Starting Position

Head level, looking straight ahead.

Ending position

Face parallel to the ceiling.

Clinical Significance

Although the extent of motion is usually best checked with passive motion (to exclude loss of motion due to motor failure), many physicians are reluctant to test head and neck motion passively–it’s too reminiscent of something from pro wrestling. (ie, potentially harmful!)

The atlanto-occipital joint is responsible for approximately 50% of neck flexion and extension; the rest is distributed among the lower vertebrae.

Limitations here could be from generalized arthritis, scoliosis or pain due to cervical nerve root compression.