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  • Dr Andrew Smy

Axis and Axles

“It hurts to look over my shoulders while driving”, is a phrase we’ve heard all too often in the practice and is often one of the first signs clients notice before experiencing more concerning symptoms. If you have said this or know some who has read on.


The act of looking over your shoulders is called cervical rotation and is primarily carried out by C2 the second vertebrae in your spine. Also referred to as the Axis, C2 is the main provider of rotation normally allowing for 80 degrees rotation over each shoulder. This means you should be able to keep your shoulders still and rotated or twist your head around enough so your chin is in line with your shoulders. A common way of compensating for a lack of rotation is to twist your entire body and shoulders and although this may allow you to look over your shoulder while driving it shows your lacking the ability to rotate fully and there is restriction to C2.





Restriction to C2 means you’ve lost the ability to fully rotate 80’ this is called a subluxation, and can have a detrimental effect on your nervous system. Commonly restriction to C2 is associated with headaches due to the location of its referral pattern but if left untreated for long enough can cause a breakdown of structures elsewhere in the body too. As every moving joint provides the nervous system with information, a restricted joint will reduce that amount of information. Which will result in a loss of control and function such as a muscle weakness, change in weight bearing or even balance. This is how a subluxation at C2 could be the true root cause for lower back pain despite the two areas being at opposing ends of the spine.


The good news is not only can we identify subluxations by identifying a painful restricted joint with an associated neuromuscular change but we as clinicians can also treat and resolve them. Meaning not only can you look over your shoulders better again but the headache or lower back pain resolves as well.


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