Head rotation

Therapist`s aim
To improve head rotation.
Client`s aim
To improve your head rotation.
Therapist`s instructions
Position the patient in sitting or standing. Instruct the patient to sit or
stand with a good posture. Instruct the patient to gently turn their head
to one side, back to neutral and then to the other side. Instruct the
patient to try to rotate a little further each time so that they can see
over each shoulder.
Hold for __ seconds. Client`s instructions
Repeat __ times. Position yourself in sitting or standing with a good posture. Gently turn
your head to one side, back to neutral and then to the other side. Try
to rotate a little further each time so that you can see over your
shoulder.
Progressions and variations
Less advanced: 1. Decrease the amount of rotation. More advanced:
1. Increase the amount of rotation.
Precautions
1. This exercise may cause discomfort but it should not increase your
pain or symptoms. 2. Perform the exercise in a slow and controlled
manner.

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Head rotation in supine
Therapist`s aim
To improve head rotation.
Client`s aim
To improve your head rotation.
Therapist`s instructions
Position the patient in supine with their head on a pillow. Instruct the
patient to gently turn their head to one side and then the other side.
Instruct the patient to try to rotate a little further each time.
Client`s instructions
Position yourself lying on your back with a pillow under your head.
Hold for __ seconds. Gently turn your head to one side and then the other side. Try to
Repeat __ times. rotate a little further each time.
Progressions and variations
Less advanced: 1. Decrease the amount of rotation. More advanced:
1. Increase the amount of rotation until your head is in line with your
shoulder.
Precautions
1. This exercise may cause discomfort but it should not increase your
pain or symptoms. 2. Perform the exercise in a slow and controlled
manner.

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Head rotation propped on elbows
Therapist`s aim
To retrain the muscles at the back of the neck.
Client`s aim
To retrain the muscles at the back of your neck.
Therapist`s instructions
Position the patient in prone propped up on their elbows. Instruct the
patient to push through their elbows to prevent their chest sagging.
Instruct the patient to gently turn their head from side to side.
Client`s instructions
Position yourself in prone propped up on your elbows. Push through
Hold for __ seconds. your elbows to prevent your chest sagging. Gently turn your head
Repeat __ times. from side to side.
Precautions
1. This exercise may cause discomfort but it should not increase your
pain or symptoms. 2. Perform the exercise in a slow and controlled
manner. 3. Do not rotate your neck more than 30 degrees.

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Head turn
Therapist`s aim
To maintain or improve range of motion and stretch tight tissue over
the neck and shoulder.
Client`s aim
To stretch tight tissue over your neck and shoulder.
Therapist`s instructions
Position the patient in sitting with good posture. Instruct the patient to
rotate their head to the side with their contralateral shoulder lowered.
The patient might need to adjust their position to find the maximal
area of stretch by side flexing, extending or flexing their neck or a
combination of all. This will be individual to each patient and their area
Hold for __ minutes.
of tightness.
Client`s instructions
Position yourself in sitting with good posture. Turn your head to the
side with your opposite shoulder lowered. You might need to adjust
your position to find the maximal area of stretch by tilting, extending or
turning your neck or a combination of all as instructed by your
physiotherapist.
Progressions and variations
More advanced: 1. Increase the stretch by turning your head further.
2. Use your hand to assist the stretch.

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Head turn with over pressure
Therapist`s aim
To maintain or improve range of motion and stretch tight tissue over
the neck.
Client`s aim
To stretch tight tissue over your neck.
Therapist`s instructions
Position the patient in sitting with good posture. Instruct the patient to
rotate their head to the side with their contralateral shoulder lowered.
The patient might need to adjust their position to find the maximal
area of stretch by side flexing, extending or flexing their neck or a
combination of all. This will be individual to each patient and their
Hold for __ minutes.
area of tightness. The patient can increase the stretch by over
pressing with the ipsilateral hand.
Client`s instructions
Position yourself in sitting with good posture. Turn your head to the
side with your opposite shoulder lowered. You might need to adjust
your position to find the maximal area of stretch by tilting, extending or
turning your neck or a combination of all as instructed by your
physiotherapist. You can increase the stretch by over pressing with
your hand.

