Case Report: Can Myofascial Release increase Cervical Flexion

The subject of my most recent case report is: Can myofascial release increase cervical forward flexion?
This client was in an accident several years ago. She suffered a head injury and still has headaches (mostly on the top of her head) and difficulty flexing her chin toward her chest.

Goniometers are tools used to measure range-of-motion.

The plan is for the subject to rate her pain on a scale of 1-10. I will then measure the ROM pre-treatment, apply myofascial release to the appropriate muscles, then re-measure to see if any change has been made.

All measurments and procedures used, and for what duration will be recorded in the first and subsequent sessions. The client will refrain from other treatments such as PT and chiropractic during this time. The duration for this study will be 1 30-minute session, 1x/week for 4 weeks.

Photo courtesy of ABMP

Pain Relief for racers at Bayfield Race Week!

My colleague, BeckySue, and I are providing massage for the racers during Bayfield Race Week 2012 in Bayfield, WI. As a pain relief specialist I want to know how I can best help them. To answer my own questions, I thought about what kinds of pain people who sail might have. I thought more and I tried to mimic some of the repetitive actions used in sailing to get more ideas. I researched pain associated with sailing. I even interviewed someone from the Wayzata Yacht Club.

What I found out was that most people have pain between their shoulder and their neck. Many have forearm pain in an area that we massage therapists call the "wad of three," (For more information about forearm pain, please read my blog post entitled Tour De Cycling Anatomy). Still others have low back pain and knee pain.
There is a famous quote by Ida Rolf, a founder of the structural integration types of bodywork. It goes: "Where you think it is, it ain't." I want to relieve pain by correcting postural malalignment, breaking up adhesions, restoring muscles to a more normal resting length and freeing nerves that may be entraped by soft-tissue.

When Bayfield Race Week racers come to me for their massage, I will provide a brief but solid assessment: Is one shoulder higher or lower? More anterior? Do they stand with a forward bend?When they stand, do I see the back of the hands? These types of observations give me clues about the kind of pain they may be experiencing.  For example, if I see a high shoulder on the right, I can lengthen the muscles that elevate the shoulder. On the low side, I can restore the shoulder depressors to a more normal resting length. Similarily if I see a lot of the back of their hands, I know that the "medial rotators of the humerus" will need some TLC. If they bend forward when standing, I can lengthen the muscles that flex the hips, thereby taking some strain off the muscles that are stuck check reining the spinal flexion.

So... you might be wondering what does all of this mean to the Bayfield Race Week racers, in English?  It means that I use Precision Neuromuscular Therapy techniques to address structural shifts, restore muscles to a more normal resting length, relieve trigger points that can refer pain, and free nerve entrapments. People LOVE the way they feel when they are closer to neutral balance alignment and the work feels GREATwhile it is being performed!

Thanks for reading and have a remarkable, pain-free Bayfield Race Week!

Gina McCafferty, LMT
Pain Relief Specialist

What do you mean by "Pain Relief Specialist"?

Many people have heard me, a L.M.T., say “I’m a Pain Relief Specialist” or “I help people have less pain and more range-of-motion” and I get such varied responses that I would like to use my first blog to explain what more about I mean. I've been providing therapeutic massage and neuromuscular therapy for pain relief since 2005 and I’d like to answer some frequently asked questions such as what makes Precision Neuromuscular Therapy (PNMT) different? And what conditions can be improved with neuromuscular therapy?

PNMT founder, Douglas Nelson, sums up the former well in one of his texts. “Precision Neuromuscular Therapy is less a modality than it is an approach to treatment of musculoskeletal pain. Rather than being tied to a certain treatment technique, PNMT is committed only to the end result. We measure accurately, treat precisely and aim for stellar results. If the results are less than remarkable we switch strategies instead of doing the same technique harder or longer than the first time.  PNMT takes time and effort to master the palpation, anatomical mastery and clinical reasoning processes”.

My colleague, Nicole Ftacnik (a Certified PNMT practitioner in Cincinnati, Ohio) has this to say about the kind of work that we do: “PNMT is a treatment using soft tissue manipulation techniques for dysfunction and pain caused by misalignment of the body by the muscular skeletal system. Misalignment or distortions of the body may be caused by muscle imbalance, which are caused by poor posture, repetitive movement patterns, and/or trauma. Restoring weight bearing equality and symmetry are essential for good health, which is why it is so important to bring people into neutral balance alignment!” That is exactly right.

Most of the pain I treat comes from one of 5 causes. When a client comes into my office presenting with pain I have to decide which of 5 elements of pain it is before beginning the journey to neutral balance alignment. The 5 arenas that cause pain are:

• Ischemia: Lack of blood flow to the muscle.

• Structural : Any distortion of the optimal position and carriage of the frame will have a negative impact on the muscles, connective tissues and joint function.

• Functional: This category includes muscular strength, length, ability to relax/release and the ability to fire in the appropriate and/or optimally efficient order

• Trigger Point/Referred pain: Includes the various kinds of trigger points that disturb muscle function, refer pain, or reduce muscle length. Referred pain is often pain felt at a place different than the origin of injury.  Carpal tunnel symptoms, for example, can be caused by problems in the neck, shoulder or upper arm that misaligns the muscles and tendons down the arm. The pain may not be felt in the shoulder, but instead pain that is similar to carpal tunnel. When the “carpal tunnel syndrome” is treated directly, it never seems to go away.

• Neural: Neural pain includes both the ability of nerves to affect muscular function and the capability for muscles to influence or entrap nerves.

By now, you have an idea that precise treatment (as opposed to broad, general gliding strokes) can restore your muscles to a more normal resting length (optimally, neutral balance alignment) and you may be wondering what conditions NMT can improve. Some examples of common conditions that PNMT is successful with include, but is not limited to: Low back pain, neck and shoulder pain, headaches/migraines, TMJ dysfunction, whiplash injuries, frozen shoulder, sciatica, osteoarthritis, plantar fasciitis, tennis elbow, carpal tunnel syndrome' shin splints, tendonitis, bursitis, muscles spasms, cramps, strains, postural distortions, fibromyalgia... and many more!

Hope this helps you on your way to a pain-free lifestyle once again!

Gina McCafferty, LMT