the back of the head.  This pain is due to poorly controlled motion into cervical extension and poor posture resulting in excessive cervical extension (forward head posture).

Diagnostic Tests:

  • Forward head posture or kyphotic thoracic and lumbar spine.
  • Younger patients demonstrate excessive motion into cervical extension while older patients usually demonstrate decreased motion.
  • Anterior translation accompanies cervical flexion, especially in supine.
  • Posterior translation with extension in prone or quadruped.

Kinetic Control / Uncontrolled Movement Tests:

  • Upper Cervical Extension Control Tests
  1. Backward Head Lift Test
  2. Horizontal Shoulder Retraction Test
  • Mid-cervical translation (during extension) Control Tests:
  1. Head Back Hinge Test
  2. Chin Lift Hinge Test


  • Correct scapula and thoracic spine posture.
  • Correct cervical posture
  • Deep cervical flexor training – sitting, supine, with arm movements
  • Taping as neede
  • Intrinsic cervical extensor training

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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