Transverse Ligament Stress Test

Original Editor - Tamara Eller and Audrey Pittman

Top Contributors - Tamara Eller, Audrey Pittman, Rachael Lowe, Evan Thomas and Tony Lowe


Test for hypermobility of the atlantoaxial articulation

Technique [1]

  • The patient is placed in a supine postion with the Therapist supporting the patient's head with the palms and 3rd-5th fingers.
  • The Therapist then places the index fingers between the occiput and spinous process of C2, so the index fingers are over the neural arch of the C1 vetebra.
  • The Therapist then lifts the patients head and C1 vetebra anteriorly, without allowing flexion or extension.
  • The position should be held for 10-20 seconds.
  • A positive test is the recurrence of symptoms:
    1. Abnormal pupil response
    2. Eye twitching or nystagmus
    3. Soft end feel
    4. Muscle spasm
    5. Dizziness
    6. Nausea
    7. Paresthesia of the lip face or limb
    8. Lump sensation in the throat


Provide the evidence for this technique here


Pettman E: Stress tests of the craniovertebral joints. In: Boyling, JD, Palastanga N, eds. Grieve's Modern Manual Therapy: The Vertebral Column, 2nd edn. Edinburgh: Churchill Lingstone, 1994:529-538.