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Isometric neck extension
Therapist`s aim
To strengthen the neck extensors.
Client`s aim
To strengthen the muscles that extend your neck.
Therapist`s instructions
Position the patient in sitting or standing with their hands behind their
head. Instruct the patient to gently push their head into their hands.
Instruct the patient to keep their head still and only use approximately
10% effort.
Client`s instructions
Hold for __ seconds. Position yourself in sitting or standing. Place your hands on the back
Repeat __ times. of your head. Push gently against your hands. Keep your head still
and only use approximately 10% effort.
Precautions
1. This exercise may cause discomfort but it should not increase your
pain or symptoms. 2. Perform the exercise in a controlled manner. 3.
Only use approximately 10% effort.

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Isometric neck flexion
Therapist`s aim
To strengthen the neck flexors.
Client`s aim
To strengthen the muscles that bend your neck.
Therapist`s instructions
Position the patient in sitting or standing with one hand on their
forehead. Instruct the patient to gently push their head into their hand.
Instruct the patient to keep their head still and only use approximately
10% effort.
Client`s instructions
Hold for __ seconds. Position yourself in sitting or standing. Place one hand on your
Repeat __ times. forehead. Push gently against your hand. Keep your head still and
only use approximately 10% effort.
Precautions
1. This exercise may cause discomfort but it should not increase your
pain or symptoms. 2. Perform the exercise in a controlled manner. 3.
Only use approximately 10% effort.

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Isometric neck lateral flexion
Therapist`s aim
To strengthen the muscles in the neck.
Client`s aim
To strengthen the muscles in your neck.
Therapist`s instructions
Position the patient in sitting or standing with one hand on the side of
their head. Instruct the patient to gently push their head into their
hand. Instruct the patient to keep their head still and only use
approximately 10% effort.
Client`s instructions
Hold for __ seconds. Position yourself in sitting or standing with one hand on the side of
Repeat __ times. your head. Gently push your head into your hand. Keep your head still
and only use approximately 10% effort.
Precautions
1. This exercise may cause discomfort but it should not increase your
pain or symptoms. 2. Perform the exercise in a controlled manner. 3.
Only use approximately 10% effort.

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Isometric neck rotation
Therapist`s aim
To strengthen the neck rotators.
Client`s aim
To strengthen the muscles that rotate your neck.
Therapist`s instructions
Position the patient in sitting or standing with one hand on their cheek.
Instruct the patient to turn their eyes towards their hand as if to look
over their shoulder and gently push their head into their hand. Instruct
the patient to keep their head still and only use approximately 10%
effort.
Hold for __ seconds. Client`s instructions
Repeat __ times. Position yourself in sitting or standing. Turn your eyes towards your
hand and gently push your head into your hand while looking over
your shoulder. Keep your head still and only use approximately 10%
effort.
Precautions
1. This exercise may cause discomfort but it should not increase your
pain or symptoms. 2. Perform the exercise in a slow and controlled
manner. 3. Only use approximately 10% effort. 4. Ensure that your
chin is relaxed and pointing down slightly.

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Lifting head off one pillow
Therapist`s aim
To strengthen the neck muscles.
Client`s aim
To strengthen your neck muscles.
Therapist`s instructions
Position the patient lying on one pillow. Instruct the patient to slide
their head up the pillow and nod their head. Instruct the patient to
gently lift their head off the pillow.
Client`s instructions
Position yourself lying on one pillow. Slide your head up the pillow
Hold for __ seconds. and nod your head. Gently lift your head off the pillow.
Repeat __ times.
Progressions and variations
Less advanced: 1. Increase to two pillows.
Precautions
1. This exercise may cause discomfort but it should not cause you
pain or any symptoms. 2. Perform the exercise in a slow and
controlled manner.

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Lifting head off two pillows
Therapist`s aim
To strengthen the neck muscles.
Client`s aim
To strengthen your neck muscles.
Therapist`s instructions
Position the patient lying on two pillows. Instruct the patient to slide
their head up the pillow and nod their head. Instruct the patient to
gently lift their head off the pillow.
Client`s instructions
Position yourself lying on two pillows. Slide your head up the pillow
Hold for __ seconds. and nod your head. Gently lift your head off the pillow.
Repeat __ times.
Progressions and variations
More advanced: 1. Decrease to one pillow.
Precautions
1. This exercise may cause discomfort but it should not cause you
pain or any symptoms. 2. Perform the exercise in a slow and
controlled manner.

