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Pain Underfoot: Metatarsalgia
Foot pain can interfere significantly with normal activities and severely limit participation in sports. Metatarsalgia is foot pain involving the metatarsal bones in the forefoot – the complaint of pain on the bottom of the ball of the foot.
MPA Media Wins 7 Publishing Awards
MPA Media, publisher of Dynamic Chiropractic and DC Practice Insights, among other titles, has been recognized for editorial and design excellence with an unprecedented seven publishing awards by the American Society of Business Publication Editors (ASBPE), the nation's largest organization for business-to-business publications.
9 Common Causes of Thyroid Imbalance and How You Can Help
How you sleep, how easily you wake up, and how much energy and stamina you have during the day are directly related to levels of the thyroid hormones.
Building From the Bottom Up
I caught up with my dear friend Honora Wolfe, in her Colorado painting studio where, if she is not praying in Bhutan or doing charitable work in a Nepali free clinic, she spends most of her time now.
Peer Points: Always Seeking To Grow
Ellen "Kiki" Geary has spent the last decade honing her craft. As a specialist in integrative holistic care, she went straight from completing her master's degree in acupuncture and chinese herbal medicine from Bastyr University to building a successful and thriving practice in the small community of Anacortes, Washington.
A Vibrating Capsule for Constipation? Relevance to Your Chiropractic Practice
The relationship between gastrointestinal (GI) complaints and back pain is not typically written about or discussed.
New Medical Technologies You Need to Know
We're all familiar with how fast computers become obsolete, as well as the rapid pace of development in the field of cell phone technology. The latest smart phones are far more powerful than desktop computers were only a few years ago.
Finders Keepers: The Secret to Relationship-Based Marketing
Becoming a successful practitioner has less to do with what you learned in school, and more to do with your ability to find new patients and keep them!
Why Young People Need Chiropractic Now More Than Ever
According to a recent study published in BMC Musculoskeletal Disorders, "It is now widely acknowledged that neck pain (NP), mid back pain (MBP), and low back pain (LBP) (spinal pain) start early in life and that the lifetime prevalence increases rapidly during adolescence to reach adult levels at the age of 18."
News in Brief
National Chiropractic Health Month: Be Proactive; Collegiate Roundup: Academic Appointments at Parker, Logan.
Chiropractic Research in Review
Chiropractic Treatment of Lateral Epicondylitis; Cost / Benefit Analysis: Different Doses of SMT for Low Back Pain; Imaging for Occult Rib and Costal Cartilage Fractures; Treating Neck Pain: Thoracic Thrust Manipulation vs. Non-Thrust Mobilization.
Don't Turn a 2 Into a 10
The Wong-Baker FACES Pain Rating Scale1 is so useful because it can be used by almost anyone. Patients can use the numbers associated with the faces depicted on the scale or select the face that demonstrates their current level of pain from 0-10.
A History Worth Telling
The popularity and the use of acupuncture for the treatment of animals in the United States is at its peak.
Waking Up the Gluteus Maximus
In previous articles in this series, we expounded on the importance of the gluteus maximus (GM) in athletic performance and protecting the knee from injury. We also know there is a link between iliotibial band syndrome and GM weakness.
A Chinese Medicine Story: An Interview with Mazin Al-Khafaji
Mazin Al-Khafaji's work has interested me for years. In February 2014, we invited him for the second time to speak at the Southwest Symposium in Austin, Texas.
Medical Qigong for the Heart: Part III
Part 1 and Part II of this series focused on the physical aspect of the Heart and mental emotional aspects of the Heart respectively. Now, I would like to focus on the spiritual aspect of the Heart.
A Guide for Talking to Doctors about Acupuncture and Brain Chemistry
Before I begin any discussion of how to talk about the effects of acupuncture on brain chemistry, nervous and endocrine function, it is essential to understand just what physicians most need help with.
CCE Finally Takes a "Baby Step" Toward Reform
During a 16-month period from October 2010 to February 2012, I devoted four separate columns to the heavy-handed attempt by the Council on Chiropractic Education to radically change the chiropractic profession through the accreditation process.
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 more information about David Kent, LMT, NCTMB.
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