Neck Pain

Understanding the generator of neck pain is paramount when it comes to treating it. In some cases we refer directly to MRI findings. Although there can be findings on a MRI that might suggest a reason for the pain, we have to be sure to also address the pain from a biomechanical standpoint. The position of the head in relation to the chest, shoulders and trunk in general can help give us a clue about the muscular and myofascial involvement in neck pain. Therefore, even if there are MRI findings, we can still address the dynamic shearing forces that may have led to the deterioration of some of the spinal structures, putting undue demand on the muscle and fascia system.

Neck pain is often explained by upper crossed syndrome in Valdimar Janda’s research and the dynamics of the fascia system anatomy. Our treatment includes myofascial release, posture retraining, and specific scapular strengthening.

There have been abundant research, treatment theories and applications that have been used over the year in regards to reducing neck pain. Dr. Janda observed a muscle imbalance phenomenon that he called the upper crossed syndrome. This is where the sternocleidomastoid and the pectoralis muscles are tight and active along with the upper trapezius and the levator scapulae. These overly tight muscles overpower the inhibited deep cervical flexors, the lower trapezius, and the serratus anterior. Dr. Berger in the middle of the 19th century was able to observe a condition he called the sternal syndrome, in which the entire rib cage is drawn forward due to shortening of the abdominal structure and tightening of the pectoralis major. This postural distortion tends to result in a forward flexed position that puts unusual demands on the musculature and structure of the spine. This will then lead to disc deterioration and muscle spasms. Dr. Ida Rolf discovered the fascial binding that is prevalent throughout the entire body, but specifically that which affects the head, the clavicle and the T1, the jaw and the base of the skull. Thomas Myers, in his anatomy trains book, demonstrates the anatomical dynamics of the fascial system as it affects the cervical spine and posture from a longitudinal anatomical aspect.

So you can see that there is a lot of dynamics at play, but my understanding is that in working with them we can help you understand why you have pain and headaches, what can be done about it, and how we can alleviate some of your pain and loss of function.

Neck pain develops because of the above mentioned dynamic forces that result in deterioration of the spinal structure. We still need to be able to assess specific types of radiculitis and must always be aware of neurologic findings that can lead to loss of motor function, reflexes, and movement. For this purpose, an MRI can be extremely important at the right time. However, when issues around the pain problem do not correlate directly to MRI findings we can precede with a treatment plan based on what we know about the biomechanical and postural dynamics. There is a direct correlation between the structure and position of the entire shoulder girdle and the posture of the trunk, and its contribution to neck symptoms.

Treatment plans are based on postural restructuring, myofascial release and specific strengthening to restore the posture of the truck and the shoulder girdle while strengthening specific weak areas of the neck and shoulder.

In our office we can help you by evaluating all of these postural defects and help determine when to ask for the proper medical studies. We also have a dynamic program, as well as a multi-cervical strengthening computerized device for inhibited neck muscles. In addition, we have a dynamic program for stabilizing the scapula and sorting out the fascial bindings while restoring proper alignment for the truck, shoulder girdle and neck. Our treatment approach is a full hands-on program that alleviates muscular and fascial dysfunction, a exercise program for specific weak and inhibited muscles, and an overall postural restoration and movement retraining.

By understanding how you got hurt in the first place and treating the specific weakened structures, you now know how to avoid future injuries.

Injuries to the neck such as whiplash or other severe trauma have a treatment plan that is similar. One needs to understand the mechanism of injury with whiplash and/or traumas and allow enough time for healing. A dynamic ongoing program of hands-on care, along with an appropriate level of movement facilitates the healing time and limits the likelihood of a long-term disability.

Patients with significant and obvious radiculitis will need to be observed carefully.
In this case, one needs to collaborate closely with a spine surgeon for a thorough diagnosis, and work as a team on an appropriate treatment plan which may or may not include surgical intervention.

Patients with radiculitis not related to cervical spine dysfunction have every potential of benefiting from the above-mentioned program to further alleviate nerve tissue entrapment at a fascial level that is further exacerbated by poor posture and weakened muscular structure.

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Dallmeyer Physical Therapy Treats Neck Pain