Presencing: Locate yourself in the here and now.

Touching, contacting or holding the body part for a few breaths as you presence yourself. Not classically “doing anything” like a massage stroke, but rather favoring being with, noticing, and being generous with your appreciative listening. Drop into one or more “Presencing” cues like the “Loop of Attention” practice as you wonder what else you might notice inside you and outside of you?

PAPA-PCR Step 2: Assessing Supine Neck

ASSESS
Assess target location, ROM & feedback Assess the exact location where your client is experiencing the most sensation, immobility, or challenge and confirm that you are in the accurate location with your client’s feedback. Assessing and moving the structure through its natural and safe ROM as client and/or therapist describes what they notice (give and receive feedback)

PAPA-PCR Step 3: Progressive Stretching Supine Neck

PROGRESSIVELY STRETCH
Progress from the end-feel of ROM into Light then Medium and finally Deep expressions of the stretch. Traction the joint to create space prior to and during mobilization to encourages optimal spaciousness and functional alignment 

PAPA-PCR Step 4: Advanced Tools Supine Neck

ADVANCED TOOLS

Utilizing static or moving massage therapy techniques with positive pressure (soft fists, forearms, percussion tools) and/or negative pressure (cupping, K-taping)

PAPA-PCR Step 5: Pin & Stretch Supine Neck

PIN & STRETCH OR GLIDE & MOVE
Therapist statically presses (“Pins”) and/or gradually slides (“Glides”) the stroke as they facilitate client’s joint movement(s) blending ROM and/or stretching (generate multiple variations combing pressure and movement)

PAPA-PCR Step 6: Call for Motion Supine Neck

CFM (Call For Motion) and/or PNF (Proprioceptive Neuromuscular Facilitation)

In CFM, therapist pins or glides pressure over targeted area as client perform the movement instructions given by the therapist. Pin or Glide with Soft Fist or Soft Knuckles on Traps (near Scalenes attachment at rib) while client moves through lateral flexion for 2-3 reps on each side. *If the client can ’t move through full ROM, you may be pressing too deeply; clients will receive better results by reducing pressure so that maximum call for motion can be experienced. *Hint* You will be required to demonstrate and explain several CFMs during your hands-on final exam.

Also consider adding advanced stretching interventions like PNF, which combines client’s gentle activation of the agonist muscle for three repetitions of 5 seconds on, and 10 seconds off (during the client’s lax 10-second phase, therapist may invite safe, deeper ROM as available).

PAPA-PCR Step 7: Reassess Supine Neck

REASSESS

Reassess ROM, pain scale and give/exchange feedback about what you and your client noticed. Did anything change? Stay the same? Better? Worse? Get details and descriptive words from client and communicate your own observations and recommendations. This may be where you offer a healing move or at-home therapies.