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Repetitive Strain Injury/Chronic Lightheadedness, Stiff Neck, Tension Headache

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QUESTION: Hello Dr. Donnelly. I am 27 years old and I have a chronic condition (which i believe is repetitive strain injury) that has lasted for 6 months and has not been diagnosed or identified. My main symptoms are lightheadedness, stiff neck, and tension headache. These symptoms occur every day and are more or less intense. These symptoms become worse in reaction to certain activities - talking, coughing, sneezing, laughing. Even sound and music is irritating.

I believe my condition was caused by trauma to the neck which occurred 6 months ago. The symptoms began after an exercise session. The trauma involved an exercise that included prolonged periods of hyperflexion of the neck muscles. I believe the fibers in these muscles were damaged and were not able to heal correctly due to reoccurring irritation to the injured area - via coughing, sneezing, talking, laughing, actions which all seemed to produce symptoms and still do.

I have had a CT Scan, MRI of the Brain, MRA of the Brain, and an MRI of the cervical spine - all of which came back negative, except the MRI of the cervical spine which reported "some loss of cervical lordosis, alignment of the vertical bodies is unremarkable".

It's also important to note that I have taken a medication called temazepam (30mg) for insomnia for the past 6 years. This medication is a muscle-relaxer and my symptoms DIMINISH SIGNIFICANTLY after taking this medication, which is the main reason I believe it is muscle-related.

My main question is: Does this sound like a case of repetitive stress injury? It's important to note that I have very little pain that is sharp and usually indicative of an injury. Most of my pain is in the form of dull tension headaches.

My secondary question is: What should I do to heal this repetitive strain injury? Because it's been 6 months, I do not think my body will heal this problem on its own. Can you recommend any kind of therapy or treatment?

-Thanks

ANSWER: Hi Shane,

The most important thing here is that you have gone for all the medical tests that would have proven if something really serious is happening, and they are all negative.  That’s perfect because it shows that the problem is muscular, just as you had suspected.

The description you give leads me to think of two muscles, the first is the scalenes, and the second is the sternocleidomastoid (SCM for short).

There are three sections of the scalenes: anterior, lateral, and posterior (front, side, back of the neck). Each of them originate on your first rib and then insert into your cervical vertebrae, and when they contract you pull your head in that direction.  As you were doing the hyper-flexion, your anterior scalenes were being contracted and held for an extended period of time. Then you move your head back but the muscle is too short and is pulling the bones forward.

Think about what is happening here.  Your brain narrows down to become your spinal cord, which then passes through the opening in the center of each vertebrae, going all the way down your back and then splitting and goes down to your feet.  However, as your cervical vertebrae are being pulled forward they are putting pressure on your spinal cord, right at the base of your brain. This would certainly causes the lightheadedness you describe.

When you are sneezing or coughing, your head normally tilts forward, putting additional stress onto your spinal cord, and I would imagine as you are laughing your head is also tilting in one direction or another.

The second muscle is the sternocleidomastoid (SCM).  The SCM is also a two part muscle, one part originates on your sternum (breast bone), and the other head originates on your clavicle (collar bone), and then the two muscles both insert into the bone that is behind your ear, your mastoid bone.  When only one side is contracting you will turn your head in the opposite direction (ie: when the left SCM contracts, you turn your head to the left). When both sides are contracted at the same time you will bring your head down toward your chest.

When the two SCM muscles (left and right) are tight, and you are trying to bring your head up straight, they will put  pressure on your mastoid bones, which will then cause your neck to “bow.”  It’s not a huge movement, but it does happen, and it causes yet more pressure on your spinal cord.

If you go to http://www.julstro.com  you can read the sections titled “Muscles and Joint Pain” and “What’s Happening Exactly,” to get more information about repetitive strain injuries.  Fortunately you can easily self-treat each of these muscles. It’s just a matter of applying direct pressure on the muscle and then holding the trigger point (spasm) for 30-60 seconds. Then release the pressure, and then press down again.  Do this several times along the entire length of the muscle.  When you are on the website you’ll see books that will teach you how to do the self-treatments.

I believe you’ll get some immediate relief by doing the self-treatments, and if you continue doing them you’ll release the tension in these muscles and therefore, the pressure on your spinal column and spinal cord.

Wishing you well,

    Julie Donnelly


---------- FOLLOW-UP ----------

QUESTION: Hi, it's Shane again. I'm interested in buying the e-book that contains the directions on how to relieve the sternocleidomastoid and scalene muscle tension, but there are several books and I'm not sure which one to buy. Can you tell me the name of the book that I need?

Thanks again.

ANSWER: Hi Shane,

There are two books. The first book would be "Stop Tinnitus Pain FAST!" This book is smaller and has only the treatment for the sternocleidomastoid.  The other book is much bigger and has treatments for the entire body. The title is "Treat Yourself to Pain-Free Living."  Right this minute it does not have the treatment for the scalenes, but I'm working on including it by the end of next week.  If you decided to get that book, please send me an email and I'll send it to you separately.