Neck extension
Therapist`s aim
To improve neck extension.
Client`s aim
To improve your ability to extend your neck.
Therapist`s instructions
Position the patient in sitting or standing. Instruct the patient to sit or
stand with a good posture. Instruct the patient to gently look towards
the ceiling and return to neutral. Ensure that the patient tucks their
chin in prior to carrying out the movement.
Client`s instructions
Hold for __ seconds. Position yourself in sitting or standing with a good posture. Gently look
Repeat __ times. up towards the sky and return to the upright position. Ensure that your
chin is tucked in prior to carrying out the exercise.
Progressions and variations
Less advanced: 1. Decrease the amount of extension. More
advanced: 1. Increase the amount of extension.
Precautions
1. This exercise may cause discomfort but it should not increase your
pain or symptoms. 2. Perform the exercise in a slow and controlled
manner.

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Neck extension in 4-point kneeling
Therapist`s aim
To strengthen the neck muscles.
Client`s aim
To strengthen your neck muscles.
Therapist`s instructions
Position the patient in 4-point kneeling. Ensure that the patient has
their knees under their hips and their hands under their shoulders.
Instruct the patient to gently draw their belly button towards their
spine, push gently through their shoulder blades and lift their head up
so that it is level with their shoulders. Ensure that their chin remains
tucked in. Instruct the patient to slowly look up towards the ceiling and
Hold for __ seconds.
Repeat __ times. then return to the neutral position.
Client`s instructions
Position yourself in 4-point kneeling. Ensure that you have your knees
under your hips and your hands under your shoulders. Gently draw
your belly button towards your spine, push gently through your
shoulder blades and lift your head up so that it is level with your
shoulders. Ensure that your chin remains tucked in. Slowly lift your
head towards the ceiling. Return to the neutral position.
Progressions and variations
Less advanced: 1. Decrease the amount of extension. More
advanced: 1. Increase the amount of extension.
Precautions
1. This exercise may cause discomfort but it should not increase your
pain or symptoms. 2. Perform the exercise in a slow and controlled
manner. 3. Maintain and hold a safe four point kneeling position while
doing the exercise.

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Neck flexion
Therapist`s aim
To improve neck flexion.
Client`s aim
To improve your ability to bend your neck.
Therapist`s instructions
Position the patient in sitting or standing. Instruct the patient to sit or
stand with a good posture. Instruct the patient to gently flex their neck
and then return to the neutral position.
Client`s instructions
Position yourself in sitting or standing with a good posture. Gently look
Hold for __ seconds. down towards your chest and then return to the neutral position.
Repeat __ times.
Progressions and variations
Less advanced: 1. Decrease the amount of flexion. More advanced: 1.
Increase the amount of flexion.
Precautions
1. This exercise may cause discomfort but it should not increase your
pain or symptoms. 2. Perform the exercise in a slow and controlled
manner.

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Neck flexion and extension in 4-point kneeling
Therapist`s aim
To strengthen the neck muscles.
Client`s aim
To strengthen your neck muscles.
Therapist`s instructions
Position the patient in 4-point kneeling. Ensure that the patient has
their knees under their hips and their hands under their shoulders.
Instruct the patient to gently draw their belly button towards their
spine, push gently through their shoulder blades and lift their head up
so that it is level with their shoulders. Ensure that the patient keeps
their chin tucked in. Instruct the patient to slowly bend their neck
Hold for __ seconds.
Repeat __ times. towards their chest and then return to the neutral position. Instruct the
patient to slowly look up towards the ceiling and then return to the
neutral position.
Client`s instructions
Position yourself in 4-point kneeling. Ensure that you have your knees
under your hips and your hands under your shoulders. Gently draw
your belly button towards your spine, push gently through your
shoulder blades and lift your head up so that it is level with your
shoulders. Ensure that your chin remains tucked in. Slowly lift your
head to look at the ceiling. Return to neutral. Slowly take your chin
towards your chest. Return to the neutral position.
Progressions and variations
Less advanced: 1. Decrease the amount of flexion and extension.
More advanced: 1. Increase the amount of flexion and extension.
Precautions
1. This exercise may cause discomfort but it should not increase your
pain or symptoms. 2. Perform the exercise in a slow and controlled
manner. 3. Maintain and hold a safe four point kneeling position while
doing the exercise.

