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Repetitive Strain Injury/I have a question about neck weakness

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QUESTION: Hi Julie. I've been dealing with neck weakness for about 7 weeks now. It initially occurred after a few days of stretching where I stretched my neck downward by using both of my hands on the back of my head. Ever since then I've had difficulty holding my head upright without a brace or other kind of support. If I don't support my neck I usually have neck spasms accompanied by dull pain. Sometimes it appears as though I'm improving but then I'll have a relapse. One such relapse occurred immediately after I yawned one morning. I don't yawn anymore but I still don't seem to be making much improvement. I assumed that maybe I strained my neck but I haven't once felt the kind of sharp pain that I assume would be associated with significant tissue damage. I was wondering what you could make of the situation. Thank you.

ANSWER: Hi Shane,

I have some thoughts about the muscles that can be involved in this situation, but first I think it is important to have an MRI to assure that you haven't torn any ligaments or tendons. Both ligaments and tendons don't have nerve innervation, so they don't cause pain when they are damaged. The most that happens is when the muscle is pulling on the tendon it will cause an inflammation either at the point where the muscle attaches to the tendon, or the tendon attaches to the bone.

After you have eliminated the ligament/tendon tear from the mix, please feel free to post again so we can look into muscles.  While you are waiting for the results, I suggest you go to http://www.julstro.com to read about tendonitis.  I'll look forward to hearing from you again.

Wishing you well,
   Julie Donnelly

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

QUESTION: I had an MRI of the cervical spine and talked to my doctor about it yesterday. He said there's no damage to the vertebrae or ligaments. He believes it is an issue with the nerves or muscles.

I'm interested to know which muscles you believe are involved. I would also like to point out that recently I've been having headaches on the top of my head. The pain is dull and constant, as if something heavy is pushing down on the top of my head.

ANSWER: Hi Shane,

Good, now that you've had it checked out by your doctor we can be confident to move forward with muscles as a cause of your pain.  Did you go to the website I mentioned?  You can get a LOT of information on that site.

Apparently you overstretched the muscles along your cervical, and probably thoracic, spine.  I would suspect that the muscles of the front of your neck (scalenes) are in spasm.  I wish you were in Florida so I could check them out, but since you aren't we'll go about this differently. It's too complicated for me to teach you in this venue. If you go to www.Julstro.com and click on the neck of the graphic, it will explain more about the scalenes.  I work with people via Skype, or you can look for a qualified Trigger Point massage therapist in your area.  Ask him/her to treat the spasms in your scalenes (it's tricky, but someone who is knowledgeable can do it easily).  

After the scalenes spasms are released, you can start to do exercises to strengthen the muscles in the back of your neck. These are specifically: splenius capitis, splenius cervicis, erector spinae, and trapezius. When you're doing the exercises, don't allow your head to bend forward at all, only backward.

I did a quick look on the internet and kept finding the promoted exercises teaching you to bend your head forward. One even promoted the very thing you did that stretched the muscles in the first place.  So I'd like to offer you an exercise I give to my clients who are having neck issues because of being on their Smart Phones too much.  To strengthen the posterior neck muscles put the palm of your hand at the back of your head.  Then press your head hard into your palm, resisting with your palm so the muscles are contracting deeply. It's like doing a sit-up with your posterior neck muscles.  You'll be able to feel them contract. During the day, frequently bring your head back, causing the muscles to contract.  

The pressure on the top of your head is a common referred pain for the sternocleidomastoid muscle (SCM).  That is one I definitely can't explain in this message.  I believe I wrote an instructional blog on how to do it in my therapy practice website: http://www.FlexibleAthlete.com.  I'm in the process of revising that website, but the blogs are still there.

After completing this response I looked into the internet search again.  I found this: http://www.livestrong.com/article/328063-strengthening-exercises-for-the-upper-b, just don't do the exercise for the "anterior neck sit-ups," but the rest look good.

Meanwhile Shane, just knowing that there isn't anything structurally damaged, please feel confident that you're going to resolve this eventually, and don't give up.

Wishing you well,
   Julie Donnelly


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

QUESTION: Hey Julie, I was wondering if you could help me with a few more questions.

The good news is my neck appears to have been strengthening over the past week as I haven't needed to artificially support my neck as much. Unfortunately there are other symptoms that are still problematic.

My neck has been stiff for several weeks now. I am not able to rotate my neck either left or right without becoming lightheaded and getting a headache for several minutes. Typically the pain subsides after about 30 minutes. I've tried warm showers to loosen the muscles but I still get the same result. I am eager to try trigger point therapy but I'm not sure which muscles to target. So my question is which muscles tend to be responsible for neck stiffness?

I also recently had a case of extreme dizziness where the room is literally spinning. It just occurred two days and ago and it only happens if I lay on my right side and put pressure on the right side of my head. I have since stopped doing that. I was just wondering if this type of symptom is typical of a muscle disorder or if I should look into another cause (ENT for example).

Thank you for your time and effort. Always appreciated.

Answer
Hi Shane,

Good news about your muscles getting stronger!  Now it's time to release the tension in the neck muscles that are preventing you from turning your head normally.  The muscle that causes the dizziness (SCM) is a part of that situation.

If you go to http://www.julstro.com and read the information on that website, you'll have a much better understanding of the muscles that cause neck pain (as well as pain in the rest of the body).  I suggest you consider getting my book "Treat Yourself to Pain-Free Living," and then do the treatments for the neck and upper back.  You need to do all of the treatments because your stiff neck is caused by many, if not all, of them being in spasm.

The good news is, it isn't difficult to do these treatments yourself.  The sternocleidomastoid (SCM for short) is in that chapter, you'll be able to read how to get relief from the spasms in this muscle.  The SCM originates on your collar bone and then inserts into the bone at the back of your ear.  When it contracts normally you turn your head in the opposite direction (ie: a contraction in your right SCM will turn your head to the left).

I believe you'll be able to resolve both of your neck problems with this book.  Be sure to use enough pressure that it "hurts so good."  If you go to lightly you won't be affecting the muscles that are causing the 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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