Sometimes it is an unusual suspect, a less well-known muscle, that is the underlying cause of our client’s pain and dysfunction pattern.
Tension Headaches
A tension headache is caused by excessive pulling force of tight muscles in the back of the neck that exert tension on their attachments on the head.
Forward Head Posture
Forward head posture is extremely common, especially as we age. It is part of a larger posture dysfunctional pattern known as upper crossed syndrome.
Greater Occipital Neuralgia
Greater occipital neuralgia is caused by compression of the greater occipital nerve, usually by a tight upper trapezius or semispinalis capitis muscle.
Thoracic Outlet Syndrome
Thoracic outlet syndrome is a condition that causes compression of nerves and/or blood vessels where the thorax outlets into the upper extremity.
Osteoarthritis of the Cervical Spine
The causative mechanism of osteoarthritis is excessive physical stress placed on the joint, resulting in cartilage and then bony degeneration.
How do we treat piriformis syndrome with manual therapy?
Manual therapy treatment for a tight piriformis (that can cause piriformis syndrome) involves moist heat, soft tissue manipulation, and stretching.
Hypertonic / Tight Musculature of the Neck
Tight musculature is the most common presenting complaint that a manual therapist will confront and is a component of every neck musculoskeletal condition.
Fascial Adhesions of the Neck
Fascial adhesions may bind together the two opposing surfaces of a soft tissue interface, resulting in restricted mobility.
Sprains and Strains (Whiplash) of the Neck
A whiplash is named for the characteristic whiplike motion of the person’s head/neck during a car accident, usually resulting in strain/sprain of the neck.
Signs, symptoms, and assessment (diagnosis) of piriformis syndrome
Piriformis syndrome causes compression upon the sciatic nerve; therefore it causes symptoms of sciatica, similar to sciatic nerve entrapment at the spine.
Joint Dysfunction of the Cervical Spine
A joint functions to allow motion, so two forms of joint dysfunction exist: Hypomobile joint has restricted motion; Hypermobile joint has excessive motion.
Pathologic Disc Conditions of the Neck
The danger with a disc bulge or herniation is that the disc can compress the spinal nerve within the intervertebral foramen, causing a pinched nerve.
What are the self-care and medical approaches to treating a pathologic disc?
Self care for a herniated disc: avoid postures/activities that increase stress upon the disc and stretching/strengthening the musculature around the disc.
What is piriformis syndrome and what are its causes?
Piriformis syndrome occurs when a tight piriformis muscle compresses against the sciatic nerve, causing symptoms of sciatica into the lower extremity.
Motions of the Cervical Spine
Table 1 shows average healthy ranges of axial motion of the cervical spine (head and neck), from the atlanto-occipital joint through the C7-T1 joint.
Manual Therapy Precautions When Working the Neck
It is essential to exercise caution when working the anterior neck. However, this should not prevent therapeutic manual therapy work to the anterior neck.
Musculature of the Cervical Spine
To perform orthopedic manual therapy to the neck that is accurate and specific, we need to know the attachments and actions of the muscles of the neck.
Ligaments of the Cervical Spine
The “action” of a ligament is similar to that of an antagonist muscle. If either is tight/taut, it restricts motion in the opposite direction.
Cervical Spinal Joints
The disc joint is a cartilaginous joint that is composed of outer fibers called the annulus fibrosus that encircle the inner nucleus pulposus.
Introduction to the Cervical Spine
It is extremely important to be able to locate and palpate the laminar groove of the cervical spine because the thickest musculature is located there.
How we assess (diagnose) Tennis Elbow?
Assessment (diagnosis) of tennis elbow is done with active and passive range of motion, manual resistance, and palpation.
What are the self-care and medical approaches to Tennis Elbow?
Self-care for tennis elbow should include frequent stretching of the hand and fingers into flexion. If inflammation is present, icing should be done.
What are the signs and symptoms of Tennis Elbow?
Symptoms of tennis elbow include pain and tightness at the common extensor belly/tendon, directly distal to the lateral epicondyle of the humerus.
A manual therapy case study on overpronation.
Case Study: Kerrati came in for wellness massage, but during the postural examination, the therapist noticed that her right arch drops markedly.
Signs, symptoms, and assessment (diagnosis) of overpronation
The first and most obvious sign of overpronation is a flat foot / dropped arch. A supple flat foot loses the arch only when weight bearing.
