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Breathing and Neck Pain

Have been seeing a few clients lately with neck pain with trigger points present in their scalenes muscles. These muscles are side of the neck (more towards the front than the back) and they are used to tilt the neck and also stabilise the ribs when breathing.

Typically this arises when the person is what is known as paradoxically breathing or thoracic breathing when we should be diaphramatically breathing.

Some people can diaphragmatically breathe in one position but not in another. For example, many of us fail when we are sitting typing on a computer. Yet, We should be able to breathe correctly whether standing, sitting or lying.

One technique that is often used to train our breathing patterns is to put your right hand on your chest and left hand on your stomach. With your eyes closed then breathe in through the nose to a count of around 4 and then exhale via the mouth. This exhalation is also performed to the count of four. Whilst this exhalation is taking place then the abdomen should be returning to the original position.

This exercise should be practiced for around 60 seconds at any one time and should be repeat during the day whilst standing, sitting and lying down.

A demonstration of breathing exercises is shown in the video below.

  

Massage and Nausea

Unfortunately an occasional side effect of massage is that you can occasionally feel a little nauseous after the massage. Whilst you will hopefully feel relaxed, looser with less muscle and joint pain, it is possible that you may just feel a little off colour for a while.

For most people, this side effect of massage only last for a relatively short period. Some people will need to have a lie down and sleep. Others will drink plenty of water to feel as though they are giving their system a flush. Regardless, in the vast majority of cases, the nausea is only a transient hindrance.

Dizziness and nausea post massage
There is much discussion regarding the cause of the nausea and dizziness after a massage and it may well be the case that there are a number of different causes. One theory which is discounted by most therapists is that the nausea is caused by toxins that are release by the massage. For a discussion of this fallacy then please check out www.innerwestmassage.com.au/massage-toxins.php.
A recent hypothesis is that “Post Massage Soreness and Malaise” is the result of a mild case of Rhabdomyolysis which occurs when muscle cells are damaged and it interferes with the blood chemistry.

Personally whilst there may be some evidence to support this theory, if you follow this theory then you would agree that the deeper the massage, then the more likely you would be affected. Although this is a personal viewpoint, it doesn’t tally with my experiences.

For me nausea is more likely if I haven’t had a massage for a while and I have never noticed any correlation between the pressure/intensity of the massage and the degree of nausea experienced. I tend to subscribe to the theory of Dr Keith Eric Grant who considers that massage is about returning the body towards homeostasis and that the nausea may be the result of giving the lymphatic system a bit of a kick-along. Other therapists may argue differently to this but regardless this type of nausea post massage is very normal and not a cause for concern.

However, if you start vomiting and feel extremely dizzy post massage then that is a different kettle of fish. This happen whilst I was massaging someone a while ago and we had to stop the massage after about 20 minutes as the client was unable to continue. Although massage had only been carried out to the back, just the act of lying prone was too much for the client. Although she recovered and started to feel better once she rose from the table, this was not a normal state of affairs and seeing her doctor was the next step.

Although uncommon, one possible explanation for the extreme nausea in this case is atlantoaxial instability.

Atlantoaxial instability can be considered as a loose upper spine and is the loss of the integrity of the joint between the top two vertebrae, the atlas and the axis. For some people who may have had a neck injury or trauma, then when they move their head or neck then a bone projection (the “dens”) from the axis may effectively make contact with their brain stem. The result of this can range from mildly unpleasant through to downright dangerous.

  
Whilst massage is not necessarily precluded for people who suffer from atlantoaxial instability, extreme caution would be required. The neck can be considered vulnerable and only relatively gentle strokes should be attempted with the approval of a suitably trained diagnostic therapist. Most doctors would strongly recommend that there be no manipulation such as a chiropractic adjustment.

Although there may not have been a formal diagnosis of the condition then a massage therapist should be alert to the possibility. A client may be particularly tight high in the neck or be very guarded and protective of the way they hold their head. If any alarm bells are rung for the therapist then they back off with the intensity of their work and use the adage “too little is better than too much”.

By Richard Lane

Why Does My Neck Hurt?

Regardless of where a problem may originate in the body, the neck and shoulders are very often the manifestation of the issue.  This is true of both physical and emotional dysfunctions.

On top of the cervical vertebrae is a large roundish object which is virtually always in motion in an attempt to stay balanced and to keep the eyes horizontal.   If this object, also known as the head, is well balanced on the vertebrae then the loads on the muscles of the neck and shoulders are relatively low.   However, physical disturbances all down the body to the feet can interfere with this dynamic leading to greater loads on and tension in the muscles.  For example, a shortening of calf muscles from, say, wearing high heels, tilts the pelvis forward which alters the curvature of the spine which will impact on how the head sits.

In addition, our necks are always adjusting to any imbalances in our body.  If we sidebend to one side then there is a tendency for our neck to counteract this movement in order to keep our eyes level with the ground.

Chickens are often used to demonstrate this to great effect!

Our emotions often arise in our stomachs and we are all familiar with the sensation of butterflies or tightening in our bellies.  From there they will wind up again to our necks where the emotions can often be expressed in the form of tightening of the muscles of the neck and shoulders.  If this becomes a near constant state of tension then we can lose a degree of flexibility in our spine to create a bottleneck in the area.

  
Furthermore the complicated movements and requirements on the cervical spine and muscles can lead to problems more easily than elsewhere in the body where there is more protection and less mobility demands.

For these reasons, whenever you book in for a massage, then your therapist is likely to find restrictions and painful areas in your neck that you may not even have been aware of.  However, if you do present with a neck problem then it may very well be the case that your therapist could spend significant time working on parts of the body other than the neck if they consider that the root cause of the neck issues may not actually be with the neck.

By Richard Lane


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