Alar Ligament Test
Original Editor - Rachael Lowe
Top Contributors - Rachael Lowe, Admin, Tony Lowe, Evan Thomas, Kim Jackson, Scott Buxton, George Prudden, Kai A. Sigel, WikiSysop and Claire Knott
Purpose
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To assess the integrity of the alar ligaments and thus upper cervical stability.
Technique
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With the patient in supine, place one hand on the occiput and use the other hand to palpate the spinous process of C2. Laterally flex or rotate the head to one side; you should feel the spinous process move to the opposite side. Repeat on the other side. Absence of the spinous process moving to the opposite side may indicate alar ligament injury. If you block the spinous process of C2 from moving, you may stress the ligament. You should encounter a firm end-feel in this case. Significant movement may indicate ligamentous injury.
Clinical texts state that tests should be performed in 3 positions: neutral, flexion, and extension.
The range of craniocervical rotation during rotation stress testing of intact alar ligaments should typically be 21 degrees or less[1].
Evidence[edit | edit source]
Both side-bending and rotation stress testing have been validated to result in a measurable increase in length of the contralateral alar ligament[2].
Resources[edit | edit source]
add any relevant resources here
Recent Related Research (from Pubmed)[edit | edit source]
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References[edit | edit source]
- ↑ Osmotherly PG, Rivett D, Rowe LJ.. Toward understanding normal craniocervical rotation occurring during the rotation stress test for the alar ligaments. Phys Ther. 2013 Jul;93(7):986-92. doi: 10.2522/ptj.20120266.
- ↑ Osmotherly PG, Rivett DA, Rowe LJ. Construct validity of clinical tests for alar ligament integrity: an evaluation using magnetic resonance imaging. Phys Ther. 2012 May;92(5):718-25.
