Tuesday, June 30, 2009

The Nuchal Ligament

The what? That's what probably many think when they here that. The nuchal ligament is a ligament that runs from the base of your external occipital protuberance (the bump on the back of your head) to the spinous process of the 7th cervical vertebrae. (the last bone of your neck). For a long time, it was thought that it wasn't a major player in restraining cervical flexion. New studies have shown that it is a primary restrainer of flexion, so it's role was vastly underestimated! Not only this but there is now evidence that there is continuity between the nuchal ligament and the dura at the atlanto-occipital interspace. In laymens terms this suggests that the nuchal ligament has a role of some sort in cervicogenic headaches. It is also important for keeping the proper curve of the neck.

Recent theories have even surfaced that it is one of the reasons human being have the ability to run. How cool is that! Glute max, the achillies tendon and the nuchal ligament are what many scientist believe we need to propel our bodies across the world and not just slowly walk.

So we know that the nuchal ligament is important, we also know it's obviously a ligament. With this knowledge what do we do with it? Ligaments are passive, which means they are active without our control. Ligaments and bones are passive restraints. Muscles would be active. If a passive structure hurts, it would hurt when someone moved it for us. If an active structure hurts, it would hurt when we move it, but not when someone moves it for us. So we must look at what active structures limit cervical flexion, if we get those stronger, it will in turn ensure the nuchal ligament stays strong and healthy and able to function.

Over the next few weeks we'll look more closely at these muscles and some exercises you can do to strengthen them.


Anonymous said...

The nuchal ligament is attached to the tip of the 7th cervical ligament, the Vertebral prominens(VP). I have suggested in a clinical tip in the Canadian Family Physicians Journal, Dec 2006, that firm pressure on the VP (Google: Mohan, Clinical sign, Depression screening)is a three second screen for depressive symptoms. Those without depressive symptoms are surprisingly painless on palpation on this site. People without a diagnosis of depression but who have sub treshold depressive symptoms will be positive for pain at this site. Unpublished data (Mohan, McLean et al.) has shown a statistically significant correlation with the Zung depression rating scale. For further info, email Dr. Frank Mohan at tonky@xplornet.com

Frank said...

New Contact information for Dr. Frank Mohan regarding "A Three Second Screen for Depressive Symptoms": tonkynato@gmail.com

Frank Mohan MD, FCFP.

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