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Universal Design: Principles & Practice
In many respects, universal design serves as the core of ergonomics. It's also a good tool to use when designing a return-to-work program for injured and/or ill patients. Let's take a closer look at universal design and why it should matter to you and your patients.
An Unexpected Diagnosis: The Result of Lacking Communication
A couple years ago I had a case that showed me the importance of open communication between health practitioners. We need to show up with less fear, and let go of our judgments so we can do better for the patient.
Bill With Confidence: Learn What to Collect
Q: I am trying to understand what I may collect from my patient when there is insurance. Do I have to accept the amount allowed by the plan or may I collect up to my billed amount? Please note, I am not a member of any insurance plan.
Creating Good Business Buzz
What do patients really think about working with you? Rarely do you hear the whole truth. Those who improve may be candid in their gratitude.
A Major Role in Back Pain: The Multifidus
Back pain affects roughly 80 percent of the population at one time or another and is one of the leading causes of doctor visits.
Is It Time to Rethink Mental Illness? (Pt. 1)
Invariably, patients will ask their chiropractor about depression or various mental illnesses. Some practitioners will reflexively offer a cervical adjustment, suggest St. John's wort or contemplate a referral to a specialist.
Why I Quit Doing House Calls
My father was a chiropractor who did house calls, so when I became a DC, I figured doing house calls was part of the job. My March article recalled my experience as a small boy, accompanying my dad while he went to patients' homes to treat them.
Balancing Spring Challenges
As the winter months come to a close and warmer spring weather appears, patients may begin to present with new challenging pattern presentations.
Eczema & Acupuncture: A Sound Solution (Part 1)
Eczema affects approximately 3.5 percent of the global population and is one of the most common skin complaints seen by dermatologists.
Clearing Blocks: A Way to Improve Cosmetic Acupuncture
As a Five Element acupuncturist who teaches facial acupuncture classes nationally, I was surprised to learn that one of the basic principles I was taught in school is unfamiliar to most acupuncturists.
Taking the Chiropractic Message to the Press
"There is no better place on earth to have a news event," the National Press Club boasts, and it's easy to understand why: Every year, the 108-year-old Washington, D.C.-based organization hosts countless press conferences on the hottest topics impacting America and often the world.
Give Yourself the Digital Advantage
When you see this article in the print version of this issue and swear you read it already, don't be alarmed: you probably did. That's because by that time, the May issue will have been available online in digital format for three weeks.
Women's Hormones: A Western & Eastern Perspective
Sometimes it may seem that you require a degree in medicine to understand hormones and how they function.
News in Brief
ACA Adopts New Governance Model; ACA 2017 Awards; CCA Helps Calif. DCs "Share the Love"; $1 Million to Help Advance the Profession; D'Youville Raises the Bar on Anatomy Education; ErRatum.
The Visual Error Scoring System: A Concussion Tool
Postural stability and oculomotor function are the most easily recognized physical indicators of neurologic motor dysfunction associated with concussions.
An Integrated Approach to Chronic Pain
Findings from a unique Medicaid pilot project in Rhode Island involving high-use Medicaid recipients from two health plans were recently presented to the state's Department of Health, demonstrating stellar outcomes with regard to medication use, ER visits, health care costs and patient satisfaction.
A Daily Strategy for Heavy-Metal Detox
In modern society, we are constantly exposed to heavy metals such as cadmium, lead and mercury. These heavy metals have no essential biochemical roles in our body, and conversely, can cause us a great deal of harm if they build up to toxic levels.
Raditation & Your Smartphone: Is it Worth the Risk?
If radial arteries could talk (and in my experience they can to some extent), they would say, "Step away from the smartphone." At least that is the message I am receiving loud and clear as I feel the pulses of many patients.
New Relationships, Old Trauma: AOM & Other Healing Strategies
Being in love is one the most beautiful and enjoyable experiences. Most of us are willing to pay almost any price to have that experience, and still often find it elusive or fleeting. Navigating the ups and downs of loving relationships are often challenging — even for the most psychologically balanced among us.
