Rob Zukowski is a New York State LMT, certified by the National Certification Board for Therapeutic Massage & Bodywork, a Certified Medical Massage Therapist and holds a degree in Occupational Studies, with a focus on massage therapy, from the prestigious Swedish Institute College of Health Sciences. He has advanced training in sports massage, various relaxation therapies, and training in multi-therapeutic approaches to massage for oncology.

In addition to private practice, his experience includes being a massage therapist, lead therapist and member relationships manager in assorted fitness centers, spas, clinics and holistic healing settings and working in corporate wellness environments. Rob also works as a client services manager at a healing center, authors his own column on the subject of complementary and alternative medicine in a national HIV/AIDS magazine, works in student outreach and lectures on therapeutic massage for various pathologies.

Friday, December 13, 2013

Tension Headaches: Some related muscles and connective tissue

Tension headaches can be caused by a variety of things including stress, posture and muscle spasms. Many people suffer with headaches caused by the suboccipital muscles and fascia.

The suboccipital muscles are located at the base of the skull and help hold the head into extension, or upright. When these muscles are overly contacted or in spasm, it can aggravate the greater suboccipital nerve resulting in a series of events that produce tension headaches. In addition, tension headaches can be related to "kinks" in the fascia. Fascia is a layer of fibrous; a structure of connective tissue that surrounds muscles, groups of muscles, blood vessels, and nerves, binding some structures together, while permitting others to slide smoothly over each other. Fascia is a lot like a web surrounding and covering many structures within the body. A kink or adhesion in that covering somewhere, or anywhere, could cause the fascia to bind and pull tight anywhere. Think about it; if your socks are too tight around the ankles and don't move as you walk, it could restrict the movement of you toes, causing pain. So while the tension or adhesion is around your ankles, it inhibits movement in your toes. Fascia can work similarly. Many tension headaches occur at the top of the head or in the forehead or temples. So, it stands to reason that if your head is in "looking down" position at your computer monitor or phone, or if you head hangs for any reason, that your sub occipitals or the fascia could be pulling on these areas and causing the headache.

Poor posture can be associated with suboccipital muscle spasms and headaches. When the head and shoulders are leaning forward the suboccipital muscles compensate to lift the head. With chronic head forward postures, the muscle become overwhelmed and spasms.

Massage therapy can decreases the intensity and frequency of tension headaches. Massage is very effective at decreasing muscle pain, spasms and kinks in the fascia. A trained massage therapist can work on the suboccipital, trapezius, scalene, SCM, cervical spinal, thoracic paraspinal, and rhomboid muscles. These muscles, all located around the upper back and shoulders, base of head, and neck tend to be involved in tension headaches.

In addition to massage, cervical exercises and stretches can increase the range of motion and flexibility of the muscles that cause tension headaches and improve tissue state and function of neck joints and muscles. The movements at the cervical spine include flexion (the head moving forward), extension (the head falling backward), rotation (the head rotating to look left and/or right) and lateral flexion (the head tilting to leaning to one side or the other). Doing these actions, without overstretching, can help relieve tension headaches caused by the suboccipitals and related fascia.

Now, I would NOT suggest letting anyone who is not trained stretch your cervical spine. For example, damage or issues with the vertebral artery come into play with extension stretches of the cervical spine. You also must consider AROM (Active Range of Motion, or you do the stretch) and PROM (Passive Range of Motion, or someone stretches you). The degrees of movement differ, in some movements, deepening on whether you are the one moving the structure or someone else is. For example, the normal or average range of motion for rotation of the head is 70 to 90 degree either way, but flexion is typically 45 to 60 degrees when flexed actively (by you) and 80 to 90 degrees when flexed passively (by someone else). The normal range of motion for lateral flexion actively is 25 to 40 degrees, while passively it is 75 to 80 degrees.

By the way, in case you are wondering why there is a difference in degrees of movement; when you are sitting or standing in your normal posture, all sorts of muscles are at work to keep you upright and these muscles can inhibit your stretches. But, when you are relaxed and not actively using those muscles, the massage therapist can perform the movements for you, without the other muscles inhibiting movement.

Give your head an neck a gentle stretch a few times a day. Gentle. Don't push or overstretch. Take a deep breath in and then let it out as your move into the stretch. Let your head fall forward, backward and from side to side and hold hold 10 seconds or so. Roll your head, gently, in circles in both directions. This can help stretch the muscles and fascia and relieve or prevent tension headaches.

There are wonderful Proprioceptive Neuromuscular Techniques such as body mobilization techniques and tense and relax techniques that can help with tension headaches or any muscle tension pain in the body. Be sure to see a trained professional.

________________________________________________________________ I am not a doctor. These are my own personal opinions, ideas and processes from my own research, studies, trial and error. Take 'em, leave 'em, either way, consult a medical professional as needed. 

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