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Neck flexion and extension propped on elbows
Therapist`s aim
To retrain the muscles at the back of the neck.
Client`s aim
To retrain the muscles at the back of your neck.
Therapist`s instructions
Position the patient in prone propped up on their elbows. Instruct the
patient to push through their elbows to prevent their chest sagging.
Instruct the patient to look at a spot between their forearms. Instruct
the patient to lower their head. Instruct the patient to raise their head.
Ensure that they continue to look down while raising their head.
Hold for __ seconds. Client`s instructions
Repeat __ times. Position yourself in prone propped up on your elbows. Push through
your elbows to prevent your chest sagging. Look down at a spot
between your forearms and lower your head and neck. Continue
looking down while you raise your neck back up.
Precautions
1. This exercise may cause discomfort but it should not increase your
pain or symptoms. 2. Perform the exercise in a slow and controlled
manner.

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Neck flexion in 4-point kneeling
Therapist`s aim
To improve the ability to bend the neck.
Client`s aim
To improve your ability to bend your neck.
Therapist`s instructions
Position the patient in 4-point kneeling. Ensure that the patient has
their knees under their hips and their hands under their shoulders.
Instruct the patient to gently draw their belly button towards their
spine, push gently through their shoulder blades and lift their head up
so that it is level with their shoulders. Ensure that the patient keeps
their chin tucked in. Instruct the patient to slowly bend their neck
Hold for __ seconds.
Repeat __ times. towards their chest and then return to the neutral position.
Client`s instructions
Position yourself in 4-point kneeling. Ensure that you have your knees
under your hips and your hands under your shoulders. Gently draw
your belly button towards your spine, push gently through your
shoulder blades and lift your head up so that it is level with your
shoulders. Ensure that your chin remains tucked in. Slowly take your
chin towards your chest. Return to the neutral position.
Progressions and variations
Less advanced: 1. Decrease the amount of flexion. More advanced:
1. Increase the amount of flexion.
Precautions
1. This exercise may cause discomfort but it should not increase your
pain or symptoms. 2. Perform the exercise in a slow and controlled
manner. 3. Maintain and hold a safe four point kneeling position while
doing the exercise.

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Neck flexion in sitting
Therapist`s aim
To strengthen the neck muscles.
Client`s aim
To strengthen your neck muscles.
Therapist`s instructions
Position the patient sitting in a chair with their head resting on the wall.
Instruct the patient to slide their head along the wall and nod their
head. Instruct the patient to gently take the weight of their head off the
wall.
Client`s instructions
Hold for __ seconds. Position yourself sitting in a chair with your head resting on the wall.
Repeat __ times. Slide your head along the wall and nod your head. Gently take the
weight of your head off the wall.
Progressions and variations
Less advanced: 1. Keep the chair close to the wall. 2. Decrease the
hold time. More advanced: 1. Move the chair away from the wall. 2.
Increase the hold time.
Precautions
1. This exercise may cause discomfort but it should not cause you
pain or any symptoms. 2. Perform the exercise in a slow and
controlled manner.

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Neck flexor/extensor stretch
Therapist`s aim
To stretch or maintain range of the neck.
Client`s aim
To stretch or maintain range of your neck.
Therapist`s instructions
Position the patient with their head facing forwards. Instruct the patient
to flex then extend their neck.
Client`s instructions
Position yourself with your head facing forwards. Bend your neck
forwards then straighten your neck upwards.
Hold for __ minutes.
Precautions
1. Only administer after attaining medical approval.
2. Stop with first signs of pain.
3. Impaired or absent sensation of stretch.

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Neck lateral flexion
Therapist`s aim
To improve neck lateral flexion.
Client`s aim
To improve side bending of your neck.
Therapist`s instructions
Position the patient in sitting or standing. Instruct the patient to sit or
stand with a good posture and their head centred. Instruct the patient
to gently laterally flex their neck to one side. Instruct the patient to
return to the centre and then gently laterally flex their neck to the other
side. Inform the patient that they may feel a gentle neck stretch.
Hold for __ seconds. Client`s instructions
Repeat __ times. Position yourself in sitting or standing with a good posture. Centre
your neck. Gently bring your ear down towards your shoulder. Return
to the centre. You should feel a gentle stretch in the side of your neck.
Progressions and variations
Less advanced: 1. Decrease the amount of lateral flexion. 2. Perform
this exercise in sitting. More advanced: 1. Perform this exercise in
standing. 2. Increase the amount of lateral flexion.
Precautions
1. This exercise may cause discomfort but it should not increase your
pain or symptoms. 2. Perform the exercise in a slow controlled
manner.

