Posts Tagged ‘sternocleidomastoid’

This is a Pain in the Neck…and All the Way Down the Arm

By Laura Gordon

Clients come to us with all kinds of musculosketal issues. The more we become familiar with different TOS1symptomology the better we are equipped to help them. Of course we do not diagnose, however, in listening to what the client is telling us, doing a visual assessment, palpating and testing range of motion we can determine the best treatment to give the client.

In this blog we are going to take a look at Thoracic Outlet Syndrome.TOS

Signs and symptoms
Shooting pain, numbness, weakness, tingling in the arm particularly in the wrist and hand, but not always, and possibly a difference in temperature and or color of the arm.

Definition 
Nerve or blood vessel impingement, in the area behind the clavicle and between the scapula and the humerous called the brachial plexus. The muscles include the trapezius, the sternocleido-mastoid, the scalenes, and the pectoralis minor.

Treatment

scalenes stripping & comprssionScalenes: With the client supine,

1.) Strip from the skull to the collar bone. Technically you are stripping from origin to insertion over the anterior, medial and posterior scalenes.

2.) Follow this up with deep compression at the insertion of these muscles behind the collar bone/clavicle.

Pectoralis Minor: The client remains supine with the effected arm slightly abducted and bent at the elbow.

1.) The therapist’s fingers slowly penetrate intopec minor the muscle tissue under both pecs along the fifth rib (See illustrations)

2.) Move fingers inferior to superior along the muscle ending below the axilla at the coracoid process. Repeat again one more time.

Now add compression. The client is in a side lying position with affected arm over the head. With fingers wrapped around posterior shoulder blade or scapula, the therapist grasps the pec minor with the thumb.pec grasp

3.) Compress into the pec minor with the thumb until it releases.

Additional treatments can be found in Basic Clinical Massage Therapy by Clay and Pounds.

Homework

1

 

1.) Laterally flex neck on painful side and flex forearm and wrist to shoulder.

 

2

 

 

2.) Open fingers and extend arm while keeping neck laterally flexed

 

3

 

3.) Abduct arm parallel to the ground and horizontally hyperextend the arm as far as it will go with palm down, neck laterally flexed

 

4 b

 

4.) Extend wrist and laterally flex neck to the other side

 

 

5 flex lower

 

 

 

5.) Flex wrist, adduct arm, laterally flex neck to original side

 

6 return to position 1

 

 

6.) Return to original flexed position and repeat.

 

This is one of two Nerve Slide Exercises for Thoracic Outlet Syndrome as demonstrated by Dr. Donald Ozello DC of Championship Chiropractic.

Comment:
Please attempt this simple exercise and tell us what you experienced.

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Resources:

“Basic Clinical Massage Therapy; Integrating Anatomy and Treatment”, 2nd edition, James Clay & David M. Pounds, 2008.

“A Massage Therapist’s Guide to Pathology”, 3rd edition, Ruth Werner, 2005

www.youtube.com/watch?v=SmU7xvS10Ko

30

05 2014

Sternocleido-what? Part 3 of 4

By Sharon Truelove

In parts 1 and 2 of our Sternocleidomastoid series of 4, we discussed referred pain and balance problems.

The Sternocleidomastoid is palpated easily.  It attaches at the sternum, the clavicle and the mastoid process which is behind the ear. It allows the head to turn and also helps to maintain stability of the head when the body is in movement.  Trigger points in SCM, can cause a wide variety of symptoms that are often misdiagnosed.

When trigger points are found in the sternal  branch of SCM; blurred, dimmed or double vision may result.  Trigger points in SCM can also cause droopy eyelids from referred spams in orbicularis oculi as well as eye twitching. When you are reading, the text may seem to jump around on the page. Red eyes, tearing of eyes, even a runny nose can be culprits of referred trigger points.

 

 

 

 

 

Technique:  To see if you have any tender spots, feel along the attachment site at the sternal end. If you find any tenders spots, apply compression and as you feel the tissue soften begin to apply cross fiber friction.

Challenge:

1. Do any of you suffer from the above trigger point symptoms that affect vision/eyes?

2. Locate your own SCM and see if there are any tender spots in the sternal branch.  If so, massage them out and report your findings.

3. Find someone with tender or trigger points in their SCM and help them feel better via massage and report you findings.

