Still technique is a passive technique, meaning the patient should not be actively contracting their muscles. It is both indirect and direct. Remember that Still technique is performed by placing the patient in a position of ease (indirect portion), applying a vector force (compression or, less commonly, distraction), then moving the dysfunctional area back to the position of restriction (direct portion). The starting position will always be the patient’s somatic dysfunction (position of ease), and the final position will always be the patient’s restriction (barrier). Since compression is used more frequently than distraction as a vector force, this technique’s sequence can easily be remembered as “ease, compress, barrier.”

Refer to the “Diagnosing cervical somatic dysfunction” learn page to obtain a proper diagnosis prior to beginning treatment with Still technique. This treatment can also be performed in the supine position by following the same steps.

Treatment

1. Stand behind or in front of the seated patient
2. Place your 1^st or 2^nd finger at the base of the occiput on the side of somatic dysfunction, and your other hand on top of the patient’s head
3. Flex or extend, side bend, and rotate the head and neck into the patient’s somatic dysfunction (position of ease)
4. Apply gentle axial compression from the top of the head to the level of the OA joint
5. While maintaining the compression, reverse the flexion / extension, side bending, and rotation component until they are positioned into their restriction (barrier)
6. Gently release the compression and return the head and neck to neutral position

Refer to the “Diagnosing cervical somatic dysfunction” learn page to obtain a proper diagnosis prior to beginning treatment with Still technique. This treatment can also be performed in the supine position by following the same steps.

Treatment

1. Stand behind or in front of the seated patient
2. Place your 2^nd finger on the posterior aspect of the transverse process of C1 on the side of somatic dysfunction, and your other hand on top of the patient’s head
3. Rotate the head and neck into the somatic dysfunction (position of ease)
4. Apply gentle axial compression from the top of the head to the level of the AA joint
5. While maintaining the compression, rotate the head and neck in the opposite direction (barrier)
6. Gently release the compression and return the head and neck to neutral position

Refer to the “Diagnosing cervical somatic dysfunction” learn page to obtain a proper diagnosis prior to beginning treatment with Still technique. This treatment can also be performed in the supine position by following the same steps.

Treatment

1. Stand behind or in front of the seated patient
2. Place your 2^nd finger on the posterior aspect of the articular pillar of the dysfunctional segment, and your other hand on top of the patient’s head
3. Flex or extend, side bend, and rotate the head and neck into the patient’s somatic dysfunction (position of ease)
4. Apply gentle axial compression from the top of the head to the level of the dysfunctional segment
5. While maintaining the compression, reverse the flexion / extension, side bending, and rotation component until they are positioned into their restriction (barrier)
6. Gently release the compression and return the head and neck to neutral position

Refer to the “Diagnosing rib somatic dysfunction” and “Rib HVLA” learn pages to obtain a proper diagnosis of the 1^st rib prior to beginning treatment with Still technique. Recall that your fingers are placed in the patient’s supraclavicular fossa and are used to assess both the superior / inferior movement and motion upon springing of the first ribs.

Treatment

1. Stand behind the patient
2. Place one hand on the dysfunctional rib to monitor motion, and the other hand on top of the patient’s head
3. Movements differ slightly between inhalation dysfunctions and exhalation dysfunctions:
   • For inhalation dysfunctions (1^st rib is stuck in elevated position) – side bend the head and neck away from the dysfunctional rib (position of ease)
   • For exhalation dysfunctions (1^st rib does not fully elevate) – side bend and rotate the head and neck toward the dysfunctional rib, while flexing the neck until motion at the 1^st rib or T1 is felt (position of ease)
4. Apply gentle axial compression from the top of the head to the dysfunctional rib
5. While maintaining the compression, reverse the side bending (and rotation and flexion / extension components for exhalation dysfunctions) until they are positioned into their restriction (barrier)
6. Gently release the compression and return the head and neck to neutral position