Tension type headaches, which originate most often in the cervical spine and which generally manifest as a tight band of discomfort, affect almost half of the population. Headaches, in fact, are responsible for many billions of dollars of healthcare spending by both public and private agencies, and the overall economic impact includes significant lost work time when individuals are prevented from performing their usual employment duties.
Though the primary cause of cervical dysfunction is not yet well understood, recent studies have shown that poor muscular strength in the cervical spine is likely to play a major role in neck and head discomfort. Weaknesses in the anterior and posterior musculature ultimately cause degradation within the biomechanics of the upper spine, which can then place undue stress on the flexor muscles within the neck itself. Forward head posture (FHP) is a key indicator of cervical weakness, especially when compared with the postures found within normalized control groups.
Proactive exercise programs are often helpful in ameliorating tension type headache pain. Sufferers of headaches can perform a number of routine exercises that will improve the strength and endurance of muscles in the target area. The following are likely to benefit:
Neck flexor muscles can be trained in a similar manner. As the target muscle groups are strengthened, body posture will improve at the same time.
There are a number of exercises that can be done to improve the posture of the body. The “Rocket,” which is one of the most useful and practical, is generally accomplished from a sitting position. Individuals can press against the armrests of the chair (or against the bars of a specialized posture device) to create lift within the torso. The idea is to lengthen the spine by performing this exercise in sets of threes several times each day. Any hints of dizziness should bring the repetitions to a stop.
The “Release” works in tandem with the “Rocket.” The entire upper portion of the spine, including the neck and shoulders, should be capable of operating as one unit. When the build-up of stress occurs in the upper portion of the spine, the head and neck may loll slightly forward, which will place undue pressure on muscles, bones, and even nerves.
From the standing position, individuals can release some of the extra tension in the upper back by gripping and pressing lightly against a solid object. Through time, myofascial trigger points will become much less apparent, and most men and women find that their posture, as well as the overall biomechanics of the spine, will be more in line with clinical norms.
Regular performance of both of these exercises may lead to an amelioration of pain associated with the following conditions:
Ultimately, headache pain can be controlled with the right exercise regimen. By strengthening the deep neck flexors and concentrating on FHP, most individuals can address their postural imbalances. Targeted tweaks to the body’s biomechanics can prevent headaches, decrease healthcare costs, and improve productivity in the workplace going forward.
and a faulty diagnosis can make treatment a total waste of time.
Failure to accurately diagnose a condition in its early stages can lead
to chronic problems and sometimes devastating results.
Diagnostic musculoskeletal sonography (MSUS) provides the perfect tool for the rehab practitioner. Yet many doctors and physical therapists have no experience with MSUS, are unaware of its advantages, and have no idea how to use it as a diagnostic tool.
Below is a prime example of how ultrasound can take the guesswork out of diagnosis.Successful Treatment
A bad physical therapy experience is one of the primary causes of unnecessary surgery.
We have equipped our clinic with the latest research-grade technology to arrive at objective and accurate diagnoses, and to objectively measure our patients’ progress.
Most importantly, we are the only facility in the US where structural medical diagnosis is reflected in functional treatment, and vice versa.
In this instance, an athlete was originally diagnosed with minor quadriceps muscle strain and was treated for four weeks, with unsatisfactory results. When he came to our clinic, the muscle was not healing, and the patients’ muscle tissue had already begun to atrophy.
Upon examination using MSUS, we discovered that he had a full muscle thickness tear that had been overlooked by his previous provider. To mitigate damage and promote healing, surgery should have been performed immediately after the injury occurred. Because of misdiagnosis and inappropriate treatment, the patient now has permanent damage that cannot be corrected.
The most important advantage of Ultrasound over MRI imaging is its ability to zero in on the symptomatic region and obtain imaging, with active participation and feedback from the patient. Using dynamic MSUS, we can see what happens when patients contract their muscles, something that cannot be done with MRI. From a diagnostic perspective, this interaction is invaluable.
Dynamic ultrasonography examination demonstrating
the full thickness tear and already occurring muscle atrophy
due to misdiagnosis and not referring the patient
to proper diagnostic workup
Demonstration of how very small muscle defect is made and revealed
to be a complete tear with muscle contraction
under diagnostic sonography (not possible with MRI)
Complete tear of rectus femoris
with large hematoma (blood)
Separation of muscle ends due to tear elicited
on dynamic sonography examination