With the symptoms you describe I would suggest you consider the larger book, and then do all of the treatments for the entire neck, shoulders, and upper back.  All of these muscles can cause a problem with the cervical vertebrae, so I wouldn't be surprised if you found tender trigger points in several of the muscles. I believe you'll be pleased when you see how easy they are to self-treat, and how quickly the spasms release.

Wishing you well,
   Julie Donnelly

---------- FOLLOW-UP ----------

QUESTION: Hi. It's me again. I ordered the e-book "Treat Yourself to Pain-Free Living". I've been reading and learning alot. I remembered that prior to my injury I had a habit of jaw-clenching so I started trigger point therapy on my jaw muscle (masseter I think) and I've had great results. My tension headaches are nearly completey gone! The only issues that remain are the stiff neck and light-headedness (which have also decreased slightly). I am thoroughly convinced that the SCM and Scalenes are the problems.

I tried doing SCM therapy but I don't seem to be able to pressure the muscle without disturbing the carotid artery. Perhaps I just need to use less pressure?

I am also ready to start treating the Scalenes so I am ready to e-mail you but I'm not sure what your e-mail address is. Can you send it to me please?

Thanks

Answer
Hi Shane,

I'm so happy to hear the wonderful results you've experienced so far because you are using my book, "Treat Yourself to Pain-Free Living."  The odds are you are grabbing your SCM in the very middle of your neck, which is exactly where the carotid artery is located.  Try moving your fingers up much closer to your ear, in fact, go as far as you can.  You may need to tilt your head toward the side you are treating in order to get a grip of the muscle.  

For example, if you are working on your left SCM, tilt your head a little toward the left and then put your fingers very close to your jaw bone before gripping the muscle.  The carotid artery is far enough away that you won't grasp it.

As for the scalenes treatment, it's on my today agenda to add it to the "Treat Yourself to Pain-Free Living" book.  I can't put my email address onto this website, but if you go http://www.julstro.com and send me a message through "Contact Us," my assistant will forward it to me and I'll get back to you.

Shane, my only form of marketing is word-of-mouth, please share my website with others so we can help so many people who are living in pain.

Wishing you well,
    Julie

Repetitive Strain Injury

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Julie Donnelly, LMT

Expertise

I can accept questions that relate to chronic or acute pain caused by muscle spasms and contractions. Repetitive Strain Injury is actually Cumulative Trauma to muscles. Releasing the spasm &/or contraction will relieve the strain that is felt at the insertion point on the bone. I am the co-developer of the unique safe-stretching program "Focused Flexibility Training," which combines easy instruction for self-treating spasms throughout your body with proven yoga stretches. I have recently authored two new books: "The 15 Minute Back Pain Solution," and "The Secret to Your Best Golf Game EVER!

Experience

Since 1989 I have been working with endurance athletes and individuals suffering from chronic pain conditions. I have authored seven self-treatment books and three self-treatment DVDs and I have developed the Julstro System for the treatment of carpal tunnel syndrome, Trigger Finger, and other Hand/Wrist pain. I am a national and international presenter at conventions, seminars, and workshops. Principle topics are "Work Shouldn't Hurt," and "The Pain Free Athlete." In 2005 and 2006 I was the massage therapist for ultracyclists competing in the Race Across America (RAAM) 3000+ mile race from San Diego, CA to Atlantic City, NJ. I've taught the Julstro techniques to physical therapists at the Cleveland Clinic, to massage therapists in areas around the USA, and I've taught Julstro self-treatment clinics to dancers at Juilliard School of Performing Arts (NYC),the sprinting team at NC State, and I am working closely with several Olympic-hopeful. We have successfully eliminated the repetitive strain injuries that could keep them out of the Olympic Games, and the best part is they know how to do the self-treatments so they can stay pain-free and flexible.

Publications
Triathlete Magazine, Endurance Magazine, multiple national and international trade journals.

Education/Credentials
Swedish Institute of Allied Health, NY, NY - Initial education in massage therapy Licensed NYS Massage Therapist since 1989. SUNY Empire State College, Saratoga Springs, NY - B.Sc. degree in Interdisciplinary Health Education I was an Associate Professor helping to develop the massage training program for SUNY Rockland Community College

Past/Present Clients
Privacy prevents me from filling in this section without prior consent from my clients. Life Experience: I have been specializing in the treatment of chronic pain and sports injuries since receiving my NY massage license in 1989. A personal bout with carpal tunnel syndrome was the catalyst to my developing a self-treatment that heals the symptoms of carpal tunnel syndrome quickly and without surgery. My work with endurance athletes was the inspiration to teach people how to self-treat so they could stop pains even during a race or heavy training day. Both of these situations ultimately became the products that are sold on my websites: http://www.FlexibleAthlete.com and http://www.julstro.com. I currently treat people in my offices in Sarasota, FL, Cary, NC, or Pearl River, NY

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