Yoga as Therapeutic Exercise: A Practical Guide for Manual Therapists

4. Basic exercises for the shoulder girdle and the cervicothoracic junction4. Basic exercises for the shoulder girdle and the cervicothoracic junction 5. Basic exercises for the cervical spine, head, and temporomandibular joint5. Basic exercises for the cervical spine, head, and temporomandibular joint
   5. Basic exercises for the cervical spine,
   head, and temporomandibular joint

We have summarized these three areas together as there

is a close connection between them. The head, neck, and

jaw are called the stomatognathic system. All the mus-

cles connecting these areas as well as the shoulder girdle

are in constant, dynamic cooperation. “The efficiency of

this balancing system contributes to effective function of

the mouth, throat, cervical spine and head, as well as the

thorax and upper limb” (Stone 1999, p. 227 ). The hyoid

bone plays a central role in this system; it connects the

shoulder girdle, mandible, and cranium.

Where there are problems with the temporoman-

dibular joint a dental investigation should be carried

out first. In addition gentle local mobilization often

releases tension. In many cases the posture and move-

ment patterns of other areas of the body are involved

and have to be corrected. The mandible can move up

and down, forwards and backwards, and to both sides.

All these movements are combined in chewing. When

you open your mouth the mandible moves forwards;

it moves backwards when the mouth is closed.

These complex connections require particular

mindfulness for the position and movements of the

head. The head should be kept in the midline as far

as possible, and the movements should be performed

in a gentle, mindful way. Particularly vulnerable areas

of the upper cervical spine are the ligaments and the

vertebral artery. If there is any dizziness or there are

neurological signs and symptoms, stop the exercise

immediately. If the symptoms continue then medical

investigation should be sought as quickly as possible.

To protect this vulnerable area during exercising we

recommend awareness during any exercise, precise

positioning of the head, particularly in back-bending,

rotations, and inversions, and strengthening the cer-

vical muscles (Roth 2009). Refining the head move-

ments, particularly rotation, so that the superficial

throat muscles stay relaxed, strengthens the deep

stabilizing muscles and protects the cervical spine.

Exercise 5.1: Atlas and axis

Aim: mobilizing the upper cervical spine.

1. Lie on your back with your abdomen and
   lumbar area relaxed, your shoulders relaxed and

your head resting comfortably; use a pillow for

your head if necessary (Figure 6.105).

2. Very gently roll your head to the right as you
   exhale; with the inhalation bring it back to the
   center, gently lengthening the neck (Figure 6.106).


3. Very gently roll your head to the left as you
   exhale; with the inhalation bring it back to the
   center, gently lengthening the neck.

Figure 6.105

Figure 6.106