The patient lays supine while the therapist palpates the spinous process of C2 with the thumb and index finger. The therapists opposite hand grasps the top of the head and adds slight compression to ensure desired movement will take place at C1-C2.
The patient's head is sidebent to one side with the axis of rotation is taking place through the nose. The therapist should immediately feel the spinous process of C2 move in the opposite direction of the head. The head should not be sidebent more than 15 degrees. The opposite side is then tested and compared.
• The left alar ligament is tested during the sidebending right motion and vice versa for the opposite direction.
• A positive test is an onset of symptoms or failure of the C2 spinous process to immediately move during passive sidebending of the head.
