One of the main reasons that my clients come in to see me is because they have some significant neck or upper back pain. Now there is a common reason for most of this and it generally has to do with the forward head posture. You see that there are a lot of things in our lives that are pulling the head forward. Things like a c-section or work that we do sitting at a desk a lot, doing a lot of work that requires foreword flection, nursing babies, these sorts of things. They all tend to pull our head forward and down. Even things like spending too much time on our smartphones will have a negative impact on our neck and back.
So with all these things, of course the right way to approach the massage therapy is to work with the core issues first. If the core issues have to do with posture at work, then the client needs to take responsibility for that and change something with how they do their work. Whether that’s getting a different desk, uh, perhaps a standup desk, perhaps doing a job that doesn’t require sitting so much. There needs to be something that happens that changes in their day to day life or the problem is going to keep on coming back. Of course the massage therapist will be happy to see you again, but any good massage therapist does not want a client to come to them over and over and over again for the same problem. A good massage therapist will want to deal with the core issues and then have the client move on and having resolved the problem. Some of the problems are not so much an external force like sitting at the wrong desk. Other problems can be from previous surgeries. These also can pull the head forward and down. Things like a car wreck.
We’ll do that as well and impact with the seatbelt. We’ll place tension on the chest, the tension on the chest. We’ll pull the head forward and will pull the neck forward as well. This is going to increase the strain on the neck two ways. The first is by having that head forward posture, it exponentially increases the weight that the muscles have to bear on the back of the neck. And the second is that the front muscles are actively pulling down. So those back muscles has to fight against two things. I have to fight against the extra weight and they have to fight against the front muscles that are too tight. So a great place to start with this is to release the muscles that are in the front first. Everything from the abdominal muscles all the way up to the sternum and other muscles that are called the s c muscles, the sternocleidomastoid muscles. These muscles have the job of pulling the head forward. And if they are not released, we’re never going to get that head back into a neutral position. So as a massage therapist is working, he is going to notice the intricacies of the various clients. He’s going to notice why the head is being pulled forward is not just the fact that it’s being pulled forward, but we need to know why so that we can deal with the problem more effectively. So after we have released the front muscles, then we can go to release some of the muscles in the back. Some of the muscles that have a lot of trouble in the back are the trap muscles. These tend to get very, very tense and very, very hard. We love to have the massage and rubbed. It feels good. Sometimes it feels painful as well if they are extremely tight, but we need to get these muscles relaxed and we need to take the Fascia of the muscles and bring it back and down. The same thing needs to happen with the scaly muscles.
These are the muscles that are on the side of the neck that give the neck some stability. If these scalings particularly the scalings in the front are not released, then the head again is going to be pulled forward, so we need to release these scalings as well. When the massage therapist is releasing the scalings, he needs to pay particular attention to the cues that the client gives him. If the client is feeling tingling or numbness in their hands, this is a clue that the massage therapist is inadvertently putting extra pressure on some of the nerves that come out of the neck. These nerves, they go out of the neck and through the scaliness and so if their scalings are tight, this can lead to finger tingling, finger numbness, hands falling asleep, that sort of thing. Once these scalings have been released as well, then we want to make sure that the neck bones have the mobility that they need. They need ability to move from side to side. They need the ability to move forward and back. They need the ability to rotate from side to side as well. When the massage therapist gives the client this ability, then the neck muscles can relax. They don’t have to do as much work as the neck slowly starts to go back into position, so the massage therapist has released the muscles in the front of the neck. The massage therapists are really at least the muscles in the on the sides of the neck and he has also released the bones of the neck so that they can have the ability to move. Now incidentally, along with this, when massage therapy is coupled with chiropractic work, particularly if the massage is done first, then the chiropractor is able to do his or her work much more effectively and much more quickly and much more permanently because now the body is ready to accept the chiropractic inputs.
So with all of these releases in the neck, now it is time to physically take the neck back, take the head back and put it back on the shoulders. So what the massage therapists will do is have the client come back on the table so that her head is completely off the table and resting in the massage therapists hands. This is where it is very important for the massage therapist to have already established trust with the client. If the client trusts the massage therapists, then she will relax her head into his hands knowing that it is safe, knowing that he is not going to do something that is going to hurt her. At this point, the massage therapist can lightly traction the head backwards and downwards, down towards or backwards and um, and superior. This is going to have the effect of taking the neck back and the client will feel a noticeable difference. They will often feel a difference in the base of their throat because the Fascia that had been in the throat had been used to that forward head posture and had kind of tightened into that position. Now that the Fascia has been released and the neck has been released, now the head can come back and it’ll feel a little bit strange in the throat. But as the body gets used to the new position and can relax into it, that Fatia will relax as well and the tension will come off of it. This is an excellent way to reduce a forward head posture. So a good massage therapist will know both why there is a forward head posture and we’ll be able to do something about it.