 

REFERENCES

The Trigger Point Therapy Workbook; Clair Davies, NCTMB with Amber Davies, NCTMB; Second Edition; Copyright 2004

27

04 2012

Sternocleido-what? Part 2 of 4

By Sharon Truelove

Daily stress can accumulate and hold in the neck area and escalate to the point of restricting out daily activities.  Let us continue our discussion from Part 1 of 4 to see how we can help decrease the tension  and take a quick review of Sternocleidomastoid  before we continue to Part 2 of 4.

The Sternocleidomastoid is palpated easily.  It attaches at the sternum, the clavicle and the mastoid process which is behind the ear. It allows the head to turn and also helps to maintain stability of the head when the body is in movement.

Trigger points in SCM, can cause a wide variety of symptoms that are often misdiagnosed. We studied Balance problems in Part 1. In Part 2, we discuss referred pain.

Even though trigger points in SCM may be tender, they won’t usually cause pain in the SCM itself. Swollen lymphs usually get the blame when SCM trigger points are misidentified. These particular trigger points may actually present with no pain, but the stiffness it may cause can prompt leaning the head to one side.

When trigger points are located in the sternal branch they may exhibit as deep eye pain, tongue pain upon swallowing, headaches over the eye, behind the ear, and on top of the head and may also play a role in TMJ pain felt in the jaw muscles or the back of the neck. Frontal headaches are a sign of SCM trigger points.

Some rare referrals are: SCM pain being  referred down to the top of the breastbone,  pain felt in the side of the face imitating “trigeminal neuralgia”, or pain in the cheek being taken for sinusitis.

The clavicular branch may produce deep earache and toothache of the back molars.

To massage the clavicular branch of SCM first locate it by turning your head to one side. While looking in a mirror, firmly grasp that cable of muscle that pops up between your fingers and thumb and knead it. Spend only a couple of minutes on each side daily. Don’t massage if you feel a pulse, this is probably the carotid pulse.

 

Your homework:

1. Locate your own SCM and see if there are any tender spots. If so, massage them out and report your findings.

2. Find someone with tender or trigger points in their SCM and help them feel better via massage and report you findings.

 

REFERENCES

The Trigger Point Therapy Workbook; Clair Davies, NCTMB with Amber Davies, NCTMB; Second Edition; Copyright 2004

30

03 2012

Sternocleido-what? Part 1 of 4

By Sharon Truelove

The Sternocleidomastoid is a muscle that can be seen and palpated easily. Attached at the sternum, the clavicle and the mastoid process which is behind the ear;  sternocleidomastoid (SCM) allows the head to turn and also helps to maintain stability of the head when the body is in movement.

When trigger points are present in SCM, they may cause are great variety of symptoms that are often misdiagnosed and can be divided into four groups.

Balance problems

Referred pain

Visual disturbances

Systemic problems

Causes of SCM trigger points are often caused by holding postures too long or abnormally or injury. Examples are holding your head back to work (painting a ceiling), holding the head turned to one side (sleeping on your stomach), lower body issues that cause abnormal posture can cause the neck muscles to be overtaxed in an effort to compensate, whiplash, heavy lifting, respiratory problems.

Part  I will discuss balance problems. Trigger points in the clavicular branch of SCM can cause:

Dizziness

Nauseous

Tendency to lurch or fall

Fainting

These symptoms may last anywhere from a few minutes to days and often physicians may diagnose someone with vertigo or Meniere’s disease.

 

 

The myofascia in the clavicular branch of SCM helps with spatial orientation. When the tissues tighten it can send confusing signals to the brain. These trigger points can also cause unilateral deafness because of tiny stapedius and tensor tympani muscles that attach to the tiny middle ear bones; much like winding a guitar string too tight, vibrations are inhibited in the inner ear. Massage of the jaw and SCM  trigger points has been reported to bring back normal hearing.

To massage the clavicular branch of SCM first locate it by turning your head to one side. While looking in a mirror, firmly grasp that cable of muscle that pops ups between your fingers and thumb and knead it. This simple technique has been known immediately cure pain that it may cause. You should not have to spend more than a couple of minutes on each side daily. Don’t massage if you feel a pulse, this is probably the carotid pulse.

Locate your own SCM and see if there are any tender spots. If so, massage them out and report your findings. If you happen to be so lucky as to not have any tender SCM points, find someone who does and help them feel better.

REFERENCES

The Trigger Point Therapy Workbook; Clair Davies, NCTMB with Amber Davies, NCTMB; Second Edition; Copyright 2004

 

02

03 2012