Introduction to Head & Neck Pain

Focus: This week's lesson provides an overview of the analysis and treatment of head and neck pain. This area is subject to a wide range of perpetuating factors, and proper analysis is critical if we're to be successful in treating the pain in a lasting manner. Breathing, anterior and lateral posture, stress, work and sleep ergonomics and many other factors must be uncovered in order to treat pain in the head and neck successfully.  

• Head & Neck Pain Overview Slides & Downloads
• Head & Neck Pain Overview Lecture

Head & Neck: Treatment Principles & Assessments

Focus: Many factors tend to converge at the head and neck, so we have to undertake a thorough analysis of several perpetuating factors to get to the source of pain in this area. The muscles that stabilize the head and neck are sensitive to lateral and anterior postural asymmetry, breathing dysfunction, shoulder positioning, overall stress, sleeping position, and much more. In this week's lesson, we will go into detail on how to conduct this analysis and each of the key assessments.  

• Treatment Principles
• Postural Assessments
• Head Range of Motion Assessments
• Postural Assessments Demo

Introduction to the EPS

Focus: The electronic point stimulator is a very useful tool for CTB work. Because it directly influences the neuromuscular junction and stimulates sarcomere contraction, it can be very effective at quickly softening taut fibers and removing peripheral sensitization. The EPS is particularly useful in certain muscles, often in areas that have superficial exposure through the skin. This week's lesson will introduce the tool and show several common treatment examples. We use the EPS heavily in the neck muscles, and it will show up in many of the weekly head and neck lessons.  

• EPS Overview
• EPS Example: Forearm
• EPS Example: Vastus Medialis
• EPS Example: Neck Muscles

Detailed Treatment of High Trapezius & Sternocleidomastoid

Focus: Basic high trapezius and SCM treatment begin any head/neck protocols, as down-regulating these muscles can provide an immediate relaxing effect to the entire upper body, as well as soften 2 muscles that may prevent progress in other areas if not treated first. Both tend to be headache and migraine muscles, so this work early on in the session can provide significant keys to how to focus the rest of your session.  

• High Trapezius & SCM - Anatomy and Theory
• High Trapezius - Palpation
• High Trapezius - Treatment (Manual & EPS)
• High Trapezius - Treatment (Muscle Liberator)
• SCM - Treatment 1 (Manual & EPS)
• SCM - Treatment 2 (Manual & EPS)

Detailed Treatment of Levator Scapulae & Scalenes

Focus: Levator Scapulae is known as the "stiff neck" muscle.  It can severely limit neck rotation when there are trigger points due to pain on movement.  Trigger points in this muscle commonly react and produce pain when the muscle is shortened, actively or passively.  For example, when a person turns their head to the right and they feel pain on the right posterior lateral neck, this is due to the shortening levator scapulae muscle on the right side.  The referral pain also commonly spreads downward into the upper back and sets up problems in the mid and low trapezius. Levator scapulae attaches above to the transverse processes of the first four cervical vertebrae and attaches below to the superior angle of the scapula.  So when the scapula is fixed, levator scapulae turns the head to the same side and side flexes.  When the neck is fixed, it rotates the scapula downward and elevates the scapula.  Both levator scapulae acting together are extensors of the neck and checkrein flexion. Trigger points in levator scapulae can occur during sudden overload, as in whiplash or a fall.  Also TrPs commonly develop when the muscle is actively or passively shortened for an extended period of time, such as during sleep with the head turned or when working without arm support.  This muscle responds wonderfully to both EPS and Muscle Liberator treatment. The scalenes are neck stabilizers and side flexors of the neck.  The anterior scalene also assists in flexion.  These muscles produce a wide array of referral into the shoulder, upper back, arm and hand.  They can also entrap the brachial plexus by closing the space between the clavicle and first rib. These muscles do not produce head or neck pain.  For more extensive information on scalenes, please refer to Year One, Week 16 of the membership where they are covered extensively in relation to shoulder pain.  In terms of head or neck pain, if the scalenes have trigger points, they will limit side flexion and can block the lengthening of the high trapezius and levator scapulae, so need to be treated in head/neck focused sessions.  

• Levator Scapulae & Scalenes - Anatomy & Theory
• Levator - Treatment
• Scalenes Treatment 1 -
• Scalenes Treatment 2 -
• Levator & Scalenes Treatment -
• Levator Scapular Treatment - Muscle Liberator

Complete Head & Neck, Foot/Ankle, Low Back, Forearm & Hand... and More!

We will continue to delve deeply into head & neck pain thru week 62, also diving into tinnitus. From there, we jump into foot pain and ankle mobility, as there is a powerful, hidden relationship between foot and ankle issues and pain complaints in other parts of the body. We then move into low back pain (incl. gluteal, sacral & pelvic), as low back is one of the most common and disturbing issues that therapists see. er important and common areas of pain complaints: knee pain, sciatica, low back, mid back, hip pain and much more. Given that this is a multi-year program, we have time to explore deeply each pain complaint. Students have opportunities to interact with instructors via a private Facebook group, course comments and live events.