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Neck lateral flexor stretch
Therapist`s aim
To stretch or maintain length of the lateral neck flexors.
Client`s aim
To stretch or maintain length in the muscles at the side of your neck.
Therapist`s instructions
Position the patient with their head facing forwards. Instruct the patient
to laterally flex their neck to bring their ear towards their shoulder.
Ensure that the head faces forwards.
Client`s instructions
Position yourself with your head facing forwards. Move your neck to
Hold for __ minutes. the side to bring your ear towards your shoulder. Ensure that your
head faces forwards.
Precautions
1. Only administer after attaining medical approval.
2. Stop with first signs of pain.
3. Impaired or absent sensation of stretch.

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Neck retractor strengthening
Therapist`s aim
To strengthen the neck retractors.
Client`s aim
To strengthen the muscles at the back of your neck.
Therapist`s instructions
Position the patient in sitting with your hand behind their head. Instruct
the patient to retract their neck. Apply resistance.
Client`s instructions
Position yourself sitting with someone`s hand behind your head. Push
your head backwards into their hand. Ensure that you tuck your chin
Perform __ sets of __ reps. in.
Do__ sessions per week.
Precautions
1. Seek medical clearance for patients with recent injuries.

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Neck rotation in 4-point kneeling
Therapist`s aim
To strengthen the neck muscles.
Client`s aim
To strengthen your neck muscles.
Therapist`s instructions
Position the patient in 4-point kneeling. Ensure that the patient has
their knees under their hips and their hands under their shoulders.
Instruct the patient to gently draw their belly button towards their
spine, push gently through their shoulder blades and lift their head up
so that it is level with their shoulders. Ensure that their chin remains
tucked in. Instruct the patient to slowly turn their head to look over
Hold for __ seconds.
Repeat __ times. their shoulder and then the other shoulder. Ensure that the head does
not drop down.
Client`s instructions
Position yourself in 4-point kneeling. Ensure that you have your knees
under your hips and your hands under your shoulders. Gently draw
your belly button towards your spine, push gently through your
shoulder blades and lift your head up so that it is level with your
shoulders. Ensure that your chin remains tucked in. Slowly turn your
head to look over one shoulder and then the other shoulder. Ensure
that your head does not drop down.
Progressions and variations
Less advanced: 1. Decrease the amount of rotation. More advanced:
1. Increase the amount of rotation.
Precautions
1. This exercise may cause discomfort but it should not increase your
pain or symptoms. 2. Perform the exercise in a slow and controlled
manner. 3. Maintain and hold a safe four point kneeling position while
doing the exercise.

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Neck rotator strengthening in sitting
Therapist`s aim
To strengthen the neck rotators.
Client`s aim
To strengthen your neck muscles.
Therapist`s instructions
Position the patient in sitting with your hand on the side of their
forehead. Instruct the patient to rotate their neck. Apply resistance.
Client`s instructions
Position yourself sitting with someone`s hand on the side of your
forehead. Rotate your head into their hand.
Hold for __ seconds.
Precautions
Repeat __ times.
1. Only administer after attaining medical approval.
2. Do not apply excessive resistance.
3. Stop with first signs of pain.

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Neck rotator stretch
Therapist`s aim
To stretch or maintain length of the neck rotators.
Client`s aim
To stretch or maintain length in the muscles at the side of your neck.
Therapist`s instructions
Position the patient with their head facing forwards. Instruct the patient
to rotate their head to the side. Ensure that the head remains upright.
Client`s instructions
Position yourself with your head facing forwards. Turn your head to
the side. Ensure that your head remains upright.
Hold for __ minutes.
Precautions
1. Only administer after attaining medical approval.
2. Stop with first signs of pain.
3. Impaired or absent sensation of stretch.

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