What Is Atlantoaxial Instability?

The atlantoaxial joint is located between the first two vertebrae of the spine, C1 (atlas) and C2 (axis).  It is responsible for the rotating and tilting movements of the head in relation to the neck. When there is too much flexion and movement around the neck region, it creates atlantoaxial instability. This can lead to pain and hypermobility of the neck.


How Does This Happen?

Looking down at our screens and sitting for long periods of time can contribute to a posture where there is a forward tilt of the hips, spine, and head instead of a neutral alignment. Furthermore, this means that sitting forward for an extended time will cause the hips to tilt forward and a restricted rib cage which then leads to uneven shoulders and can result in excessive movement of the neck. This is because the shoulders and neck help to balance the head on top of the body. With this asymmetry and surrounding weak muscles and ligaments, it creates atlantoaxial joint instability.

Signs of Atlantoaxial Instability

  • Noticeable forward head tilt
  • Difficulty maintaining neutral shoulder alignment
  • Pain and tenderness around the neck, shoulders, and upper back


How Do You Fix Atlantoaxial Instability?

To address atlantoaxial instability, it is important to focus on restoring lumbo-pelvic alignment and stability. We would recommend the following exercises:

  • Release – sternocleidomastoids and suboccipitals – 60 sec each
  • Activate – deep cervical flexors – quadruped cervical flexion 2 x 2min
  • Integrate – Laying cobra with neck flexion 2 x 20
  • Strengthen – standing neck flexion with band and band scaption 2×20