November, 2013, Vol. 13, Issue 11
The Sternocleidomastoid Muscle and Cervicogenic Headaches
By David Kent, LMT, NCTMB
There are many types of headaches with a long list of triggers from hormones to food, drinks, sleep deficiency, dehydration, and emotional and physical stress. A cervicogenic headache (CeH) is characterized as unilateral head pain with a cervical source.Symptoms include a dull ache with restricted cervical range of motion. Contributing factors often include poor posture, sedentary lifestyle, prior neck injuries, and improper computer and workplace ergonomics.
While many muscles can be involved in a cervicogenic headache, I want to share information on the sternocleidomastoid muscle and ways to educate clients of its referred pain, as it can directly affect whether the client reschedules, upgrades to a package of treatments or refers friends, family and co-workers.
Physicians, depending on their specialty, can be a great referral source for clients suffering with cervicogenic headaches. Doctors are familiar with myofascial trigger points and referred pain. A cervicoengic headache can also be caused by the bones, discs and or joints in the neck.
Clients rarely report pain in the front of their neck when experiencing a cervicogenic headache unless recently involved in a motor vehicle accident or other physical trauma. Educate clients about the sternocleidomastoid muscle, integrating three learner styles; visual, auditory and kinesthetic.
Take postural analysis photos with your smartphone, iPhone or iPad to show the position of their head and how the sternocleidomastoid muscle is involved. Use skeletal, muscular and trigger-point charts to show the structural and myofascial patterns.
Provide auditory support for each visual by explaining the details in each photo and image. For example, in posture photos, discuss a high shoulder or forward head posture. On trigger-point charts, explain that the "X" indicates the common location of trigger points and the red color indicates the referral areas patients report pain, tension, burning, tingling, numbness and headache (Photos 1-2).
Now, when you palpate (kinesthetic) an active trigger point in the sternocleidomastoid muscle and it refers pain to the patient's head, they realize why and what is taking place. Without pretreatment education, the patient might think you are pressing on a nerve versus treating an active trigger point.
Use intake forms to screen clients and identify contraindications. Watch for procedures like coronary bypass, stints, angioplasty or a carotid endarterectomy, a surgical procedure for cleaning out the carotid artery to restore blood flow to the brain. Other red flags include blood thinners and carotid sinus hypersensitivity (CSH); even if a client states they have previously received massage, I will not proceed without a prescription for treatment from their physician.
Practice palpating and treating the sternocleidomastoid muscle on your own neck. The name of this muscle reveals its attachments to the sternum, clavicle and mastoid process. To palpate the right SCM, begin in a supine position, shorten the muscle by turning your head to the left, lateral flexion of the cervical spine and place support under your head. Practice muscle testing the right sternocleidomastoid by lifting your head from the support and palpating the outline of the muscle. Relax the muscle prior to treatment, by placing your head back on the support and then using pincher compression to treat each division, checking for active trigger points.
In Myofascial Pain and Dysfunction, The Trigger Point Manual, Drs. Travell and Simons documented numerous active trigger points in the sternocleidomastoid muscle. They found the sternal division refers pain into the forehead, behind the eye, the anterior cervical region and can produce throat pain, discomfort or tightness (Photo 1); while active trigger points in the clavicular division can refer pain to the forehead, behind and/or into the ears (Photo 2).
Recently, the Journal of Manipulative and Physiological Therapeutics published a pilot randomized clinical trial titled, "Manual Treatment for Cervicogenic Headache and Active Trigger Points in the Sternocleidomastoid Muscle." The preliminary findings show that manual therapy targeted to active TrPs in the sternocleidomastoid muscle may be effective for reducing headache and neck pain intensity, and increasing motor performance of the deep cervical flexors, pressure pain thresholds (PPT) and active cervical range of motion (CROM) in individuals with CeH showing active trigger points in this muscle. Studies including greater sample sizes and examining long-term effects are needed.
Active trigger points in the sternocleidomastoid muscle may be a contributing factor to a client's cervicogenic headaches. Providing education to the general public, local doctors, healthcare providers and clients is essential to building your practice.
Click here for previous articles by David Kent, LMT, NCTMB.
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